Sickle cell anemia in pregnant Saudi women and its impact on birth weight and gestational maturity

BACKGROUND

It is well documented that sickle cell anemia (SCA) in pregnancy increases the risk of problems that can influence the growth and maturation of the newborn. To assess the gestational maturity and birth weight of babies born to Saudi mothers with SCA in the Jazan region.

METHODS

A case-control study was conducted in three hospitals in the Jazan region. An interview with a semi-structured questionnaire was used to collect data from the participants' women, and then the birth weight was taken.

RESULTS

Of 187 delivered women, 20.3% had SCA (13% had sickle cell disease, and the remaining had sickle cell trait). Among the 38 affected mothers, 15.7% were considered to have an additional risk (7.9% had diabetes mellitus, 5.3% had hypertension, and 2.6% were smokers). The mean birth weight was 2.95 ± 0.40 kg and 2.99 ± 0.55 kg in the case and control groups, respectively. However, the low birth weight babies constitute 31% of the delivered babies in the SCA group with a weight of 2.33 ± 0.16 kg and 15% of the control group with a mean weight of 2.16 ± 0.30 kg. The gestational age was 39.36 ± 1.02 weeks in the SCA group compared to 39.5 ± 1.17 weeks in the control group. Maternal age and hypertension significantly influence the birth weight in the SCA group compared to the influence of diabetes mellitus on the birth weight in the control group.

CONCLUSION

This study indicates that SCA in pregnant mothers influences birth weight, which is more impacted by maternal age and co-morbidities. Therefore, a multidisciplinary approach must monitor these risky pregnancies well to avoid undesirable neonatal outcomes.

Prevalence and Pattern of Birth Defects in Saudi Arabia: A Systematic Review of Observational Studies

INTRODUCTION

Birth defects are a significant concern since they can lead to permanent disability and death. This study comprehensively reviews the prevalence and patterns of birth defects in Saudi Arabia.

METHODS

A systematic analysis of the literature retrieved from three databases (Pub Med, Science Direct, and the Saudi digital library) published between 1989 and 2022 was performed. Observational studies that addressed the prevalence and patterns of birth defects in Saudi Arabia were chosen based on the eligibility criteria, while systematic reviews, review articles, non-relevant articles, and studies that did not fulfill the eligibility criteria were excluded. Quality and risk of bias were evaluated based on the JBI and GRADE tools, respectively.

RESULTS

We identified 26 eligible publications of 1277 records that included 297,668 patients from different regions of Saudi Arabia. The highest overall prevalence of birth defects was 46.5 per 1000 live births compared to a lowest rate of 8.6 per 1000 in one study. Several studies have reported positive associations of consanguinity, maternal folic acid supplementation, family history of birth defects or genetic abnormalities, and maternal co-morbidities. The most frequent birth defects include cardiac, genitourinary, craniofacial, and nervous system defects.

CONCLUSION

Robust findings have improved our understanding of the prevalence and pattern of birth defects in Saudi Arabia. Importantly, future studies will likely require multicenter collaboration to arrive at appropriate sample sizes in the context of the effects of risk factors on elevated prevalence. Furthermore, quantitative data require careful evaluation in more complex statistical models.

Neonatal mortality contributors using the three delays audit: a study from Albuluk paediatrics teaching hospital in Sudan

 Background: In certain developing countries neonatal mortality rates still showed a slower decline. Many factors were attributed to neonatal mortality that varies from one country to another. This study investigated factors attributed to neonatal mortality in Sudan.Methods: Data was collected from 72 neonatal deaths records at Albuluk pediatrics' teaching hospital, and then it was analyzed using a modified three delays model to determine contributing delays.Results: 31.9% of neonatal mortality occurred on the first day after birth and 86.1% thereafter. Newborn characteristics showed that more than half of dead newborn were male and more than 80% admitted in the age of more than 2 days although there was 26% of involved newborn were preterm. About two third of deliveries were home deliveries and only 52% of the mothers were in regular antenatal care. The leading causes of death were sepsis and pneumonia in 83% followed by birth asphyxia in 11% of total neonatal mortality. Regarding the three delays audit; delay in decision making were present in 54.2% and that was due to inability of the mothers to recognize danger signs, delay in reaching the health care facility was present in 9.8% of the neonatal mortality, while delay in initiation of treatment in the healthcare facility was present in only 6.9%.Conclusions: Maternal knowledge of neonatal danger signs and decision to seek medical care is a major contributor for neonatal mortality in this study. Further efforts should be exerting to raise knowledge of the mothers about danger signs of neonatal illness.