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  Background & Objectives: Septicemia is one of the serious infections of neonatal period that its microbial etiologies bacterial causes are different in various parts of the world. Incidence of sepsis in developing countries is much more than that of developed countries and it is one of the important causes of mortality and morbidity in neonatal period. This study was done to determine the microbial etiology, mortality and resistance pattern of septicemia.

 Methods: This study was a retrospective cross-sectional study for three years on blood cultures of 210 neonate admitted in pediatric hospital in Tabriz. Demographic information, clinical findings, types of bacteria in blood culture and antibiogram were analyzed.

 Results: Mean age of patients was 8±2 days in which sixty percent were male and the rest were female. Among 12 isolated bacteria, negative staphylococcus coagulase was the most common. 68.6% of isolated bacteria were positive gram. 31.4% of negative gram were in which klebsiella pneumoniae had the most frequent incidence. 22.9% of neonates died, in which 9% of them weighed less than 1500 grams. Among 8 antibiotics used by disc diffusion method, ampicillin showed the highest (97.4%) and vancomycin the lowest (6.7%) resistance.

 Conclusion: septicemia is still the main problem in neonatal ward and neonatal intensive care unit. The etiologic agents and resistance pattern of each area should be considered in starting empirical treatment.

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  Background & Objective: Preeclampsia is an unknown disease. It was seen in 3.7% of live births and it is the cause of mothers' death in 18%. In addition to complications for mothers, fetal damage have also been seen. Also we sought to consider predictors of neonatal outcome in women with preeclampsia and normal women.

  Methods: It is a prospective and cross-sectional study that was performed on 127 preeclampsia pregnant women and 254 normal pregnancy. Statistical analysis was performed by software SPSS/Win and was used X² test for analysis of the results.

  Results: Prevalence of preterm labor was 54.4% in women with preeclampsia and 25% in normal pregnancy. There was no statistical difference such as parity (P=0.157), age (P=0.256) and type of delivery (P= 0.226). There was a significant difference between two groups in gestational age (P<0.0001), birth weight (P<0.0001), neonatal mortality (P=0.013), neonatal Apgar score (P=0.005) and NICU admission (P<0.0001).

  Conclusion: It is clear that the difference between two groups is mainly because of preterm labor in preeclampsia group. Attention to exact control of illness and avoidance of making rash decision for terminating pregnancy in mild preeclampsia can improve outcomes of Neonates.

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  Background & Objectives: Neonatal mortality rate is a main indicator of hygienic development and recognition of the mortality causes is the first step for reduction of the mortality rate and promotion of this indicator. Therefore, in this study, the causes of neonatal mortality have been investigated in Ardabil medical university related hospitals.

  Methods: This study is a retrospective, cross-sectional and descriptive-analytical one that has been done on the bases of admission's units and filling the medical record form for all neonates who have been admitted to Alavi and Imam Khomeini hospitals in Ardabil from September 2006 to September 2007. The questions of forms consisted of infant’s sex, birth weight, gestational age, cause and age of death. The data were analyzed by SPSS software with utilizing T- test and Chi-Squares.

  Results: During this study, there were 1881 admissions of which there were 148 deaths (7.86%). The causes of mortality were hyaline membrane disease (HMD) (52.02%), sepsis (14.86%), pneumonia (9.45%), congenital anomaly (12.83%), asphyxia (7.43%) and meconium aspiration (3.37%). Among the dead neonates, 54.72% were male and others were female. There were 550 LBW neonates and 111 deaths in this group result of our study showed that mortality rate in LBW neonates was 20.18%. There were 578 preterm neonates and 122 deaths in this group prevalence of mortality rate in preterm neonates was 21.10%.

  Conclusion: Prematurity and low birth weight are the most important and fixed cases of infant mortality. The most common causes of mortality were hyaline membrane disease and sepsis. Therefore, the prevention of preterm labor for reduction of prematurity and its related complication recommended which may lead to decreased rate of neonatal mortality.

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  Background & objectives: Screening and early diagnosis of delayed development in children particularly among high risk groups are obligatory. Children with a history of one or more risk factors in pre-natal, peri-natal and post-natal periods are prone to delayed development in comparison with normal population. This study was launched to assess the developmental status in children with a history of NICU admission.

  Methods : In this study 114 children, aged between 4-60 months with a history of NICU admission were recruited. ASQ questionnaires including information in 5 fields: communication, fine and gross motor status, personal-social and problems solving, were filled for each one of the cases by their parents. The data were analyzed using descriptive statistics and Chi square test.

  Results: Among 114 cases, there were 71.1% male. Totally 70.2% of cases were premature. The most prevalent reason for admission was immaturity. The average weight of infants was 2233 ± 680 gram. Figures of abnormal findings in 5 fields were: communication 20.2%, gross motor 17.5%, fine motor 19.3%, problem solving 8.8% and personal-social 16.7%. In this study 67.5% of children showed normal development while 6.1% were abnormal in all 5 fields and 26.3% were abnormal in at least one filed. Statistically, there weren’t significant differences between various developmental fields and genus, length of hospital stay and birth weight.

  Conclusion : Despite normal developmental status in majority of children with a history of NICU admission, a considerable number of them had delayed development in at least one field. These findings suggest a need for patient screening and intense follow up programs.

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Background & objectives: Weight loss and hypernatremic dehydration is a common problem in infants with inadequate nutrition. Determination of risk factors and clinical characteristics of these neonates may help to prevent or early detection of hypernatremia. This study designed to determine the prevalence of clinical signs and risk factors for hypernatremic dehydration.

Methods: This study is a sectional descriptive study that conducted on 418 newborns during 1385 to 1393 AHS that referred to Ghaem hospital in Mashhad. The hypernatremic group consisted of 197 neonates with serum sodium level higher than 150 mg/dl and 221 isonatremic newborns with sodium level less than 150 mmol/L were included as controls. Both groups were compared in terms of clinical symptoms of dehydration and maternal risk factors. All data were recorded and coded. Data analysis performed using paired T test and chi square tests by SPSS 16 software.

Results: In the present study, 2.8% of infants were hypernatremic. The most common symptoms were neonatal jaundice (62.2%), hyperthermia (25.8%), lethargy (23.6%), agitation (20.8 %) and mucous membranes dryness (17.2%). Problems in pregnancy (p=0.002), inappropriate feeding techniques (p=0.000), the first lactation duration (p=0.022) and frequency per day (p=0.000) had statistically significant difference between case and control groups.

Conclusion: Prevalence of hypernatremic dehydrationis considerable in our study and identifying the risk factors may help to reduce its incidence or exacerbation. Weight loss, especially in newborns having jaundice, hyperthermia and irritability, may be helpful in the early diagnosis of hypernatremic dehydration

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Background & objectives: Staphylococci are considered as one of the most important etiological agents of omphalitis. Due to the importance of early diagnosis of omphalitis in newborns, this infection can be diagnosed by novel techniques such as multiplex PCR which is rapid, cost- effective and more accurate than microbial culture. The aim of this study was to determine the frequency of Staphylococcus aureus, S. epidermidis and S.hominis species in umbilical cord infection in newborns.
Methods: In the present study, 45 umbilical cord samples were collected from Shahid Afzali pour hospital in Kerman, Iran. Followed by DNA extraction, Multiplex PCR reactions were performed using specific 16srDNA primers for S. aureus, S. epidermidis and S.hominis. Finally, PCR products were analyzed using electrophoresis and sequencing. Also, microbiological and biochemical differentiation tests were performed for the diagnosis of Staphylococci on all specimens.
Results: Amplification of 16srRNA genes for S. aureus, S. epidermidis, and S. hominis using Multiplex PCR demonstrated that the frequency of S. epidermidis ,S. aureus and S.hominis were 4.4%, 6.6% and 2.2% in the studied samples, respectively. The prevalence of staphylococcal isolates using differential tests was shown to be 33.3%.
Conclusion: This study indicated that, Multiplex PCR is a proper method for simultaneous identification of S. aureus, S. epidermidis and S.hominis species. Also, Staphylococci can be considered as a significant cause of umbilical cord infection in newborns. However, further studies urgently are needed to confirm this finding.
 

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Background & objectives: Low birth weight is considered one of the most serious health problems in the world that puts tremendous pressure on the health care system and family. The aim of this study was to investigate the relationship between some maternal risk factors and low birth weight.
Methods: The present study was a cross- sectional study performed on 264 cases. The data gathering tool was a checklist with two parts to compare two groups in this research. The first part was related to the infant's characteristics (sex, weight, and gestational age of the newborn), and the second part related to maternal characteristics. Data were analyzed using SPSS software. Inferential statistics including Mann–Whitney u, chi-square, fisher exact test and logistic regression were used to investigate the relationship between the variables.
Results: In this study, the level of education was lower in mothers with term low birth weight neonates (p=0.024), also normal delivery was reported more frequently among mothers with low birth weight infants (p=0.0001). Also, the mean BMI and the weight at the beginning of pregnancy and overweight in mothers with term neonates and normal weight were greater (p=0.0001, in all). The first minute Apgar score and the fifth minute Apgar score were lower in mothers with low-birth term infants (p=0.002 and p=0.0001). Also distinguished that the gestational age (week) was lower in mothers with low-birth term infants (p=0.0001).
Conclusion: According to the results, increasing progress the pregnancy per week makes it possible to increase the normal weight of newborns by 3.11%.