Gender differences in outcomes of low birth weight and preterm neonates: the male disadvantage.

Various studies conducted worldwide have shown that male neonates have higher rates of mortality and morbidity in the perinatal period compared with females. However, there has been only one study from India on this subject. Therefore, this study was conducted to establish the difference in mortality between males and females among neonates born with two established risk factors of septicaemia--low birth weight (<2.5 kg) and preterm birth (<37 weeks). One hundred and fifty consecutive neonates which were either preterm or had low birth weight were recruited after obtaining informed consent from the parents. Blood culture was done, and the bacterial isolates were identified by standard protocol. Statistically significant association was found between male gender and mortality among culture-positive neonates. Therefore, results of the present study indicate that preterm or low birth weight male neonates have higher likelihood of mortality compared with their female counterparts in the Indian scenario.

Pattern and determinants of breast feeding and contraceptive practices among mothers within six months postpartum.

The present study aims to determine the patterns of breast feeding, return of menstruation, and contraceptive practices in the first six months postpartum in women visiting the outpatient department at a teaching hospital in Lucknow, Northern India. Mothers of infants between six to eight months of age visiting the outpatient department of Era's Lucknow Medical College were interviewed regarding breast feeding practices, return of menstruation, sexual activity, and contraceptive practices within the first six months postpartum using a structured questionnaire. Of all women interviewed only 75.8% practiced exclusive breast feeding with the mean duration of exclusive breast feeding (EBF) being 3.5 months with only 41% practicing EBF for six months, 28% were sexually active within six weeks postpartum, 64.5% women had a return of menstruation within six months. Contraception was practiced by only 54.4% women with a barrier method such as a condom, being the most common. Better education was the only factor significantly affecting EBF (p < 0.004) and use of contraception (p < 0.027). There were a total of 10 pregnancies within six months postpartum. In conclusion, optimal breast feeding practices are poor in this part of the country and lactational amenorrhoea cannot be effectively and reliably used as a method of contraception. Therefore, optimal breast feeding practices, timely introduction of contraception and institutional delivery need to be encouraged.

Transabdominal amnioinfusion in preterm premature rupture of membranes.

OBJECTIVE: To evaluate the effect of transabdominal amnioinfusion on prolongation of pregnancy, and maternal and neonatal outcomes in preterm premature rupture of membranes (pPROM). METHODS: We conducted a prospective randomized controlled study of women with pPROM during singleton live pregnancy-between 26 and 33+6weeks-whose amniotic fluid index (AFI) was less than the 5th percentile. The study group underwent transabdominal amnioinfusion at admission and then weekly if their AFI fell below the 5th percentile again. The control group received expectant management. RESULTS: The difference in the mean interval from pPROM to delivery between the groups was not statistically significant. Neonatal and maternal outcomes were significantly improved in the study group compared with the control group (fetal distress [10% vs 37%]; early neonatal sepsis [17% vs 63%]; neonatal mortality [17% vs 63%]; spontaneous delivery [83% vs 53%]; and postpartum sepsis [7% vs 33%]). CONCLUSION: Transabdominal amnioinfusion reduced fetal distress, early neonatal sepsis, and neonatal mortality. In the study group, more participants delivered spontaneously and there were fewer cases of postpartum sepsis, although the pPROM-delivery interval was not increased.