Department of Pediatricshttp://ir.lib.ruh.ac.lk/xmlui/handle/iruor/74112024-03-28T19:27:38Z2024-03-28T19:27:38ZTHE PROFILE OF INFANTS WITH STRUCTURAL BIRTH DEFECTS IN GALLE, SRI LANKADe Silva, J.Amarasena, S.Jayaratne, K.Perera, B.http://ir.lib.ruh.ac.lk/xmlui/handle/iruor/129792023-11-28T04:27:07Z2022-02-01T00:00:00ZTHE PROFILE OF INFANTS WITH STRUCTURAL BIRTH DEFECTS IN GALLE, SRI LANKA
De Silva, J.; Amarasena, S.; Jayaratne, K.; Perera, B.
Birth defects among children has become a significant public health problem and
epidemiological profile of such cases is imperative to make health interventions.
Objective:
The aim was to find out the epidemiological profile of infants with non-genetic, structural birth
defects (SBD) in Galle, Sri Lanka.
Methods:
A hospital-based, descriptive cross-sectional study was carried out. Infants with SBD which
were not found to have a genetic basis, aged up to six months residing in Galle were studied.
Data on SBD, confirmed by a paediatrician were gathered from the available medical records.
Results:
Three-hundred and fifteen (315) infants with SBD were studied. One hundred and seventynine
(57%) were male infants. Fifty-six (18%) were born preterm. Eighty-one (26%) infants
had SBD found in multiple systems. A total of 620 SBD was reported. The majority were
cardiovascular (CVS) defects (n=398, 64%) followed by the musculoskeletal defects (n=56,
9%, skeletal 41, muscular 15) and central nervous system (CNS) defects (n=52, 8.4%). Thirty six (6%) oral-facial clefts, 30 (5%) gastrointestinal defects and 22 (3.5%) urinary tract defects were reported. The most common SBD of the CVS was ostium secondum atrial septal defect (OS II ASD)
(n=219, 55%). Isolated ASDs were found among 84 infants while the rest were presented with
other CVS defects or extra cardiac defects. The second and third commonest CVS defects were
patent ductus arteriosus (PDA) (n=79, 19.8%) and ventricular septal defect (VSD) (n=48,
12.1%) respectively.. The commonest CNS defect was congenital hydrocephalus (n=18,
34.6%) followed by spina bifida (n=11, 22.7%). There were three (n=3, 6%) encephaloceles
and one anencephaly (2%). Congenital talipes (n=23, 56%) was the commonest skeletal defect
reported while congenital defects of the diaphragm (n=11, 73%) were the commonest muscular
defects. Cleft hard and soft palate (n=13, 36%) with unilateral cleft-lip was the commonest
oral-facial cleft. Imperforate anus (n=11, 37%) and intestinal stenosis (n=10, 33%) were the
commonest gastrointestinal defects.
Conclusion:
Cardiovascular, musculoskeletal and central nervous system defects were the prevalent SBD
found in this sample. Health care delivery systems of Sri Lanka should prioritize and target
these conditions in prevention and management of birth defects
2022-02-01T00:00:00ZBody composition among Sri Lankan infants by 18O dilution method and the validity of anthropometric equations to predict body fat against 18O dilutionBandara, T.Hettiarachchi, M.Liyanage, ChandraniAmarasena, S.Wong, William Wai-Lunhttp://ir.lib.ruh.ac.lk/xmlui/handle/iruor/129782023-11-28T03:36:04Z2015-05-01T00:00:00ZBody composition among Sri Lankan infants by 18O dilution method and the validity of anthropometric equations to predict body fat against 18O dilution
Bandara, T.; Hettiarachchi, M.; Liyanage, Chandrani; Amarasena, S.; Wong, William Wai-Lun
Background: Body composition indicators provide a better guidance for growth and nutritional status of the
infants. This study was designed to (1) measure the body composition of the Sri Lankan infants using a reference
method, the 18O dilution method; (2) calculate the body fat content of the infants using published skinfold prediction
equations; and (3) evaluate the applicability of the skinfold equations to predict body fat among Sri Lankan infants
against the 18O dilutionmethod.
Methods: Twenty five healthy, exclusively breast-fed infants were randomly recruited at well-baby clinics, for this
cross-sectional study. Body composition was measured using 18O dilution. Infant body weight, length, skinfold
thicknesses and mid upper-arm circumference were measured using standard procedures. The Bland and Atlman
pair-wise comparison method was used to evaluate the agreement of body fat generated using the anthropometric
prediction equations against the 18O dilution values as the reference.
Results: Mean (SD) body weight and length of the infants were 6.5 kg (0.9) and 64.7 cm (2.8) respectively. Mean total
body water, fat free mass, fat mass and % fat mass as measured by 18O dilution method were 58.8% (5.0), 4.6 kg (0.8),
1.9 (0.5) and 29.5% (6.1). Total body water and fat free mass were significantly higher in boys when compared to girls.
With the exception of three prediction equations (Bandana et al., Goran et al. and Durnin and Wormsley), most of the
other commonly used anthropometry-based prediction equations yielded a bias which was not constant but a function
of the % fat mass.
Conclusions: Body composition of Sri Lankan infants is comparable to the normative data available from the
industrialized countries. Most of the commonly used anthropometric prediction equations generated a bias which
varies with the size of the body fat. Only three prediction equations (Bandana, Goran, Durnin & Wormsley) yield a
constant bias. The Durnin & Wormsely equation showed the smallest bias when compared to the 18O dilution values
with the narrowest limits of agreement. Accuracy of some of the prediction equations is a function of gender.
2015-05-01T00:00:00ZPREVALENCE OF NEONATAL COMPLICATIONS AMONG INFANTS WITH STRUCTURAL BIRTH DEFECTS IN GALLE, SRI LANKADe Silva, J.Amarasena, S.Jayaratne, K.Perera, B.http://ir.lib.ruh.ac.lk/xmlui/handle/iruor/129752023-06-05T05:19:43Z2022-02-01T00:00:00ZPREVALENCE OF NEONATAL COMPLICATIONS AMONG INFANTS WITH STRUCTURAL BIRTH DEFECTS IN GALLE, SRI LANKA
De Silva, J.; Amarasena, S.; Jayaratne, K.; Perera, B.
Introduction:
Birth defects in children are considered as a significant risk factor of stillbirths, perinatal deaths
and neonatal, infant and childhood morbidity and mortality.
Objectives:
The objective of this study was to describe the prevalence of neonatal complications in infants
with non-genetic or non-syndromic structural birth defects (SBD) in Galle, Sri Lanka.
Methods:
A hospital-based descriptive cross-sectional study was carried out by examining 315 liveborn
infants with SBD aged up to six months of age. Neonatal complications were examined using
the medical records of the infants. Descriptive statistics were used to present data.
Results:
The sample consisted of 179 (57%) male infants. One infant had ambiguous genitalia. Fiftysix
(17%) infants were born preterm (32-36 weeks: n=40, 71%; 28-31 weeks: n=12, 22%,
<27weeks: n=4, 7%). Low birth weight was observed in 102 (32.4%) infants.
Cardiovascular defects (n=398, 64%), musculoskeletal defects (n=56, 9%) and central nervous
system defects (n=52, 8.4%) were the commonest SBDs.
2022-02-01T00:00:00ZOutcomes of infants with structural birth defects in Galle, Sri LankaDe Silva, J.Amarasena, S.Jayaratne, KapilaPerera, B.http://ir.lib.ruh.ac.lk/xmlui/handle/iruor/129702023-11-22T03:49:08Z2020-02-01T00:00:00ZOutcomes of infants with structural birth defects in Galle, Sri Lanka
De Silva, J.; Amarasena, S.; Jayaratne, Kapila; Perera, B.
Birth defects are a significant health problem among children. The outcomes of structural birth defects (SBD) vary owing to the severity of the defect and availability of the management options. Outcomes of children with SBD is vital to identify the severity of the problem, to make policies and to allocate services to manage SBD.
Methods:
A prospective longitudinal follow-up study was carried out to follow-up 620 SBD in a sample of 315 infants during their infancy. They were not diagnosed with any genetic syndrome. At the end of the first year of life the outcomes of the infants and the outcomes of the SBD were evaluated. The infant outcomes were measured as alive or dead. The outcomes of the SBD were measured as completely corrected, partially corrected (residual defect or residual impairment present) and uncorrected. Data were analyzed using SPSS version 20.
Results:
There were 179(56.8%) male infants. Fifty six (17.8%) were preterm. Three (1%) infants and 6(1%) SBD were lost to follow-up. The commonest defects were the cardiovascular (CVS) defects (n=398, 64.2%) followed by the central nervous system defects (n=52, 8.4%). The commonest CVS defects were atrial septal defect (ASD) (n=219), patent ductus arteriosus (PDA) (n=79) and ventricular septal defect (VSD) (n=48).
Forty-four (14%) infants died during infancy. They had a total of 141 defects and 79 out of them were lethal. The most common lethal defects were the CVS defects (n=44, 55.7%) followed by CNS defects (n=13, 16.4%). Among the 473 SBD found among live infants 134(28.3%), 71(15.0% and 268(56.6%) were completely corrected, partially corrected and uncorrected respectively. Among the completely corrected defects 77 were resolved spontaneously (including 43 ASD, 6 VSD, 24 PDA) and the rest were managed surgically (n=55) and medically (n=2). Among the infants diagnosed with CVS defects needing surgical correction (n=35), 23 underwent surgery and 5 of them died. Three infants among the rest of the 12 infants, died while awaiting surgery.
2020-02-01T00:00:00Z