Neonatal and prenatal causes of death in Gorgan-North of Iran.

BACKGROUND: Reduction of neonatal mortality rate can improve health and newborn status of the society. This study was done to evaluate the prevalence and pattern of causes for neonatal mortality in Gorgan, North of Iran. METHODS: this descriptive, cross-sectional study was carried out on all birth in the maternity Dezyani hospital in Gorgan, North of Iran during 1 September 2008 -31 March 2011. Causes of mortality were evaluated in newborns that admitted and died in the NICU. Died newborns were screened for primary and final causes of death. The final causes of the mortality in majority of neonates were extracted according to the International Coding of disease Ver10 (ICD10). RESULTS: The total number of births was14785. The leading primary obstetric causes of death were: spontaneous preterm labor 36(25.7%), fetal abnormality 31(22.1%), hypertensive disorders 21(15%), unexplained intrauterine death 21(15%), maternal disease 12 (8.6%), intra-uterine growth restriction (IUGR) 10 (7.1%), oligohydroamnios 5(3.6%) and ante partum hemorrhage 4 (2.9%). Mortality rate was 76.8% during the first week of life. General final causes of death were; pulmonary bleeding17.9%, septic shock16.8%, IVH15.8%, congenital anomalies and pnomotorax 13.7% in fourth grade. CONCLUSION: The risk factors, main associated reason and procedures for prevention of spontaneous preterm labor and fetal abnormality should be includes as the main themes in perinatal research. In addition, there should be emphasized on necessity of genetic consultations and health care before and during pregnancy.

Ethnical variations in the incidence of congenital heart defects in gorgan, northern iran: a single-center study.

UNLABELLED: Background : Congenital heart disease (CHD) is the most common congenital anomaly in newborns. This study was performed to determine the live birth incidence of CHD by ethnicity and sex in Gorgan, Northern Iran. METHODS: In this longitudinal, hospital-based study, 18162 live births in Dezyani Hospital in Gorgan, North of Iran, were screened for CHD, from 2007 through 2009. Clinical examination, echocardiography, color Doppler, and cardio catheterization were used as diagnostic tools. Sex, ethnicity, and type of CHD for each case were recorded in a pre-designed questionnaire. Results : The incidence rates of CHD in the native Fars, Sistani, and Turkmen subjects were 5.73 (95%CI: 4.53-7.15), 12.27 (95%CI: 8.74-16.73), and 15.93 (95%CI: 10.00-24.02) per 1000 live births, respectively. The Turkmen to native Fars and Sistani to native Fars relative risk for congenital CHD malformations was 2.77 (95%CI: 1.73-4.44; p value < 0.001) and 1.29 (95%CI: 0.77-2.18; p value < 0.323), respectively. While atrial septal defect was the most common lesion in the native Fars subjects (2.14 per 1000 [95%CI: 1.42-3.06]) and in the Sistani subjects (2.84 per 1000 [95%CI: 1.29-5.36]), in the Turkmen subjects, ventricular septal defect (4.36 per 1000 [95%CI: 1.59-9.43]), followed by atrial septal defect, was the most frequent lesion. Conclusion : This study showed that the incidence and pattern of CHD among live births in Gorgan, North of Iran, varied according to ethnicity. The risk of CHD was higher in the Turkmen and Sistani groups than in the Fars population.

Deficiencies of the microelements, folate and vitamin B12 in women of the child bearing ages in gorgan, northern iran.

BACKGROUND: The deficiencies of folic acid, vitamin B12, and microelements during pregnancy may affect the health of newborns. OBJECTIVES: To assess the serum levels of folate, vitamin B12, iron, zinc and copper in healthy women of the childbearing ages in Gorgan, northern Iran. METHODOLOGY: This descriptive, cross-sectional study was carried out on 100 women of childbearing ages in northern Iran during November 2007-March 2008. The serum levels of folate, vitamin B12, iron, copper and zinc were evaluated by laboratory tests. RESULTS: Iron, copper , folate, vitamin B12 deficiencies and folate with vitamin B12 deficiency were detected in 13%, 32% , 13% , 32% and 11% women of the childbearing ages, respectively . According to the ethnicity, vitamin B12, folate and iron deficiencies in the Sistani group were observed in 38.3%, 12.9% and 12.9% of the women, respectively. In the native Fars group, the above mentioned deficiencies were found in 31.1%, 13.4% and 7.5% of the subjects. Folate and vitamin B12 deficiencies were observed in the urban habitant in 32.7% and 11.5 % of the subjects as compared to those in the rural habitant (in 30.4% and 15.2%of the subjects respectively). The folate deficiencies in the under and above 18 years old subjects were 22.2% and 9.9%, respectively. CONCLUSIONS: This study showed that the deficiency of the micronutrients was considerable in women of the childbearing ages in Gorgan, northern Iran.

Does maternal Helicobacter pylori infection increase the risk of occurrence of neural tube defects in newborns in Northern Iran?

OBJECTIVE: To determine the relation between maternal Helicobacter pylori (H. pylori) infection and the occurrence of neural tube defects (NTDs) in newborns. METHODS: This hospital-based case-control study was carried out in Dezyani Teaching Hospital, Gorgan, Northern Iran from April 2007 to March 2009. Thirty-five mothers with NTD-affected newborns, and 53 mothers with healthy newborns were considered the cases and controls. A peripheral blood sample was obtained from all subjects, and H. pylori infections were tested by H. pylori serum antibody. The serum folic acid, vitamin B12, ferritin, and homocysteine concentrations were measured by laboratory tests. Data were analyzed using odds ratio (OR) and logistic regression. RESULTS: Forty-three percent of cases, and 26% of controls were positive for H. pylori IgG antibody, and this difference was not significant. The H. pylori seropositivity non significantly increased the risk of NTD-affected pregnancies (OR: 2.08; 95% confidence interval [CI]: 0.84-5.17, p=0.11). Serum vitamin B12 deficiency was detected in 17% of cases and 13% of controls, and folic acid deficiency in 17% of cases and 13% of controls (p=0.61). The H. pylori seropositivity was non significantly associated with low serum folate (OR 1.93 CI: 0.58-6.4, p=0.34) and ferritin (OR 1.24; CI: 0.42-3.60, p=0.68). CONCLUSION: Maternal H. pylori infection can increase the risk of occurrence of NTDs in newborns.

Knowledge and practice of urban Iranian pregnant women towards folic acid intake for neural tube defect prevention.

OBJECTIVE: To assess the knowledge and practice of urban Iranian pregnant women regarding periconceptional folic acid intake for neural tube defect (NTD) prevention. METHODS: The population-based study was done on 676 primiparous women in an urban area in Golestan province in northern Iran from June to November, 2008. A questionnaire was completed by the subjects regarding their knowledge of folic acid. Questionnaires were administered to women who were seeking routine antenatal care at health centres, private gynaecological clinic and the Dezyani Gynaecologic and Obstetric Hospital. Questions covered knowledge and use of folic acid supplements and demographic and socioeconomic characteristics. RESULTS: Out of the 676 women surveyed, 96.2% reported that they heard of folate. Of these, only 27.6% knew that folate was something important in the prevention of neural tube defects. Overall, 20.12% of the total women took folic acid during periconceptional period. The most common information sources on folate were healthcare service (54.5%). Besides, 37.6% of the subjects who heard about folate were aware that green leafy vegetables were fortified with folic acid. In univariate analysis, knowledge and intake of folic acid was not associated with education and the age of women. CONCLUSION: A healthcare plan for intervention to increase the knowledge and intake of folic acid by pregnant women during the protective period is required.

Prevalence and Pattern of Congenital Heart Disease among Neonates in Gorgan, Northern Iran (2007-2008).

OBJECTIVE: Congenital heart disease (CHD) is the most common congenital anomaly in newborns. The aim of this longitudinal, hospital-based study was to evaluate the prevalence and pattern of CHD among Iranian newborns in Gorgan, Northern Iran. METHODS: 11739 live births in Dezyani hospital in Gorgan were screened for CHD, 2007 through 2008. Clinical examination, echocardiography, color Doppler and cardio catheterization were used as diagnostic tools. Clinical and demographic factors, namely sex, type of CHD and associated anomalies of diagnosed cases were recorded in a pre-designed questionnaire for analysis. FINDINGS: The overall prevalence rate of CHD was 8.6 per 1000 live births. This was 9.96 per 1000 male births and 7.34 per 1000 female births. It was 4.5 and 13.19 per 1000 in 2007 and 2008, respectively. ASD was the commonest lesion (2.64 per 1000), followed by VSD+ASD (1.28 per 1000) and PDA (1.28 per 1000). The rate of ASD in male and female was 3.02 and 2.26 per 1000 respectively. Parents of 40 (39.6%) babies were related. 39 (38.6%) couples were first cousins. CONCLUSION: This study showed that the prevalence of CHD among live births in Gorgan is lower than reported in the studies for Middle East and European countries.