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Background and Objective: Failure to follow the standard guidelines in the selection and monitoring of infants before and during home phototherapy can result in unfavorable outcomes. The present study was conducted to determine the performance and complications of failure to follow the standard guidelines in infants undergoing home phototherapy in Mashhad, Iran. Methods: In this cross-sectional study, a total of 202 infants who were referred to neurology clinic or hospitalized at the emergency or neonatal wards due to acute or chronic outcomes of home phototherapy were included in 2020-2021. Gestational age, gender, birth weight, age at jaundice onset, age and duration of phototherapy, weight on admission, etiology of jaundice, referrer, phototherapy service providing center, type of breastfeeding, hyperthermia incidence, serum or skin bilirubin levels at the beginning and end of phototherapy, hematocrit, direct and indirect Coombs test, reticulocyte count, TSH, T4, G6PD, maternal age and blood type, parity, type of delivery, and pregnancy and delivery problems were recorded. Findings: The mean age of infants was 7.7±7.6 days, birth weight 2746±707 gr, admission weight 2601±771, bilirubin before home phototherapy 15.58±3.7 mg/dl, bilirubin on admission 17.5±5.8 mg/dl, and home phototherapy duration was 2.5±0.7 days. The frequency of causes of jaundice was as follows: ABO incompatibility (n=30), Rh incompatibility (n=22), urinary tract infections (n=13), fever and dehydration (n=19), hypothyroidism (n=7), biliary atresia (n=5), galactosemia (n=2), and etc. Thirty infants had pathologic weight loss, six had kernicterus, and three needed exchange transfusion. Conclusion: According to the findings of the present study, it seems that the non-compliance with the guidelines and standards for the selection of babies eligible for home phototherapy along with the lack of monitoring of the health status and serum bilirubin of these infants lead to serious consequences (dehydration and pathological weight loss, need for exchange transfusion and kernicterus) in them. It is necessary to closely review and monitor the process of diagnosis and referral of babies with jaundice who need phototherapy and treatment to phototherapy centers at home or hospital.

BACKGROUND AND OBJECTIVE: Despite the increased chance of premature survived infants, the morbidity of these infants is still significant. The number of NRBCs in the cord of these neonates may be effective in predicting the long-term complications of these neonates. The purpose of this study is to investigate the relationship between the number of nucleated red blood cells in the peripheral blood of preterm infants and the same prognosis about children at the age of two. METHODS: The present study is a cohort study, has been performed on 290 preterm infants younger than 32 weeks old admitted in neonatal ward of Ghaem hospital of Mashhad during years of 93 to 96 with available sampling. Cord blood samples were taken to determine NRBC/100WBC count. Data have been collected by a researcher-made checklist including neonatal, maternal, and laboratory characteristics. Infants' development up to two years of age has been studied. NRBC/100WBC numbers of infants were compared with normal prognosis (Denver 2 normal test) and abnormal prognosis (death or developmental delay). FINDINGS: Of 290 neonates, 160 of them (55.2%) had normal development, 61 cases (21%) died and 69 neonates (23.8%) had abnormal development. The mean number of mm2 /NRBC and NWBC/100WBC in neonates with abnormal prognosis were 4025.11±210.04 and 31.83±15.14 and in normal neonates were 367.47±76.91 and 5.5±5.29, respectively (p 300/mm2 suggests a poor prognosis at the age of two with a sensitivity of 75% and a specificity of 63%. CONCLUSION: According to these results the mean of NRBC2/mm2 and NRBC/100WBC can be helpful in determining neonatal prognosis at the age of two.

BACKGROUND AND OBJECTIVE: Neonatal jaundice is one of the most common problems in neonatal period. Considering that the most effective and most commonly used neonatal jaundice treatment is phototherapy, the use of complementary therapies such as massage and herbal medicines is common in our society to reduce jaundice. Therefore, the present study was conducted to compare the effect of cotoneaster manna drop (bilineaster) and massage on bilirubin in neonates under phototherapy. METHODS: This clinical trial was conducted on 68 neonates admitted to the pediatric ward of Vali-Asr Hospital in Birjand in 2015. The neonates were randomly divided into three groups. The control group (n=21) received the routine care. The massage group (n=23) received massage by field technique, three times a day for 15 minutes in addition to phototherapy. The cotoneaster manna drop (bilineaster) group (n=24) received three oral drops of bilineaster for every eight kilograms of body weight in addition to phototherapy. Then, the rate of reduction in neonatal bilirubin was compared in the three groups (IRCT: 2016101830370N1). FINDINGS: The mean reduction rate of bilirubin per hour in the first 24 hours was 0.27±0.19 in the control group, 0.23±0.17 in the massage group and 0.25±0.18 in the bilineaster drop group. In addition, the mean reduction rate in the second 24 hours was 0.4±0.26 in the control group, 0.22±0.18 in the massage group and 0.26±0.22 in the bilineaster drop group. In the third 24 hours, the mean reduction rate was 0.19±0.17 in the control group, 0.9±0.13 in the massage group and 0.7±0.1 in the bilineaster drop group, which had no significant difference (p>0.05). CONCLUSION: The results of this study showed that field massage and administration of cotoneaster manna drop (bilineaster) during neonates’ hospitalization had no effect on the reduction of bilirubin in neonates under phototherapy and these interventions cannot be effective

BACKGROUND AND OBJECTIVE: Noise is the most common environmental stressor source for premature infants admitted to the neonatal intensive care unit. Venous sampling is one of the most painful-causing actions in newborns. The aim of this study was to determine the effect of voice loss using ear protector on pain caused by intravenous sampling and heart rate of premature infants. METHODS: This randomized clinical trial study was performed on 112 premature infants aged between 36 and 28 weeks who were randomly divided into two groups of intervention (56 subjects) and control (n=56). The ear protector was used for the intervention group when the baby was subjected to intravenous sampling. Neonatal pain was measured by PIPP instrument (premature infant pain measuring instrument) in five steps (2 minutes before the needle penetration), (moment of needle penetration), (pump time), (moment of needle withdrawal) and (5 minutes after needle withdrawal). Heart rate was measured with a pulse oximeter (8 times every 30 minutes during 4 hours after using the ear protector) and compared. (IRCT: 2015210828925N1). FINDINGS: The mean changes in PIPP score were in the intervention and control groups (1.6±5.6 and 4.6±1.6), second (12.1±3.3, and 12.6±2.8), third (13.5±2.7 and 13.4±2.9), fourth (6.4±2.6 and 8.5±2.8), and fifth (5.1±4.2) and 1.6±6.2) respectively. Scores in all states except for the second and third stages were statistically significant in both groups (p

BACKGROUND AND OBJECTIVE: Low birthweight is one the common problems of infants and one of the main health indicators of a society. Weight is one the major determinants of physical and mental development in infants, particularly preterm infants. The aim of this study is to investigate the effect of multisensory stimulation on weight gain of preterm infants. METHODS: In this double-blind clinical trial, 80 preterm infants born at 32-36 weeks gestational age, were randomly divided into two groups (control and multisensory stimulation). The intervention group received multisensory stimulation program consisting of 12-minute daily sessions, 5 times a week until the day of discharge and the control group received only the usual care. Infants were weighed every day until the day of discharge (IRCT registration code: 2016073114454N2). FINDINGS: No significant difference was observed between the two groups of preterm infants in terms of gestational age, birthweight and sex. The difference between mean weight gain on the first day and the day of discharge was 131.6±10.1 g in the intervention group and 58.9±10.2 g in the control group. The difference between the two groups was significant (p

Introduction: Using the adequate and standardized educational facilities and spaces can ensure effective educational program. The purpose of the current study was developing basic educational standards for master's degree program in 'nursing neonatal intensive care'. Methods: This study is a descriptive study used Delphi approach to conduct with the participation of 40 experts in nursing neonatal intensive care from all over Iran in 2014. The study population consisted of neonatologists and medical professionals, administrators of educational department, faculties of pediatrics department, head nurses of neonatal intensive care unit, students and graduates of course in nursing neonatal intensive care were selected purposively. Firstly, the educational standards (24 items) were gathered with extensive review and secondly, experts commented to questionnaire in three rounds. The first and second rounds were performed in a meeting with participation of 20 experts from Mashhad University of Medical Sciences and the third round was performance through sending emails to 40 experts from all over Iran. Results: In the third round, 10 basic education standards for students of master's degree program in 'nursing neonatal intensive care' unit have been agreed. The standards included theoretical training classes, equipped center for clinical skills, educational workshops, evidence-based learning environment, sufficient number of beds for neonatal intensive care unit, specialized books/ study hall school and hospital, wireless Internet, shared databases, and research approved process. Conclusion: These findings can be used to evaluate the educational resources in schools, which had courses of sciences degrees and it can be a good pattern for the standardization of other majors.

BACKGROUND AND OBJECTIVE: With the advancement of medical care procedures, survival rate of preterm neonates has increased remarkably. In Iran, few studies have assessed the extent and severity of developmental disorders in these infants. This study aimed to evaluate developmental disorders in premature neonates. METHODS: This cohort study was conducted on 270 premature infants born in Ghaem Hospital in Mashhad, Iran with mean birth weight of 1460±40 grams. Data on pregnancy, parturition and complications during hospitalization were recorded. Moreover, preterm neonates were evaluated in terms of developmental delay at 6, 12, 18 and 24 months of age based on the Ages and Stages questionnaire (ASQ). FINDINGS: In this study, symptoms of developmental delay were observed in 152 neonates (56%) at six months, 115 neonates (42.7%) at 12 months, 101 infants (37.5%) at 18 months, and 49 neonates (18%) at 24 months. In addition, abnormal development was detected in different areas, including communication (n=21, 7.8%), major movements (n=53, 19.6%), minor movements (n=74, 27.5%), social interactions (n=89, 33%), and problem solving (n=153, 57%). After a two-year follow-up, 27 infants (60%) had asphyxia, 29 (28%) had respiratory distress syndrome, and 20 infants (15%) had developmental disorders. CONCLUSION: According to the results of this study, about one-sixth of preterm neonates had developmental delay at two years of age. The highest rate of developmental disorders was observed in the area of problem solving, which should be taken into account in neonatal rehabilitation services. On the other hand, appropriate monitoring of neonatal asphyxia and jaundice is likely to reduce the risk of other complications during infancy

BACKGROUND AND OBJECTIVE: Approximately 80% of premature infants are diagnosed with icterus, most of whom are treated by phototherapy. Given the adverse effects of this treatment on neonates, minimizing the duration of phototherapy seems to be necessary. This study aimed to evaluate the effects of massage on the duration of phototherapy in premature infants admitted to neonatal intensive care units. METHODS: This clinical trial was performed on premature infants admitted to the neonatal intensive care unit of Qaem Hospital of Mashhad, Iran, in 2011. The infants were randomly divided into intervention (n=30) and control (n=30) groups. The infants of both groups were similar in terms of weight, age, and the level of bilirubin. The intervention group received massage therapy (including massage and passive movements of the body parts) on a daily basis for three 15-minute courses at three consecutive hours for five days. The control group received the routine care and phototherapy. After the intervention, the two groups were compared in terms of duration of phototherapy and level of transcutaneous bilirubin. FINDINGS: The mean duration of phototherapy in the intervention and control groups was 80.8±61.58 and 112.8±75.45 hours, respectively. However, this difference was not statistically significant. On the fifth day of the intervention, the level of transcutaneous bilirubin was 9.7 and 8.1 mg/dl in the intervention and control groups, respectively, this difference was not significant as well. CONCLUSION: Massage can be used as an effective method alongside with phototherapy to minimize the duration of phototherapy for premature healthy infants in clinically stable conditions.

BACKGROUND AND OBJECTIVE: Hyperbilirubinemia is one of the most common problems during the neonatal period. Despite the severe complications of jaundice, no reliable data is available regarding the prevalence of acute and chronic complications of jaundice and the predisposing factors in our community. Therefore, this study aimed to determine the complications of neonatal jaundice and the predisposing factors in neonates. METHODS: This cross-sectional study was performed on icteric, term newborns with bilirubin level higher than 20 mg/dl, referring to Ghaem Hospital during 2003-2013. After history taking and physical examinations, developmental status of infants was followed within six and twelve months after birth, using Denver Developmental Screening Test-II. The newborns were divided into two groups, based on the occurrence or non-occurrence of complications (e.g., acute or chronic kernicterus, auditory disorders and developmental disorders). Afterwards, predisposing factors for these complications were evaluated. FINDINGS Complications of jaundice were reported in 143 (13.37%) out of 1069 neonates. The two groups were not significantly different in terms of variables such as neonatal age and gender or maternal age. However, there was a significant difference between the children with and withod complication regarding treatment modality and mean total serum bilirubin level (27 mg/dl vs. 32 mg/dl) (p

Background & Aims: Congenital hypothyroidism is a serious disorder that could be treated if detected early. Jaundice is one of the symptoms of these neonates. However, the prevalence, clinical course and severity of jaundice are not yet well defined. We compared the clinical course and severity of jaundice in a case-controlstudy of congenital hypothyroidism and other neonates of unknown etiology who are yellow. Methods: The cross–sectional study was performed during 2002-2012 on 2780 four-day or older term neonates with jaundice. In addition to the usual procedures for diagnosis of jaundice, thyroid function was performed on 706 newborns referred to the neonatal or clinic part of Ghaem Hospital of Mashhad, Iran, and their thyroid function was evaluated. The clinical progress and severity of jaundice infected with hypothyroidism [thyroid-stimulating hormone (TSH) ≥ 10 µu/ml or T4 less than 8 µg/dl] compared with infants with jaundice of unknown cause. Results: The neonates' mean age was 16.03 ± 8.80 and 8.60 ± 6.10 days (P = 0.001), age of onset of jaundice was 4.00 ± 1.60 and 2.68 ± 1.75 days (P = 0.008), total bilirubin was 15.70 ± 5.25 and 21.88 ± 5.10 mg/dl (P < 0.001), length of hospital stay was 0.80 ± 1.11 and 3.37 ± 1.71 days (P < 0.001), age of the jaundice improving was 21.00 ± 15.23 and 49.40 ± 14.60 days (P = 0.080), T4 level was 5.80 ± 2.70 and 9.63 ± 2.26 µg/dl and TSH level was 22.56 ± 1.80 and 3.31 ± 1.69 µu/ml in groups of case and control, respectively. Conclusion: Based on the findings of this study, in infants presenting with jaundice, after the second week of life, evaluation of hypothyroid may be recommended.

Background: The aim of this study is to investigate and compare the effects of administering a surfactant through a fine intra-tracheal catheter during spontaneous breathing with the usual INSURE method in premature infants., Materials and Methods: In this clinical trial, premature babies with respiratory distress syndrome who required surfactant administration were randomly assigned to two groups: an intervention group (MIST) and a control group (INSURE). The treatment results were compared in terms of complications related to treatment (desaturation, apnea, bradycardia, and surfactant reflux), respiratory complications (requirement for mechanical ventilation, duration of nCPAP, duration of oxygen requirement, frequency of pneumothorax, and pulmonary hemorrhage), complications related to prematurity (incidence of IVH, NEC, BPD, and PDA), the need for a second dose of surfactant, and the duration of hospitalization., Results: a total of 160 premature babies with a gestational age of 26-34 weeks were randomly divided into two groups. The results showed that the need for mechanical ventilation, the duration of CPAP needed, and the duration of oxygen therapy were significantly lower in the MIST group than in the INSURE group. Additionally, the incidence of BPD was less common in the MIST group compared to the INSURE group. However, surfactant reflux was more common in the MIST group than in the INSURE group. There were no significant differences between the two groups in other outcomes, including the length of hospital stay and complications such as IVH, PDA, NEC, pneumothorax, and pulmonary hemorrhage., Conclusion: The results of this research demonstrate that the less invasive method of surfactant therapy (MIST) is a feasible, effective, and low-risk alternative to the INSURE method.

Introduction: Premature rupture of membranes (PROM) is one of the most common and important causes of premature births and peripartum mortality. Maternal antibiotic treatment affects the infantile prognosis. This study was conducted to compare the efficacy of Ampicillin and Cefotaxime administered for the parturients on neonatal outcomes., Material and Methods: A comparison between the effects of Cefotaxime and Ampicillin on infantile complications of PROM was done in this clinical trial. Two hundred and twenty parturients with PROM who needed antibiotic therapy were randomized in two groups of control (Ampicillin) and intervention (Cefotaxime) treatments. The maternal/fetal statuses up to accouchement and the infants' status up to transfer to neonatal intensive care unit, death, or discharge from hospital were followed. The Apgar score, cardiac, respiratory and nervous systems, infection, immaturity, asphyxia, and mortality rates were compared in both groups., Results: The differences between the two groups were significant in: Apgar score min1 and min5, need for resuscitation, asphyxia, need for hospitalization, infection, and mortality rate., Conclusion: Administration of Cefotaxime in parturients with PROM improved the Apgar scores and decreased respiratory complications, infection, asphyxia, mortality rate, and need for ICU hospitalization in infants., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2024.)

Introduction: Respiratory distress (RD) is the most common cause of admission to the Neonatal Intensive Care Unit (NICU). The role of Vitamin D in the development and fortification of fetal pulmonary architecture and the synthesis of surfactants is well-documented. While different serum levels of 25-hydroxyvitamin D (Vit. D) have been studied for their diagnostic significance in RD, there is limited research on how it specifically affects the development of respiratory problems in infants and their mothers. The purpose of the present study is a systematic review and meta-analysis to evaluate the correlation between serum levels of Vit. D in mothers and newborns with RD, and to determine the impact of treating either population on the clinical outcomes of afflicted infants., Methods: A comprehensive literature search was conducted across various databases, including PubMed, ScienceDirect, Cochrane Library, ISI, and Google Scholar, using a combination of keywords such as RD, diagnosis, vitamin D, mothers, infants, vitamin D supplementation, Respiratory distress syndrome(RDS), and Transient Tachypnea of Newborn (TTN). The search was carried out until March 2024.The level of vitamin D in both mothers and their infants was systematically extracted and analyzed to determine the diagnostic efficacy of Vit. D levels. The mean difference (MD) was calculated along with a 95% confidence interval to determine the association between the Vit. D levels in newborns and their mothers and the likelihood of RD, RDS and TTN in infants. To assess potential publication bias, a funnel plot was generated and Egger's regression test was applied, utilizing a random-effects model., Results: Initially a total of 298 relevant articles was retrieved. Among them, 17 articles with a total of 1,582 infants (745 cases and 837 healthy controls) met the criteria as eligible studies. Of these six were prospective cohort studies, four retrospective case-control studies, four randomized controlled trials (RCTs), and three descriptive-analytical studies. The meta-results revealed a significant association between Vit. D levels and risk of RD in infants (MD = 6.240, 95 %CI: 4.840-7.840, P < 0.001) and mothers (MD = 8.053, 95 %CI: 4.920-11.186, P < 0.001). Furthermore, a strong association was found for risk of RDS (MD = 5.493, 95 %CI: 3.356-7.631, P < 0.001) in infants and TTN (MD = 6.672, 95 %CI: 4.072-9.272, P < 0.001), (MD = 8.595, 95%CI: 4.604-12.586, P < 0.001) both in infants and mothers. Administering 50,000 units of vitamin D to mothers (MD = 8.595, 95 %CI: 4.604-12.586, P < 0.001) prior to childbirth was observed to reduce the likelihood of RD in newborns by 64 % (RR = 0.36, 95 %CI: 0.23-0.57, P < 0.001). Supplemental vitamin D provided to infants was associated with several clinical benefits., Conclusion: Our meta-results indicated a significant correlation between serum levels of Vit. D and the risk of RD, RDS and TTN in infants. Prophylactic maternal administration of vitamin D plays a protective role against neonatal RD. Additionally, providing vitamin D to premature infants has shown a significant impact in reducing the incidence of respiratory complications., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Objective: Identifying factors that can better predict the prognosis of neonates with hyperbilirubinemia is important. In this study, we aimed to evaluate the relationship between electroencephalography (EEG) findings and two-year prognosis in neonates with severe hyperbilirubinemia., Methods & Materials: In a cohort prospective study, we studied neonates with a total serum bilirubin level of higher than 18 mg/dL, who were admitted to the neonatal intensive care unit (NICU) of Ghaem hospital, Mashhad, Iran. EEG was recorded upon admission, for all neonates. Patients' data, including demographic characteristics, admission information, and pregnancy and birth data were gathered by obtaining history from parents and studying case files. Also, the relationship between initial EEG findings and final developmental status was assessed., Results: Mean and standard deviation age of patients were 5.46 ± 3.13 days and average serum total bilirubin level was 23.97 ± 4.34 mg/dL at admission. Our findings revealed a significant correlation between the presence of trace alternant on EEG and developmental delay (P = .001). Presence of trace alternant waves on initial EEG at admission was significantly associated with developmental delay in the two year (P = .005)., Conclusion: These results indicate a relationship between developmental prognosis and the severity of hyper bilirubinemia in neonates. Also, our findings show that the presence of trace alternate waves on the initial EEG is significantly associated with developmental delay of the neonate in the future., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier B.V.)

This dataset offers an insight into the neurodevelopmental trajectories of preterm infants, encapsulating a wide array of neonatal and maternal factors. The data variables include demographic details alongside a detailed account of maternal health during pregnancy, encompassing aspects and other complications. Furthermore, the dataset documents neonatal health conditions. It also records critical indicators of neonatal health. The dataset is enriched with data on medical interventions and hospitalization details. It also contains information on the mother's drug usage during pregnancy and sonography results. A significant portion of the dataset is dedicated to the developmental assessment of the infants, utilizing the Bayley Scales to evaluate various domains such as cognitive, language, perceptual, fine motor, and coarse motor skills. The data are categorized to denote normal and abnormal outcomes in these domains, providing a detailed view of the developmental progress of the infants. The reuse potential of this dataset is substantial, serving as a rich resource for researchers and clinicians aiming to delve deeper into the multifaceted influences on preterm infant development. It can significantly contribute to the formulation of early intervention strategies, fostering a better understanding and enhancement of developmental outcomes in preterm infants., (© 2024 The Author(s).)

Background: There are insufficient and contradictory reports regarding the effect of delivery method on the rate of umbilical cord Nucleated Red Blood Cell (NRBC). Therefore, the present study aimed to compare the percentages of umbilical cord NRBC in vaginal delivery and emergency cesarean section (C-section) in preterm neonates., Materials and Methods: The present cross-sectional study was performed on mothers with vaginal delivery and C-section, from 2020 to 2021. The samples (n = 221) were preterm neonates selected using the convenience sampling method. The percentages of NRBC in neonates born by natural childbirth and by emergency C-section were measured and compared in this research. A researcher-made checklist, which included maternal and neonatal characteristics and laboratory evaluation, was used as a data collection tool., Results: The statistical population of thisresearch included 93 (42.10%) and 128 (57.90%) neonates born by vaginal delivery and by C-section, respectively.The mean (SD) score of gestational ages at birth was 30.75 (2.81) weeks. The mean (SD) score of umbilical cord NRBC level were estimated at 8.01 (5.93) and 25.64 (22.61) for the neonates born by natural childbirth and by emergency C-section, respectively (t=-8.43, df = 150, p <0.001). Statistically significant differences were observed in the gestational age (t=-3.36, df = 218, p = 0.001), fifth-minute Apgar score (t=-2.32, df = 200, p = 0.021), umbilical cord NRBC (t=-8.43, df = 160, p<0.001), and short-term prognosis ( p = 0.032) between the two groups. It was also revealed that the number of NRBCs in the dead neonates was about 1.5 times higher than that in the discharged neonates., Conclusions: Based on the results of the present study, emergency C-section increased the mean of umbilical cord NRBC by three times, compared to that of normal delivery. Since an increase in the NRBC raises the risk of infant death, it is advisable to take steps to maintain the health of children by identifying high-risk neonates through umbilical cord NRBC measurement immediately after delivery and special care., Competing Interests: Nothing to declare., (Copyright: © 2024 Iranian Journal of Nursing and Midwifery Research.)

Objectives: Perinatal asphyxia is the main risk factor for mortality and morbidity in neonates and neurological disorders in survived infants. We compared the neonatal and maternal 25 (OH) vitamin D levels in neonates with/without asphyxia., Materials and Methods: This cross-sectional research was done on 229 neonates (including 158 neonates [69%] without asphyxia [control group] and 71 neonates [31%] with asphyxia [case group]) from 2020 to 2023 using the available sampling method. 25 (OH) Vit D levels in mothers and neonates were assessed and compared in the 2 groups. The data collection instrument was a researcher-made checklist, containing the maternal and neonatal characteristics and laboratory evaluations. Data were analyzed by SPSS 23 using the t-test., Results: The mean maternal 25 (OH) Vit D levels in the case and control groups were 16.34±11.87 and 22.80±12.67 ng/mL, respectively. The mean neonatal 25 (OH) Vit D levels in the case and control groups were respectively 12.13±8.62 and 19.55±11.62 ng/mL (P = 0.002). The case group showed severer maternal and neonatal 25 (OH) Vit D deficiency (P = 0.000) compared to the control group., Conclusions: Neonatal and maternal 25 (OH) Vit D deficiency can increase the risk of perinatal asphyxia. Therefore, administration of 25 (OH) Vit D supplements to pregnant mothers may reduce the incidence of asphyxia.

Objectives: Hypernatremia may facilitate the diffusion of bilirubin through the blood-brain barrier and increase the risk of bilirubin encephalopathy. This study was conducted to compare the prognosis of jaundice infants with those with jaundice and hypernatremia., Methods: A total of 615 term infants with idiopathic jaundice with or without hypernatremia were enrolled in this cohort study with 24-months follow-up at Ghaem Hospital, Mashhad, Iran, between 2010 and 2022. An in-house questionnaire including the laboratory evaluation and neonatal characteristics was used as the data collection tool. The follow-up of neonatal development status was performed using the Denver test II at 6, 12, 18, and 24 months after discharging from hospital., Results: Normal outcomes were seen in 555 (90.2%) out of 615 studied infants, while 60 cases (9.8%) showed abnormal outcomes. Serum levels of sodium (P = 0.017), bilirubin (P = 0.001), urea (P = 0.024), and creatinine (P = 0.011) as well as hyperthermia (P = 0.046) and unconsciousness (P = 0.005) showed significant differences between the two groups. Approximately 16% of the newborns with both jaundice and hypernatremia, and 9% of those with only jaundice had unfavorable prognoses. Also, bilirubin level had the most predictive power (91.3%)., Conclusions: Our results suggest that hypernatremia or jaundice alone, may affect the prognosis of infants aged 2 years; but jaundice and hypernatremia together, will intensify the developmental problems in jaundice infants. However, the role of hyperbilirubinemia in the incidence of complications is more than hypernatremia.

Background: Vitamin D deficiency has been suggested to be a risk factor for neonatal respiratory distress syndrome (RDS). This study aimed to evaluate the effect of 25 (OH) D administrations in pregnant women with findings of preterm labor on the incidence of RDS in their preterm neonates., Materials and Methods: A randomized controlled clinical trial was conducted on pregnant mothers with gestational age (GA) of less than 34 weeks at risk of preterm delivery. 175 subjects were randomly assigned into two groups, including intervention (intramuscular injection of 50,000 units of 25(OH) D during 72 hours before delivery) and control (no injections). Serum concentrations of 25(OH) D were measured shortly after birth in both mothers and neonates. Then, clinical and laboratory results of mothers and their offspring were recorded (in a checklist). Short-term outcomes and the need for respiratory support were also assessed. Data were analyzed by independent t-test, Mann-Whitney U test, Fisher's exact test, and chi-square test., Results: Even though gestational age, birth weight, delivery method, and serum vitamin D levels are consistent among both groups, 45% of neonates in the control group and 20% in the intervention group developed respiratory distress syndrome (P = 0.05). The mean 25(OH) D level in neonates was 17.7±10.5 and 19.29±9.94 ng/mL in the intervention and control groups, respectively (P > 0.05)., Conclusion: A single dose of 50,000 units of intramuscular 25(OH)D in pregnant women at risk of preterm labor can lower the risk of RDS in the infant.

Introduction: Defining accurate age- and sex-specific reference intervals (RIs) for hematology parameters, especially for the pediatric population, is important for making an appropriate clinical diagnosis. To address gaps, we established age-specific RIs for 11 hematologic parameters in Iranian children younger than 30 months for the first time., Methods: Fresh whole blood samples collected from a total of 344 participants (males: 158 and females: 186) ages 3 days to 30 months, with a mean age of 12.91 ± 7.15 months, were recruited from healthcare centers in Mashhad, Iran. Hematologic parameters, including complete blood count (CBC), were analyzed on the Sysmex auto-analyzer system (KX-21 N). RIs were calculated with 90% confidence intervals using the direct method based on CLSI Ep28-A3 and C28-A3 guidelines., Results: None of the CBC parameters required sex partitioning. Of 11 CBC parameters, six required age partitions of 3 days-<4 months, 4-<10, 10-<15, and 4-<30 months. Five parameters (i.e., white blood cell count, mean corpuscular hemoglobin concentration, mean platelet volume, red cell distribution width, and platelet distribution width) did not demonstrate age-specific changes. RIs of red blood cell count and hematocrit, as well as hemoglobin, increased with age, while mean corpuscular volume, mean corpuscular hemoglobin, and platelet count, decreased with age., Conclusion: In this study, we established RIs for 11 hematology parameters in young children. Age partitioning was required for six parameters demonstrating marked changes during the early period of growth and development and necessitating the use of pediatric-specific reference standards., (© 2023 John Wiley & Sons Ltd.)

Background: The reference intervals (RIs) for liver function tests (LFTs) were determined in Iranian children for the first time., Methods: A total of 344 healthy pediatrics aged 3 days to 30 months old were recruited. Serum levels of ALT, AST, ALP, direct bilirubin, and total bilirubin were measured. RIs were determined using CLSI Ep28-A3 guidelines., Results: All analytes demonstrated age-specific differences except AST. ALT and ALP demonstrated significantly elevated levels in infants 0 to <5 months relative to the remainder of the age range. Direct and total bilirubin demonstrated markedly elevated levels in early life with mean of 0.28 mg/dL and 1.64 mg/dL observed for direct and total bilirubin, respectively, decreasing by ~50% in the adjacent partition., Conclusion: These novel data will help improve the clinical interpretation of biochemical test results in young Iranian neonates and children and can be of value to clinical laboratories with similar populations., (© 2023 The Authors. Journal of Clinical Laboratory Analysis published by Wiley Periodicals LLC.)

Objectives: Precise and early diagnosis of neonatal asphyxia may improve outcomes. Recent studies aim to identify diagnostic biomarkers in neonates at risk for brain damage. The current study was designed to evaluate the diagnostic value of new biomarkers for neonatal asphyxia., Materials & Methods: This prospective study was conducted with an available sampling of infants upper 35 weeks of gestational age, including neonates with asphyxia (case group) and healthy controls, 2014-2022, in Ghaem Hospital, Mashhad, Iran. Data collection was performed utilizing a researcher-made questionnaire, including maternal and neonatal characteristics, as well as clinical and laboratory evaluation. Serum umbilical cord levels of interleukin-6 (IL6), interleukin-1-beta (IL- 1β), pro-oxidant-antioxidant balance (PAB), and heat shock protein-70 (HSP70), as well as nucleated red blood cells count (NRBC), were determined. Data were analyzed by t-test, Chi-square, receiver operating characteristic (ROC), and regression models., Results: The differences in variables IL6, IL1β, PAB, NRBC/100WBC, and HSP70 were statistically significant between the two groups (in all cases, P<0.0001). In the diagnosis of asphyxia, the most sensitive marker (89%) was IL1β more than 2.39 pg/ml and HSP 70 upper than 0.23 ng/ml, while IL6 was higher than 9pg/ml, determined as the most specific marker (85%). Furthermore, a combination of HSP + PAB and IL6 + lL1b + PAB + NRBC/100WBC possesses the prediction power of 93.2% and 87.3%, respectively, for diagnosing asphyxia., Conclusion: According to data analysis, the combination of new biochemical markers (NRBC count, IL6, IL1β, PAB, and HSP 70) could be a reliable marker for diagnosing infants with asphyxia., Competing Interests: None

This study aims to investigate the levels of receptor-binding domain (RBD), spike, and neutralizing antibodies in pregnant women who received the Sinopharm vaccine and their newborns. A cross-sectional study was conducted at a tertiary center, Mashhad, Iran. We included 88 pregnant women who had received at least two doses of the Sinopharm vaccine. Maternal and umbilical cord blood samples taken at delivery were analyzed for antibodies using ELISA tests. Antibody levels did not vary significantly between women with two or three vaccine doses. Only 1.1% of mothers had undetectable levels of RBD antibodies, but detectable antibodies were observed in all newborns. A significant linear correlation was found between the levels of neutralizing antibodies (r = 0.7, p < 0.001) and RBD antibodies (r = 0.833, p < 0.001) in mothers and their newborns, but not for Spike antibodies (r = 0.214, p = 0.045). In mothers, high titers of antispike and RBD antibodies were observed at the time of delivery. The high titers of RBD and antispike antibodies were found in cord blood, suggesting potential neonatal immunity. Detectable levels of antibodies were found in both groups, regardless of the timing of vaccination. The Sinopharm vaccine generates detectable levels of antibodies in pregnant women, which are efficiently transferred to their newborns. The number of vaccine doses (two or three) did not significantly impact the levels of detectable antibodies. This underscores Sinopharm's potential efficacy in protecting pregnant women and their infants from COVID-19., (© 2023 Wiley Periodicals LLC.)

Introduction: Undiagnosed and untreated hyperbilirubinemia in infants may result in Kernicterus Spectrum Disorder and poor prognoses. Rhesus incompatibility and glucose-6-phosphate dehydrogenase (G6PD) deficiency are among the known causes of infantile jaundice. This study was designed to define the severity and prognosis in jaundiced infants with Rh incompatibility or G6PD deficiency., Methods: A total of 144 term, 2- 14 days old jaundiced infants (bilirubin > 20 mg/dl) with Rh incompatibility(85 infant) or G6PD deficiency(59 infant) were included in this cohort study with 24-month follow-up through available sampling at Ghaem hospital between 2015 and 2022. Denver II test was used at 6, 12, 18, and 24-month ages after discharge. Infants with Rh incompatibility or G6PD deficiency were assigned into two groups of favorable and poor prognosis. Following that, the bilirubin levels of these infants were compared at the time of admission., Results: The bilirubin level in G6PD deficient infants with poor prognoses (37.96 ± 9.25 mg/dl) and neonates with Rh incompatibility (36.23 ± 5.08 mg/dl) almost was the same (P = 0.232). 40 babies (47%) caused by Rh incompatibility and 33 (56%) babies caused by G6PD deficiency had a poor prognosis (P = 0.465). Average bilirubin in babies with RH incompatibility with favorable prognosis is 21.8 and poor prognosis is 36.2 mg/dl. In infants with G6PD deficiency, it was 24 mg/dl with favorable prognosis and 38 mg/dl with poor prognosis (P < 0.0001). The severity of hyperbilirubinemia had a significant role in the prognosis of infants in both groups (P < 0.0001)., Conclusion: The two-year prognoses of hyperbilirubinemia caused by G6PD deficiency are as poor as that of Rh incompatibility. The severity of hyperbilirubinemia had a significant role in the prognosis of infants in both groups.Exchange transfusion in cases with bilirubin < 25 mg/dl can improve the prognosis in both groups, especially in infants with Rh incompatibility., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Objective: Oxidative stress (OS) is due to a disturbance in the balance between the production of free radicals and antioxidant defense, resulting in a predominance of free radicals over endogenous anti-oxidant defenses. OS may have many causes. Pregnancy, and especially delivery, are associated with increased OS. The relationship between maternal and infant prooxidant-antioxidant balance (PAB) is unclear. Therefore, the aim of the present study was to compare PAB in mother and baby pairs., Material and Methods: This cross-sectional study was conducted in 104 mothers and normal term infants during 2017-2020. PAB was measured in healthy mothers before delivery and in umbilical cord samples after delivery. Data on the infant characteristics including age, gestational age, birth weight, Apgar score, and maternal history including the duration of mother’s education, weight of the last month, and gravidity were collected using a researcher-made questionnaire. The cord and maternal PAB were compared by statistical methods., Results: In this study, the mean PAB of the neonates and mothers was 30.76 and 214.87 HK, respectively. The results revealed a moderate association between the PAB neonate and maternal PAB before delivery but it was not significant., Conclusion: Overall, the level of oxidants and antioxidants reduced during pregnancy and before delivery, and it was found that the relative incidence of neonatal PAB increases by increasing maternal PAB., Competing Interests: Conflict of Interest: No conflict of interest is declared by the authors., (©Copyright 2023 by the Turkish-German Gynecological Education and Research Foundation. Journal of the Turkish-German Gynecological Association is published by Galenos Publishing House. Licensed under a Creative Commons Attribution-NonCommercial (CC BY-NC-ND) 4.0 International License.)

Background: One of the most important complications of premature birth is retinopathy of prematurity (ROP). Sepsis may increase the incidence of this complication. The aim of this study is to compare the incidence of ROP in neonates with and without sepsis., Methods: In a retrospective case-control study, preterm infants admitted to the neonatal intensive care unit (NICU) of Ghaem hospital from 2014 to 2022 were examined. The case group consisted of 155 preterm infants with definite sepsis (positive blood culture and clinical signs of sepsis) and the control group included 145 preterm infants without sepsis whose maternal and neonatal characteristics were collected; they were examined by a retinologist and evaluated for ROP at 32 weeks or four weeks after birth. Finally, we used the chi-square and the t test to compare the two groups., Results: Out of 155 preterm infants with sepsis, 70% and out of 145 preterm infants without sepsis, 58% had ROP ( P =0.023). Also, low birth weight, low initial Apgar score and low 5-minute Apgar score were significantly associated with ROP ( P <0.05)., Conclusion: Based on the results of this study, sepsis is a serious risk factor for ROP. We can reduce its incidence and complication by preventing sepsis in premature infants., (© 2023 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.)

Background: One of the most common problems in preterm neonates is retinopathy of prematurity (ROP). It has been shown antioxidants may be effective in preventing the development and progression of ROP. Considering the antioxidant properties of bilirubin, we decided to investigate the bilirubin level in neonates with ROP and compare it with healthy neonates., Methods: This case-control study was performed on VLBW neonates admitted to the NICU of Ghaem Hospital in Mashhad between 2014 and 2020 for a Jaundice evaluation. Complete neonate's characteristics, maternal history and laboratory results were collected in a questionnaire. Then the neonates were examined for ROP by a fellowship of the retina of an ophthalmologist at 32 weeks or four weeks after birth. The highest bilirubin levels during their hospitalization were also recorded., Results: Of 427 neonates examined, 121 (37.7%) had a normal eye examination, and 266 (62.3%) had ROP. The mean weight, gestational age and bilirubin were 1455.8 ± 431.4 grams, 31.6 ± 2.3 weeks and 8.8 ± 2.4 mg/dl, respectively. There was a significant difference between controls and neonates with ROP with regard to birth weight, duration of intermittent positive pressure ventilation (IPPV), duration of oxygen therapy, first and fifth minute Apgar scores, the maximum level of bilirubin and gestational age (P < 0.05). It was observed that the maximum level of bilirubin was lower in neonates with higher stages of ROP., Conclusion: According to the results of this study, higher levels of bilirubin in neonates may be a protective factor against ROP. Moreover, increased levels of bilirubin are associated with reduced severity of ROP. Therefore, prophylaxis phototherapy in premature infants may need to be reconsidered., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

The oxidant/antioxidant status balance is a process that begins before birth and premature infants are particularly susceptible to oxidative stress. According to the mechanisms of oxidative stress and lack of study in this field, in this prospective study, we aimed to compare the levels of serum pro-oxidant/antioxidant balance (PAB) in preterm versus term babies. This was a prospective cross-sectional study that was performed in Ghaem hospital, a university tertiary hospital, in Mashhad, Iran. The study population included all term and preterm neonates who were admitted to the hospital within birth time. In our study, 324 neonates were included. One hundred ninety-eight neonates were preterm (61.1%) and others were term (38.9%). There was a significant difference between PAB levels in term and preterm neonates. Serum PAB level was significantly lower in preterm neonates rather than in term neonates (21.86 ± 21.01 vs 50.33 ± 31.69; P = .001). There was also a significant negative correlation between PAB levels and gestational age. According to previous investigations, we showed for the first time in our study that PAB is lower in preterm newborns rather than in term ones., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.)

Introduction: Exchange transfusion (ECT) is one of effective treatments for rapid reduction of the bilirubin serum levels. The main purpose of this study was to offer greater insights into the effects of ECT on the hematologic factors and bilirubin in neonatal hyperbilirubinemia., Methods: This cross-sectional study was performed on 380 neonates over 35 gestational weeks, and 2-14 days old with a bilirubin of above 17 mg/dl who had undergone ECT at Ghaem Hospital of Mashhad in Iran from 2011 to 2021. Blood samples were examined before, immediately after, 6 h and 60 h after ECT for complete blood cell count (CBC), platelet count and bilirubin serum level analysis., Results: In this study, the mean age of neonates was 5.21 ± 3.55 days with a mean birth weight of 2810 ± 710 gr. The mean platelet count (PLT), white blood cell (WBC) and the serum level of bilirubin were estimated at 260,000/mm 2 , 12,400/mm 2 , 23 mg/dl before ECT and 97,000/mm 2 , 7370//mm 2 and 12.6 mg/dl immediately after ECT, respectively (P-value <0.001)., Conclusion: The results indicated that the mean serum levels of bilirubin, platelets, and leukocytes dropped to 55%, 30%, and 60% of their baseline levels before ECT, respectively, but they all spiked after ECT., Competing Interests: Conflicts of interest All authors declared there is no relevant interest with whole aspects of study., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Introduction: Preeclampsia is one of the four leading causes for pregnancy complications, maternal-fetal and neonatal mortality. This study was aimed at comparing the incidence of retinopathy of prematurity in neonates of mothers with preeclampsia and neonates of healthy mothers., Methods: This cross-sectional study was performed among 213 mothers, including 49 healthy mothers and 164 mothers with preeclampsia whose neonates were admitted to the neonatal intensive care unit of Ghaem Hospital, Mashhad, Iran, during 2016-2021. The participants were chosen using the convenience sampling method. The data collection tool was a researcher-made checklist including items on laboratory evaluation, maternal and neonatal characteristics, and eye examination. The data were analyzed using t -test and Chi-square., Results: In the two groups, gestational age ( P  = 0.112), first-minute Apgar score ( P  = 0.209), and fifth-minute Apgar score ( P  = 0.949) were not significantly different. There was a significant difference between the two groups in terms of maternal age ( P  = 0.0001), type of delivery ( P  = 0.0001), premature rupture of membranes ( P  = 0.003), and eye condition ( P  = 0.033)., Conclusion: The results of our study show that preeclampsia affects the prognosis of infants, and in neonates with preeclamptic mothers, the rate of premature rupture of the membranes, cesarean delivery, and retinopathy of prematurity were higher., Competing Interests: Conflicts of interestThe authors declared that they have no conflict of interest., (© Federation of Obstetric & Gynecological Societies of India 2022.)

Background: Retinopathy of prematurity (RoP) is a cause of newborn blindness. Several predisposing factors have been reported to contribute to the disease process. The current study aimed to compare serum vitamin D levels in infants with and without RoP., Methods: This case-control study was conducted on 154 very low birth weight (VLBW) infants admitted to Ghaem hospital, Mashhad, Iran, during 2016-2019. Retinal examination for RoP was done at the 32nd week of pregnancy and vitamin D level was determined using the infants' first-day serum samples. A researcher-made questionnaire including maternal, infant, laboratory, and retinal examination information was used as the data collection tool., Results: Out of 154 infants in the study, 56 (36.4%) were normal while 98 (63.6%) had RoP. Based on the severity of retinopathy, 43 infants (43.9%) were at stage I, 48 (49%) at stage II, and 7 (7.1%) at stage III. Significant differences in neonatal ( P <0.001) and maternal ( P =0.015) vitamin D levels, first and fifth minute Apgar scores ( P =0.034 and P =0.001, respectively), and weight ( P =0.014) were found between the infants with and without RoP., Conclusion: The incidence of RoP was higher in infants with lower gestational age, lower birth weight, low first and fifth minutes Apgar scores, and male sex. Low serum levels of vitamin D in premature infants and their mothers were associated with incidence of RoP. The higher the stage of RoP, the greater was the severity of vitamin D deficiency. Thus, controlling the maternal vitamin D level during pregnancy, consumption of vitamin D supplements, and investigation of serum vitamin D levels in premature infants are recommended. Early correction of vitamin D deficiency may lead to reduction of RoP., (2022 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.)

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., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2021 The Authors.)

Background: Despite the known effect of hyperbilirubinemia in neonates, the effect of phototherapy on electroencephalography (EEG) remains unknown. Therefore, we aimed to determine the alteration of electroencephalography in infants with hyperbilirubinemia before and after phototherapy., Methods: This cross-sectional study was performed on infants of≥35 weeks of gestation with hyperbilirubinemia. Information including age, sex, birth weight, hemoglobin levels, and treatment measures was recorded. In all studied infants, an EEG was performed before (in the first eight hours of hospitalization) and after treatment (after phototherapy or blood transfusion). The required duration of phototherapy, hospitalization and adverse effects were assessed then EEG of the neonates was compared before and after treatment., Results: A total of 52 infants (44% female and 56% male) were included in this study. Mean gestational age, weight, and bilirubin were 38.6±1.53 weeks, 3150±625 g, and 23.87±4.36 mg/dl, respectively. The most common findings before phototherapy were Frontal Theta (21 patients, 40.4 percent) and Delta Brush (14 patients, 26.9%), while the most common findings after phototherapy were Frontal Theta (20 patients, 38.5%) and Delta Brush (19 patients, 36.5%). Mean±SD of bilirubin in infants with and without Delta Brush was 21.30±1.67 mg/dl and 19.95±0.94 mg/dl, respectively., Conclusions: Hyperbilirubinemia in newborns may be linked to altered EEG findings. After phototherapy, the Frontal theta was reduced, but the Delta brush was intensified. Bilirubin levels were higher in infants with Delta Brush in their EEG compared to infants without this finding.

Introduction: Vitamin D deficiency is highly prevalent during pregnancy and in premature infants. This study was done to investigate the maternal and infantile levels of vitamin D in preterm infants., Methods: Using available sampling during 2018-2020, the maternal and umbilical cord serum levels of vitamin D were measured in 294 premature infants in Ghaem Hospital, Mashhad, Iran. A researcher- made questionnaire consisting of neonatal demographic and clinical characteristics was used as the data collection tool. Both maternal and placental vitamin D levels were categorized into four classes: severe deficiency (vitamin D<10 ng/ml), moderate deficiency (10.1≤vitamin D≤20 ng/ml), mild deficiency (20.1≤vitamin D≤30 ng/ml) and normal (vitamin D >30.1ng ml)., Results: Vitamin D deficiency was seen in 89% of premature infants (46.6% severe, 30.6% moderate, and 11.9% mild). Serum levels of vitamin D were 18.28±13.94 ng/ml and 14.10±9.70 ng/ml in mothers and infants, respectively. The infants below and above 32 weeks exhibited vitamin D values of 10.97±6.31 ng/ml and 18.05±11.64 ng/ml, respectively. The difference in vitamin D levels between boys (12.59±8.40 ng/ml) and girls (16.05±11.45 ng/ml) was found to be significant (P=0.009). Moderate and severe vitamin D deficiency was more common at earlier pregnancy ages (P=0.001)., Conclusion: Vitamin D deficiency is more common and severe in preterm infants and their mothers. Controlling vitamin D levels during pregnancy, especially in women at risk of preterm labor and preterm infants, may help reduce prematurity problems., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Introduction: Retinopathy of prematurity (RoP) is a vasoproliferative disorder caused by the abnormal development of retinal vessels in premature neonates. It is one of the major causes of childhood blindness, which is increasing with the increasing survival rate of low birth weight and premature neonates. This study has aimed to evaluate the role of oxidative stress and peroxidant antioxidant balance (PAB) in the pathogenesis and prediction of RoP., Materials and Methods: A total of 154 neonates weighing <1500 g admitted at the NICU of Ghaem Hospital, Mashhad, Iran, were enrolled in this cross-sectional study between 2018 and 2020. Blood samples were collected on the first day of birth to assess the peroxidant and antioxidant balance. The demographic, prenatal, and clinical course and postnatal problems were also recorded. The neonates were examined for RoP and divided into control (healthy) and affected (ROP) groups., Results: There were significant differences between the two groups in gestational age, duration of oxygen therapy, and first and fifth minute Apgar score (P < 0.005). The mean PAB in infants without and with ROP was 19.79 HK (Hamidi-Koliakos) and 38.45 HK, respectively (P < 0.0001). Also, the mean PAB in neonates with ROP grade 1 and 2 was 36.69 HK and 45.53 HK, respectively (P = 0.002)., Conclusion: According to our findings, the PAB level can be helpful in predicting ROP incidence. With increasing PAB, the possibility of ROP severity will increase., (© 2021. The Author(s), under exclusive licence to The Royal College of Ophthalmologists.)

Background: Infantile hypernatremic dehydration (IHD) is a life-threatening disease with potential cerebral adverse effects., Purpose: This study was conducted to evaluate the prognosis of IHD., Methods/search Strategy: Using convenience sampling 183 term infants with IHD (Na +  > 150 mg/dl) were enrolled in a cohort study with 36 months follow-up during 2007-2017. A researcher-made questionnaire was used for data collection. Follow-up visits were performed using the Denver Developmental Screening II test after discharging from hospital. The t -test, chi-square test, regression models, and receiver-operating characteristic curve were performed for data analysis., Findings/results: 17.5% of neonates were diagnosed with abnormal outcomes. Postpartum breast growth, breastfeeding frequency and duration, convulsion, consciousness, urination frequency, urea, Cr, sodium and brain CT scan ( p  = .000) showed significant differences ( p  < .05) between the infants with normal and abnormal outcomes. Combination of the above variables had a high predictive power (98.6%) for determining the unfavorable prognosis in infants with IHD., Implications for Practice: Sodium, urea and creatinine are high-sensitive/specific determinants of IHD prognosis. Combination of some risk factors is highly predictive for unfavorable prognosis of IHD., Implications for Research: Combination of variables such as sodium, urea, creatinine, lethargy, state of fontanels, convulsion, loss of consciousness, state of the breast during postpartum, inverted nipple and brain CT scan has a high predictive power in the determination of unfavorable prognosis in IHD.

Background: The current study aimed to evaluate growth and neurodevelopmental status in patients with retinopathy of prematurity (ROP) treated with intravitreal bevacizumab (IVB)., Methods: This historical cohort study was conducted on neonates with ROP who were treated with IVB and age and birth weight-matched controls who did not need IVB. Apgar score less than five, history of blood transfusion and history of infectious diseases were among exclusion criteria. Indirect ophthalmoscopic examinations were performed till complete retinal vascularization. Growth and neurodevelopmental status were evaluated by Age and Stages Questionnaire (ASQ) at the ages of 6, 12, and 18 months. Developmental milestones were assessed in five areas (gross motor, fine motor, personal-social status, problem-solving, and relationship) and overall issues., Results: A total of 34 cases and 36 controls were included in the present study. Birth weight and corrected gestational age were not statistically different between the groups. In a follow-up period of 18 months, bevacizumab was effective as a primary treatment in the treatment of severe cases of ROP. There was no significant difference between the two groups regarding the five areas and overall issues in follow-up intervals (P > 0.05)., Conclusions: The obtained results did not show any growth and neurodevelopmental differences between treatment-naïve infants and those receiving IVB for the treatment of ROP., (© 2021. The Author(s).)

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Background: Identification and control of the risk factors for hyperbilirubinemia can reduce the incidence and complications of this condition. Serum zinc level in newborns is reported to be one of the factors affecting the severity and incidence of neonatal hyperbilirubinemia. Therefore, the present study was conducted to compare hyperbilirubinemia incidence in neonates of zinc-taking and non-zinc-taking mothers., Methods: In this observational study, we compared the incidence of hyperbilirubinemia during the first week of birth between newborns whose mothers had received zinc supplement during the third trimester of pregnancy (case group) with those whose mothers had not taken zinc supplement (control group). The checklist of newborns' conditions in both case and control groups was completed based on the obtained data regarding the infants, mothers, and laboratory findings. Data was analyzed using chi-squared test and t -test., Results: The mean serum levels of zinc were 79.76±15 mg/dl and 70.93±15.67mg/dl in mothers who had received zinc during the third trimester and those who had not taken zinc supplement, respectively. The mean serum level of zinc in newborns who underwent phototherapy was 41.68±9.21 mg/dl, while it was 68.53±20.85 mg/dl in neonates who did not receive phototherapy. In addition, 36% of the neonates whose mothers had not received zinc required phototherapy, while only 11% of newborns whose mothers had taken zinc supplement received phototherapy., Conclusion: Zinc consumption during the third trimester of pregnancy increased the serum zinc level in both newborns and mothers and reduced the incidence and severity of idiopathic hyperbilirubinemia requiring treatment., Competing Interests: None declared.

Objective: Early diagnosis is has a crucial role in both prevention and treatment of asphyxia-related complications. The current study aimed to evaluate the prognostic value of interleukin-6 (IL-6) and hypoxic-ischemic encephalopathy grade in the prediction of mortality and the developmental status of neonates affected by prenatal asphyxia., Materials & Methods: This cohort study was conducted on 38 term asphyxiated infants at Ghaem hospital, Mashhad, Iran, from 2013 to 2017. The HIE grade and serum IL-6 levels were determined at the time of birth. The developmental status was evaluated using the Denver II test at the end of the two-year follow-up., Results: HIE grade 3 resulted in 83% mortality rate and developmental delay among all survivors. The mean IL-6 level was 2.7 ng/ml in the control group (not affected HIE), which increased up to 29, 175, and 136 ng/ml in those with HIE grades of 1, 2, and 3, respectively. According to the ROC curve analysis, the cut-off level of 24 pg/ml could predict the developmental delay with sensitivity and specificity of 96 and 92%, respectively., Conclusion: The IL-6 level and HIE grade are potential prognostic biomarkers for the determination of mortality and morbidity in asphyxiated neonates., Competing Interests: None declared.

Background: Zinc is an essential element for normal embryogenesis and embryonic and neonatal development. Therefore, we compared the birth weights of neonates born to mothers who consumed zinc supplement during pregnancy with that of neonates born to mothers who did not., Methods: In a cross-sectional study, we divided 200 pregnant mothers into two groups: case group (mothers receiving zinc supplement during pregnancy) and control group (mothers not receiving zinc supplement during pregnancy) Then, the neonate's cord zinc level and mother's serum level were measured and neonate's growth charts (weight, height and head circumference)were completed., Results: In this study, both groups of mothers were observed to have zinc deficiency; 35% of the mothers who consumed zinc supplements and 81% of the mothers who did not consume zinc supplements (P < 0.001). Based on the results, maternal serum of zinc (P < 0.001), neonatal birth weight (P = 0.008), maternal age (P < 0.001) and parity (P < 0.01) in zinc-supplemented group were higher. Neonatal birth weight was associated moderately with mother's zinc serum levels and poorly with neonatal serum zinc levels., Conclusion: Zinc consumption during pregnancy increases serum zinc level of mother and neonatal weight. Neonatal weight has a higher correlation to maternal serum zinc level.

Background: Asphyxia is one of the main causes of infant mortality and long-term neurologic complications. This cohort study was aimed to compare the diagnostic value of the hematologic and biochemical factors in the prediction of prognosis of asphyxia according to the high prevalence of asphyxia and its complications., Methods: In this cohort with a two-year follow-up study with availability sampling, 196 term asphyxic infants were involved from 2009 to 2018. A researcher-designed questionnaire was used as the data collection tool containing infantile and maternal particulars as well as the clinical and laboratory assessments. Serum levels of interleukin-1β(IL-1β), IL-6, pro-oxidant/antioxidant balance (PAB), heat shock protein (HSP) and nucleated red blood cells (NRBC) were checked in infants with perinatal asphyxia. Denver II developmental screening test (DDST-II) was performed at 6, 12, 18, and 24 month post-discharge follow-up visits. Data analysis for comparison of infants with normal and abnormal outcomes was performed using student t- test, chi-square, ROC curve, and regression models., Results: IL-6, IL-1β, PAB, and NRBC count are among the most important predictors of abnormal complications in asphyxic newborns. PAB>22 (HK) showed sensitivity and specificity of 88.6% and 71.6%, respectively in the prediction of complications of asphyxia. The sensitivity and specificity of an IL-6 higher than 28 (pg/mL) in the prediction of complications of asphyxia were found to be 96.1% and 78.6%, respectively. Elevated levels of IL-6 and IL-1β were associated with increased unfavorable outcomes., Conclusion: Combinations of: IL-1β+ IL-6 + NRBC; IL-6 + HIE grade + PAB; and IL-6+ HIE grade + NRBC had the highest predictive value (100%) for prognosis of asphyxic infants., (Copyright © 2020, Babol University of Medical Sciences.)

Background: Transient tachypnea of the newborn (TTN) is one of the most frequent causes of respiratory distress in neonates. A relationship has been shown between vitamin D deficiency and respiratory disorders in neonates. This research was carried out to evaluate the serum level of vitamin D in TTN newborns and their mothers compared to the control group., Methods: This case-control research was conducted during 2016-2019 in a general hospital affiliated with Mashhad University of Medical Sciences, Iran. Thirty-four infants with TTN and 82 neonates in the control group as well as their mothers were investigated. The levels of umbilical cord serum vitamin D in infants with TTN and also their mothers were compared to the control group., Results: The mean levels of serum vitamin D in infants with TTN and their mothers were 8.11 ± 4.32 and 12.6 ± 10.12 ng/mL, respectively (P<0.001), whereas they were 19.21 ± 12.71 and 25.96 ± 16.6 ng/mL in the newborns of the control group and their mothers, respectively (P<0.001). The mean differences (95% CI) of neonatal and maternal vitamin D level between the two groups were 11.10 (7.92-14.28) and 13.36 (7.90-18.08), respectively. In the TTN group, 100% of the infants had vitamin D levels less than 30 ng/mL (79.4% had severe, 17.6% had moderate and 2.9% showed mild deficiency). However, vitamin D levels lower than 30 ng/mL were observed in 76.4% of the neonates in the control group (28.8% had severe, 31.1% showed moderate and 16.3% had a mild deficiency) (P<0.001)., Conclusion: The serum vitamin D levels of infants with TTN and their mothers were significantly lower than the control group. Therefore, TTN in infants may be reduced through the treatment of vitamin D deficiency in mothers., (© 2020 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.)

Background and Objectives: Neonatal meningitis is one of the most important and serious neonatal infections with a high mortality and morbidity rate. The present study aimed to investigate the causes, clinical signs, laboratory parameters and mortality rates in newborns with bacterial meningitis., Materials and Methods: This cross-sectional study was performed on 468 neonates aged 2-28 days admitted to NICU in Ghaem Hospital Mashhad, Iran by available sampling method during 2009-2018. Meningitis was confirmed according to positive results of CSF culture and clinical feature. By using researcher-made questionnaire, neonate's individual data including cardiopulmonary resuscitation, the Apgar score of the first and fifth minutes, gestational age, birth weight, clinical symptoms and laboratory data such as ESR, WBC and positive culture of CSF were studied., Results: Among 468 newborn suspected to infection, lumbar Puncture (LP) was performed for 233 cases (50%). Of 233 neonates, 148 neonates (63.5%) had negative results for CSF culture and 85 cases (36.5%) had positive CSF culture. 94% of cases with meningitis were born premature. Blood culture had positive results in 80% of infants with late-onset meningitis and negative in 20%. The most common clinical findings were respiratory symptoms (94%). Klebsiella pneumoniae and Entrobacter aerugenes were the most common microorganisms of meningitis. Gestational disorders were observed in 55.3% of newborns with meningitis. C-Reactive Protein (CRP) of neonates with meningitis was twice higher than normal cases, and leukocytes and proteins in the CSF in neonates with meningitis were higher than healthy ones. Finally, 36% of neonates with meningitis died in our study. For analyzing the relationships between variables, independent t-test was used after controlling the normality, and Chi-square was used for analyzing the relationship of variables with nominal scale., Conclusion: The most common pathogens of meningitis were Klebsiella pneumoniae and Enterobacter aerogenes . Respiratory symptoms were the most common clinical signs, and laboratory symptoms included increased CRP, increased leukocytes and proteins in CSF., (Copyright© 2020 Iranian Neuroscience Society.)