MyMedR

Displaying publications 21 - 40 of 236 in total

Abstract:

Sort:

Observations on obstetric practice in a multicultural setting

TambyRaja RL

Matern Child Health J, 1999 Jun;3(2):111-3.
PMID: 10892419

Singapore provides a rich environment for investigations into ethnic differences in pregnancy outcome, as it is populated by Malays, Indians, and Chinese. Years of clinical practice and obstetric research in this environment have affirmed the observation that many factors interact in determining length of gestation and birth weight, and that these factors have differential affects among these three different ethnic groups. Although technological advances have furthered our understanding of obstetrical outcomes and provided essential tools to promote the survival of premature infants, the persistent use of uniform growth standards hampers our ability to assure positive outcomes for women of different ethnicity. Recognition of ethnic differences has resulted in declines in certain negative pregnancy outcomes for women in Singapore. The development of race-specific uterine growth curves will enhance the provision of perinatal care for all women.

Matched MeSH terms: Infant, Low Birth Weight
Hansenula anomala infection in a neonate

Wong AR, Ibrahim H, Van Rostenberghe H, Ishak Z, Radzi MJ

J Paediatr Child Health, 2000 Dec;36(6):609-10.
PMID: 11115044

We present an unusual neonatal fungal infection, Hansenula anomala in a very low birthweight infant who underwent abdominal surgery for an omphalocele. Despite treatment with adequate doses of amphotericin B, the yeast continued to grow from the blood culture, and was only eradicated with the use of oral ketoconazole.

Matched MeSH terms: Infant, Very Low Birth Weight
Growth patterns of the humeral and femur length in a multiethnic population

Raman S, Teoh T, Nagaraj S

Int J Gynaecol Obstet, 1996 Aug;54(2):143-7.
PMID: 9236312

OBJECTIVES: To study whether there are any differences in growth of the femoral and humeral length between the three major ethnic groups in Malaysia viz Malays, Chinese and Indians. The effect on fetal growth by gender of the baby and parity of the mother was also studied.
METHODS: The setting was the University of Kuala Lumpur. Thirty-four Malay, 35 Chinese and 34 Indian normal pregnant middle-class women were studied longitudinally by monthly ultrasound scans for 18 to 38 weeks of gestation. The data were subjected to regression analysis; the quadratic curve was found to be the most adequate. Dummy variables were used to determine any effects by gender, parity as well as ethnicity on the length of limb growth. There was no difference in birth weights of the three ethnic groups studied, nor in gender or parity.
RESULTS: There were found to be significant differences in limb lengths of the Indians (longer) when compared with the Malays and Chinese. Parity seems to affect only Indians in whom the multiparous fetuses have shorter limb lengths than the primaparous. There appears to be no effect by gender.
CONCLUSION: There appear to be definite differences in growth of limb length between the different Malaysian ethnic groups and this should be taken into account when growth charts are used and when fetal weight formulas are calculated using limb lengths. The limitation of this study was that the numbers of subjects studied were small. Larger studies will be able to confirm or refute the findings.

Matched MeSH terms: Birth Weight
Combined team management of diabetes mellitus in pregnancy

Ng CS, Lim LS, Chng KP, Lim P, Cheah JS, Yeo PP, et al.

Ann Acad Med Singap, 1985 Apr;14(2):297-302.
PMID: 4037689

225 women with diabetes in pregnancy were managed by a team of obstetricians, physicians (endocrinologists) and paediatricians from the National University of Singapore. A protocol of management was formulated and followed. The incidence of 1.1% or 1 in 90 pregnancies was found, with significantly higher incidence in Indians and lower in Malays. There were 37 established diabetics and 188 diagnosed during pregnancy. Of these (188), 74 were gestational diabetics. All the women were treated with Insulin and Diet or Diet alone. 177 (79%) were treated with Insulin and Diet. Blood sugar profiles were done for monitoring diabetic control. 72.8% of the women were between para 0 and 1 and 85.2% between the ages of 20 and 34. 72.5% of the women delivered at 38 weeks gestation or later. 48.9% went into spontaneous labour, 32.4% were induced and 18.7% had elective caesarean section. 62.2% of the women had labour of less than 12 hours. The overall caesarean section rate was 41.7%. There were 3 stillbirths and 2 neonatal deaths. The perinatal mortality rate was 2.2%. Thirteen babies had congenital malformations (5.8%). 77.8% of the babies had Apgar score of 7 or more at 5 minutes after delivery. 79.1% of the babies weighed between 2.5 kgm and 3.9 kgm. Pre-eclamptic toxaemia was the commonest complication in pregnancy followed by Urinary Tract Infection and Polyhydramnios. Postpartum complications in the mother were confined to 14 women (6.2%), and wound infection or breakdown was the commonest cause.

Matched MeSH terms: Birth Weight
Fulltext Update on the prevalence of malnutrition among children in Asia

Khor GL

Nepal Med Coll J, 2003 Dec;5(2):113-22.
PMID: 15024783

Approximately 70.0% of the world's malnourished children live in Asia, resulting in the region having the highest concentration of childhood malnutrition. About half of the preschool children are malnourished ranging from 16.0% in the People's Republic of China to 64.0% in Bangladesh. Prevalence of stunting and underweight are high especially in South Asia where one in every two preschool children is stunted. Besides protein-energy malnutrition, Asian children also suffer from micronutrient deficiency. Iron deficiency anaemia affects 40.0-50.0% of preschool and primary school children. Nearly half of all vitamin A deficiency and xeropthalmia in the world occurs in South and Southeast Asia, with large numbers of cases in India (35.3 million), Indonesia (12.6 million) and China (11.4 million). Another major micronutrient problem in the region is iodine deficiency disorders, which result in high goiter rates as manifested in India, Pakistan and parts of Indonesia. While under-nutrition problem persists, overweight problem in children has emerged in Asia, including Taiwan, Singapore and urban China and Malaysia. The etiology of childhood malnutrition is complex involving interactions of multiple determinants that include biological, cultural and socio-economic influences. Protein-energy malnutrition and micronutrient deficiency leading to early growth failure often can be traced to poor maternal nutritional and health care before and during pregnancy, resulting in intrauterine growth retardation and children born with low birth weight. While significant progress has been achieved over the past 30 years in reducing the proportion of malnourished children in developing countries, nonetheless, malnutrition persists affecting large numbers of children. The socio-economic cost of the malnutrition burden to the individual, family and country is high resulting in lower cognitive outcomes in children and lower adult productivity. Interventions that are cost-effective and culturally appropriate for the elimination of childhood malnutrition deserve the support of all.

Matched MeSH terms: Infant, Low Birth Weight
Anaemia in pregnancy in an aboriginal population

Ong HC

J Trop Med Hyg, 1974 Jan;77(1):22-6.
PMID: 4811560
Matched MeSH terms: Birth Weight
Evaluating the quality of antenatal care and pregnancy outcomes using content and utilization assessment

Yeoh PL, Hornetz K, Shauki NIA, Dahlui M

Int J Qual Health Care, 2018 Jul 01;30(6):466-471.
PMID: 29590356 DOI: 10.1093/intqhc/mzy041

Objective: To assess the adequacy of antenatal care (ANC) and its association with pregnancy outcomes using an approach that includes adequacy of both utilization and content.

Design: Retrospective cohort study.

Setting and Participants: Women attending ANC at public-funded primary health clinics where data were extracted from individual records.

Methods: Adequacy of utilization assessment was based on the concept of Adequacy of Prenatal Care Utilization index; adequacy of content assessed the recommended routine care received by the women according to local guidelines. Association between adequacy and pregnancy outcomes was examined using binary logistic regression.

Main Outcome Measures: Pregnancy outcomes included preterm birth and low birth weight.

Results: Sixty-three percent of women showed higher than recommended ANC utilization; 52% had <80% of recommended routine care content. Although not statistically significant, the odds of preterm birth was lower among women with adequate level of utilization compared with inadequate (adjusted odds ratios (aOR) = 2.34, 95% confidence interval (CI) 0.45-12.16) and intensive levels (aOR = 3.27, 95% CI 0.73-14.60). Regarding adequacy of content, women who received inadequate level of care content were associated with higher prevalence of preterm birth (aOR = 3.69, 95% CI 1.60-8.55).

Conclusion: The study shows inadequate content is associated with higher prevalence of preterm birth and suggests that inadequate utilization increases the risk of preterm birth. It demonstrates the relevance of using both utilization and content assessment in evaluating quality of ANC. Further studies are encouraged to review the methods used.

Matched MeSH terms: Infant, Low Birth Weight
Fulltext Association between intrauterine growth restriction and patent ductus arteriosus: Use of a dichorionic twin pregnancy model

Yang CY, Hoong MF, Li CS, Li WF, You SH, Lee YC, et al.

Taiwan J Obstet Gynecol, 2021 May;60(3):517-522.
PMID: 33966739 DOI: 10.1016/j.tjog.2021.03.023

OBJECTIVE: To evaluate the association between intrauterine growth restriction (IUGR) and the incidence of fetuses with patent ductus arteriosus (PDA) and Hemodynamically significant PDA (Hs-PDA) in dichorionic twins (DC) with selective IUGR.
MATERIALS AND METHODS: This is an observational cohort study and retrospective case assessment, involved twins born at Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan between 2013 and 2018. DC twins with selective IUGR (sIUGR) were defined as the presence of a birth weight discordance of >25% and a smaller twin with a birth weight below the tenth percentile. PDA was diagnosed using echocardiography between postnatal day 3 and 7. Hs-PDA was defined as PDA plus increased pulmonary circulation, poor systemic perfusion, cardiomegaly, pulmonary edema, or hypotension requiring pharmacotherapeutic intervention.
RESULT: A total of 1187 twins were delivered during the study period, and 53 DC twins with selective IUGR were included in this study. DC twins with PDA have higher rate of preterm birth, lower gestational age of delivery, and lower mean birth weight of both twins compared with DC twins without PDA. In a comparison of the sIUGR twin with the appropriate for gestational age co-twin, both the incidences of PDA (28.30% vs. 7.55%, respectively; P = 0.003) and Hs-PDA (24.53% vs. 5.66%, respectively; P = 0.002) were higher in sIUGR fetuses than in the appropriate for gestational age co-twins. Small gestational age of delivery was the only variable to predict PDA and Hs-PDA [p = 0.002, Odds ratio = 0.57 (0.39-0.82), p = 0.009, Odds ratio = 0.71 (0.55-0.92), respectively].
CONCLUSION: An analysis of dichorionic twins with sIUGR indicated that IUGR increased the risk of PDA and hemodynamically significant PDA.

Matched MeSH terms: Birth Weight
Fulltext The frequency of pulmonary hypertension in newborn with intrauterine growth restriction

Abbas G, Shah S, Hanif M, Shah A, Rehman AU, Tahir S, et al.

Sci Rep, 2020 05 15;10(1):8064.
PMID: 32415157 DOI: 10.1038/s41598-020-65065-2

Intrauterine growth restriction (IUGR) is a clinical definition applied to neonates born with clinical features of malnutrition and in-utero growth retardation irrespective of their birth weight percentile. This study was aimed to determine the frequency of pulmonary hypertension (PH) in neonates with IUGR. In this descriptive cross-sectional study, we followed 96 neonates with IUGR (≤28 days) and 38 neonates without IUGR born in the department of the neonatal intensive care unit children hospital complex Multan, Pakistan. We analyzed certain factors such as gender, gestational age (GA) (weeks), birth weight (BW in kg), weight percentile (WP) for GA, meconium aspiration syndrome (MAS), birth asphyxia (BA) and respiratory distress syndrome (RDS) for pulmonary hypertension (PH) in IUGR and non-IUGR group. GA was measured by the Ballard scoring system. Echocardiography was performed for all patients by the pediatric cardiologist to measure pulmonary arterial (PA) pressure using Bernoulli's equation. Out of total 96 IUGR neonates, 33.3% (n = 32) suffered from PH, of which 65.3% (n = 18) were male and 43.7% (n = 14) were female. The percentages of IUGR neonates with BA, MAS and RDS were 34.4%, 18.8% and 22.9% respectively. The data were analyzed using the SPSS-16 software to test the statistical significance of the results. A p-value less than 0.05 was considered significant. When the chi-square test was applied, it depicted that MAS was significantly associated with PH in IUGR neonates (p = 0.0001) compared to non-IUGR neonates. Our findings suggested an increased chance of PH in IUGR neonates and MAS may be a strong factor.

Matched MeSH terms: Birth Weight
Fulltext Use of the Arabin pessary in women at high risk for preterm birth: long-term experience at a single tertiary center in Malaysia

Rahman RA, Atan IK, Ali A, Kalok AM, Ismail NAM, Mahdy ZA, et al.

BMC Pregnancy Childbirth, 2021 May 10;21(1):368.
PMID: 33971828 DOI: 10.1186/s12884-021-03838-x

BACKGROUND: Spontaneous preterm birth is a global issue that contributed to perinatal morbidities and mortalities worldwide. The study aimed to describe the experience at UKM Medical Center in managing women at high risk for spontaneous preterm birth using the Arabin pessary.
METHODS: This is a retrospective observational study involving 58 pregnancies from 1st January 2013 to 31st December 2019. Inclusion criteria were previous mid-trimester miscarriage and/or preterm birth, previous cervical surgery or short cervical length on routine sonogram. The demographic data, characteristics of each pregnancy and details of outcomes and management were described.
RESULTS: The majority of women were Malay with mean age and body mass index of 32.9 ± 4.2 years and 27.1 ± 6.3 kg/m2 respectively. The most frequent indications for Arabin pessary insertion were previous mid-trimester miscarriage (46.4%) and early preterm birth (17.2%). A total of 73.4% of these women had the pessary inserted electively at a mean cervical length of 31.6 ± 9.1 mm at median gestation of 15.0 weeks. They were managed as outpatient (56.9%), inpatient (24.1%) or mixed (19.0%) with combination of progestogen (81.0%) and 53.4% received antenatal corticosteroids. Spontaneous preterm birth at or more than 34 weeks gestation occurred in 74.1% with birthweight at or more than 2000 g (82.4%). Despite cervical funneling in 12 women (20.7%), 66.7% delivered at or later than 34 weeks gestation and 2 (16.7%) resulted in miscarriage.
CONCLUSIONS: Insertion of the Arabin pessary is beneficial to prevent spontaneous preterm birth in pregnant women who are at high risk. In particular, early insertion and close monitoring allows the best possible outcomes.
TRIAL REGISTRATION: This study was retrospectively registered with ClinicalTrials.gov ( NCT04638023 ) on 20/11/2020.

Matched MeSH terms: Birth Weight
Diaphroase activity and variants in normal adults and newborns

Eng LI, Loo M, Fah FK

Br J Haematol, 1972 Oct;23(4):419-25.
PMID: 5084807
Matched MeSH terms: Birth Weight
Foetal and maternal outcomes in hyperuricaemia pre-eclampsia patients in Hospital Universiti Sains Malaysia

Jummaat F, Adnan AS, Ab Hamid SA, Hor JN, Nik Mustofar NN, Muhammad Asri NA, et al.

J Obstet Gynaecol, 2021 Jan;41(1):38-43.
PMID: 33124936 DOI: 10.1080/01443615.2019.1679731

Preeclampsia patients have frequently been found to experience hyperuricaemia and this may result in poor outcomes compared to those with normal uric acid levels. This study aimed to determine the relationship of hyperuricaemia in pre-eclampsia patients with foetal and maternal outcomes. This prospective cohort study involved 79 patients in a tertiary centre from year 2016 to 2018. Blood samples were taken antenatally and at the 6th week, post-delivery for renal function including serum uric acid level. Our findings indicate that there was a higher incidence of poor maternal and foetal outcomes in the hyperuricaemia group than the normal uric acid group. Serum uric acid has been shown to be a significant predictor for low birth weight and premature delivery in preeclampsia patients. It was also found that there was a significant negative correlation between uric acid level and antenatal creatinine clearance (rs = -0.338, p = .002). The assessment of the serum uric acid level seems to be important to ensure better outcomes in patients with preeclampsia.Impact statementWhat is already known on this subject? Preeclampsia is a serious pregnancy-related complication and remains as one of the most important cause of maternal and foetal morbidity and mortality, affecting 2-8% in all pregnancy. Many studies have established the association between hyperuricaemia and preeclampsia. Besides, numerous studies have found that hyperuricaemia contributed to adverse maternal and foetal outcomes.What the results of this study add? There was a significant increase in adverse foetal and maternal outcomes in the hyperuricaemia group compared to the normal uric acid group. This study revealed that serum uric acid remains a significant predictor for low birth weight and premature delivery in preeclampsia patients.What the implications are of these findings for clinical practice and/or further research? Hyperuricaemia does not merely become an indicator for the severity of disease in preeclampsia patients but also indicates adverse foetal outcomes. Large population-based studies are required to establish the absolute maternal and foetal outcomes in patients with hyperuricaemia. Besides, further studies are recommended on long-term implication of hyperuricaemia which is not limited to only during antenatal period.

Matched MeSH terms: Infant, Low Birth Weight
Obstetrical data in Malaysian aborigine women

Ong HC

Trop Geogr Med, 1974 Dec;26(4):384-8.
PMID: 4456697
Matched MeSH terms: Birth Weight
Fulltext Molar pregnancy with normal viable fetus presenting with severe pre-eclampsia: a case report

Atuk FA, Basuni JBM

J Med Case Rep, 2018 May 21;12(1):140.
PMID: 29779493 DOI: 10.1186/s13256-018-1689-9

BACKGROUND: While gestational trophoblastic disease is not rare, hydatidiform mole with a coexistent live fetus is a very rare condition occurring in 0.005 to 0.01% of all pregnancies. As a result of the rarity of this condition, diagnosis, management, and monitoring will remain challenging especially in places with limited resources and expertise. The case we report is an interesting rare case which presented with well-described complications; only a few similar cases have been described to date.
CASE PRESENTATION: We report a case of a 21-year-old local Sarawakian woman with partial molar pregnancy who presented with severe pre-eclampsia in which the baby was morphologically normal, delivered prematurely, and there was a single large placenta showing molar changes.
CONCLUSION: Even though the incidence of this condition is very rare, recognizing and diagnosing it is very important for patient care and it should be considered and looked for in patients presenting with pre-eclampsia.

Matched MeSH terms: Infant, Extremely Low Birth Weight
Determinants of neonatal outcome in a Malaysian maternity hospital, 1980-1981

Abdul Kader H

Malays J Reprod Health, 1983 Jan;1(1):11-8.
PMID: 12279886
Matched MeSH terms: Birth Weight
Fulltext Relevance of neonatal care in developing countries

Ho NK

Singapore Med J, 1999 Sep;40(9):558-60.
PMID: 10628240
Matched MeSH terms: Infant, Very Low Birth Weight
Fulltext A review of Orang Asli newborns admitted to a neonatal unit in a Malaysian general hospital

Kandasamy Y, Somasundram P

Singapore Med J, 2007 Oct;48(10):926-8.
PMID: 17909678

The Orang Asli are the indigenous population in peninsular Malaysia and are in fact a diverse sub-ethnic group with different languages. Our aim was to collect data on Orang Asli newborns, from western and central Pahang, that were admitted to a general hospital with paediatric specialist services.

Matched MeSH terms: Birth Weight
Fulltext Intrauterine growth of liveborn Malaysian infants between gestation of 28 to 42 weeks

Boo NY, Lye MS, Ong LC

Singapore Med J, 1994 Apr;35(2):163-6.
PMID: 7939812

A cross-sectional study was carried out on 8,478 consecutive normal singleton Malaysian neonates born in the Maternity Hospital, Kuala Lumpur. The objectives were to compare the mean birth-weights, crown-heel lengths and head circumferences of Malay, Chinese and Indian infants at gestation age from 28 to 42 weeks, and to construct the Malaysian growth charts. Above the gestation age of 34 weeks, the birthweights were significantly influenced by maternal gravida status (p < 0.03), ethnic origin (p < 0.001) and/or sex of the neonates (p < 0.026). Above this gestation age, neonates of multigravida mothers were significantly heavier than those of primigravida mothers; Indians were significantly lighter than Malays and Chinese; and males were significantly heavier than females. The head circumferences and body lengths of neonates were significantly influenced by ethnic origin, sex and/or maternal gravida status at gestation above 35 and 36 weeks respectively (p < 0.05). It was most likely due to the small sample size which explained our inability to detect statistically significant difference in all measurements (birthweight, length and head circumference) by sex, ethnicity and maternal gravida status at gestation below 35 weeks. Based on the measurements obtained in this study, percentile charts for the Malaysian population were constructed and made available for the first time. These charts will be useful for the assessment of Malaysian neonates during the perinatal period.

Matched MeSH terms: Birth Weight
Fulltext Rate of gestational weight gain trajectory is associated with adverse pregnancy outcomes

Yong HY, Mohd Shariff Z, Appannah G, Rejali Z, Mohd Yusof BN, Bindels J, et al.

Public Health Nutr, 2020 Dec;23(18):3304-3314.
PMID: 32814606 DOI: 10.1017/S1368980020002372

OBJECTIVE: To examine the gestational weight gain (GWG) trajectory and its possible association with pregnancy outcomes.
DESIGN: GWG trajectories were identified using the latent class growth model. Binary logistic regression was performed to examine the associations between adverse pregnancy outcomes and these trajectories.
SETTING: Negeri Sembilan, Malaysia.
PARTICIPANTS: Two thousand one hundred ninety-three pregnant women.
RESULTS: Three GWG trajectories were identified: 'Group 1 - slow initial GWG but followed by drastic GWG', 'Group 2 - maintaining rate of GWG at 0·58 kg/week' and 'Group 3 - maintaining rate of GWG at 0·38 kg/week'. Group 1 had higher risk of postpartum weight retention (PWR) (adjusted OR (AOR) 1·02, 95 % CI 1·01, 1·04), caesarean delivery (AOR 1·03, 95 % CI 1·01, 1·04) and having low birth weight (AOR 1·04, 95 % CI 1·02, 1·05) compared with group 3. Group 2 was at higher risk of PWR (AOR 1·18, 95 % CI 1·16, 1·21), preterm delivery (AOR 1·03, 95 % CI 1·01, 1·05) and caesarean delivery (AOR 1·02, 95 % CI 1·01, 1·03), but at lower risk of having small-for-gestational-age infants (AOR 0·97, 95 % CI 0·96, 0·99) compared with group 3. The significant associations between group 1 and PWR were observed among non-overweight/obese women; between group 1 and caesarean delivery among overweight/obese women; group 2 with preterm delivery and caesarean delivery were only found among overweight/obese women.
CONCLUSIONS: Higher GWG as well as increasing GWG trajectories was associated with higher risk of adverse pregnancy outcomes. Promoting GWG within the recommended range should be emphasised in antenatal care to prevent the risk of adverse pregnancy outcomes.

Matched MeSH terms: Infant, Low Birth Weight
Fulltext Risk factors of malnutrition among preschool children in Terengganu, Malaysia: a case control study

Wong HJ, Moy FM, Nair S

BMC Public Health, 2014;14:785.
PMID: 25086853 DOI: 10.1186/1471-2458-14-785

Childhood malnutrition is a multi-dimensional problem. An increase in household income is not sufficient to reduce childhood malnutrition if children are deprived of food security, education, access to water, sanitation and health services. The aim of this study is to identify the characteristics of malnourished children below five years of age and to ascertain the risk factors of childhood malnutrition in a state in Malaysia.

Matched MeSH terms: Infant, Low Birth Weight

Filters

Please provide feedback to Administrator (afdal@afpm.org.my)

External Links