Day 2 :
Keynote Forum
Tan Guan Hao
KK Women’s and Children’s Hospital, Singapore
Keynote: KidSTART – Singapore’s approach towards a community-based, family centered paediatric care
Time : 9:00 to 9:45
Biography:
I have been working in the Department of General Paediatrics in KK Women’s and Children’s Hospital, Singapore, since 2007, with keen interest in general paediatric patient care, and both undergraduate and postgraduate education.
At present, I am also involved in KidSTART, a pilot collaboration between Early Childhood Development Agency (ECDA) and KK Women’s and Children’s Hospital aiming to help disadvantaged families and children by identifying early developmental issues, growth delays, maternal mental health issues. Through early interventions, the pilot project hopes to achieve better integration of such families into the community agencies, rectifying paediatric growth and developmental delays through counselling and referral to tertiary institutions, to ensure good outcomes for them.
Abstract:
Community Paediatrics is a recognized subspecialty overseas, and is a relatively new concept in Singapore. The American Academy of Pediatrics (AAP) defines it as the philosophy of delivery of child health care with the principles of high accessibility, holistic vision, collaboration with parents, interagency care and teamwork, advocacy directed at the needs of all children, and a preventive orientation. It synthesizes clinical practice with public health principles directed towards providing optimal health care to a given child within the context of the family, school, and community.
Research has also shown that experiences in a child’s early years can significantly influence his/her physical, cognitive and social development. In particular, children from vulnerable circumstances may face developmental challenges compared to their peers. On the other hand, a stronger parent-child relationship and holistic early childhood development can bring about positive impact on the child’s lifelong outcomes and narrow the developmental gaps.
KidSTART is a pilot program which aims to provide support and create a conducive environment for learning and development for Singaporean children from economically disadvantaged families. The components include a home visitation programme, a supported playgroup programme and enhanced support to pre-schools. Children from eligible families can attend one or more of these components. Through these interventions, KidSTART hopes to ensure that children benefit from warm and nurturing relationships, age-appropriate and holistic child development, and a safe and secure home environment to grow up in. For home visitation, each at-risk expectant mother and her child will be given integrated support in the domains of health, child development and social services.
In summary, there is a need to give children from these families in Singapore a good start in life. The programme is currently at the pilot stage. The creation of an integrated sustainable working model will allow for future up-scaling of such model across the entire country.
Keynote Forum
Lourdes Mary Daniel
KK Women’s and Children’s Hospital, Singapore
Keynote: Poverty, development and the brain
Biography:
Lourdes Mary Daniel has been a Pediatrician in Singapore and a full-time Neonatologist. She is currently working as the Head of the Department of Child Development in KK Women’s and Children’s Hospital. She has received her Child Development training at the Kennedy Krieger Institute in Johns Hopkins Hospital, Boston Children’s Hospital and the Harvard Graduate School of Education in USA.
Abstract:
Children in poverty have worse cognitive, socio-behavioral and health outcomes than their more affluent peers. Poverty affects the brain in 4 main ways: Language and reading, memory, Executive Functions (EF) and socio-emotional processing. Numerous studies have demonstrated differences in brain structure and function between children from high and low socio-economic status. Income and total hippocampal gray matter, which are important for learning and memory, have been shown to be correlated, as well as frontal and prefrontal regions which affect emotion and stress. Poor cognitive and academic performance among children in poverty has been shown to be mediated by a small hippocampus and frontal and temporal lobes, with the decrease in the latter 2 areas explaining as much as 15-20% of the achievement deficits. The relationship between poverty and the brain has been shown to be logarithmic and not linear. Income related, most strongly to brain structure among the most disadvantaged children with the effect seen as early as 6-9 months of age. Children’s EF skills have been shown to be robustly predicted by chronic exposure to poverty and the associated environmental hazards. In adults, EF skills (which start developing in childhood) are core capabilities that are important for managing life, work and effective parenting. Bridging the achievement gap between children of low socio-economic status and their more affluent peers requires co-ordinated public policy measures. This is a huge challenge, but addressing it is necessary to protect these children from the long-term effects of poverty. This talk will also summarize the effects of various intervention programs.
- General Pediatrics | Child Abuse and Neglect | Pediatric Critical care and Emergency medicine
Session Introduction
JingHui Yang
KK Women’s and Children’s Hospital, Singapore
Title: Integrated Health and Social Service delivery using Trans-disciplinary approach in the prevention of child abuse and neglect, the Singapore Model
Biography:
Dr Yang JH graduated from NUS with an MBBS in 2005, and continued to pursue her passion in Paediatrics with various rotations in KKH and SGH. She completed her specialty training in Paediatrics in June 2014. She won the “Best Houseman Award” for her posting in General Surgery, CGH in 2006 and the “Singhealth Service from the Heart Silver Award” for her work in KKH in 2012 and 2016. She is currently working as a consultant in the Department of General and Ambulatory Paediatrics. She is also contributing to the Kids Integrated Development Service (KIDS 0-3). This is a programme aimed at equipping mothers and children from vulnerable families to have the knowledge and skills for a good start in early childhood. This is in partnership with the Early Childhood Development Agency, Ministry of Social and Family Development, under the kidSTART programme. The journey with KIDS 0-3 has ignited an interest in early childhood development and community paediatrics. The exposure has given her an insight into how we can fashion our paediatric landscape, with good partnership with our primary care providers, as well as the early childhood professionals. She looks forward to greater collaboration, with a view to develop community paediatrics in Singapore.
Abstract:
Adverse Childhood Experiences (ACES) are known to impact child health and development as well as future adult health. Kids Integrated Development Service 0-3(KIDS0-3) is a pilot preventive early intervention program to mitigate impact of ACES from pregnancy till the child turns 3 years old. The program aims to deliver an integrated health and social home visiting program through a transdisciplinary key-worker model( Fig 1).The key worker is the point of contact in equipping families with skills in parent-child interaction, monitors child health and development and to detect early signs of child neglect. Standardized tools are used for screening of maternal mental health and monitoring of child’s developmental progress. The target populations are low income families with multiple risk factors
Families risk factors are assessed by the Family Advocacy and Support Tool (FAST) and ACES check-list that helps communicate the complexity of the families. After which, a team of professionals comprising paediatricians, social workers, nurses, community health visitors and allied health professionals support the key worker in the transdisciplinary skills. The trans-disciplinary skilled worker is well placed to detect the presence of early signs of infant emotional and physical neglect. KIDS 0-3 collaborate with Child Protection Services (CPS) in using a common tool, Sector Specific Screening Guide (SSSG) and Child Abuse Reporting Guide (CARG) for assessing risk factors in the family environment. By applying this tool, CPS is able to take appropriate action and work with the KIDS0-3 team or community supporting agencies to step up infant protection strategies. In this paper, we illustrate how an integrated Health and Social service for families at risk of neglect and abuse is implemented through a Transdisciplinary key worker approach. To ensure the healthy development of our future generation, the Paediatricians need to understand the social determinant of health factors and skills to practice preventive medicine and advocacy.
M R Savitha
Mysore Medical College and Research Institute, India
Title: The study of lipid profile and other cardiovascular risk factors in children born to parents having premature ischemic heart disease
Biography:
M R Savitha is currently working as Professor of Pediatrics at the Department of Pediatrics of Mysore Medical College and Research Institute, Mysore, India. She has 22 years of experience in the field of pediatrics. She has published 39 papers in various national and international journals. She has presented 41 papers in various states, national and international conferences. Her field of interest is allergy and asthma in children and lipid profile in children
Abstract:
Objectives: To study lipid profile and other cardiovascular risk factors like hypertensive status, BMI in children aged between 5 years and 18 years born to parents having premature IHD, to study diet and life style factors in study group having family history of IHD and to study the socio-demographic profile of dyslipidemia.
Methods: Lipid profile and other cardiovascular risk factors were studied in 200 children with family history of premature IHD and compared to 200 children without family history of IHD.
Results: Amongst the cases there were 130 males and 70 females (M:F=1.8:1) as compared to 103 males and 97 females amongst controls (M:F=1.06:1).On comparison of mean lipid profile between cases and controls, HDL cholesterol was very low amongst cases as compared to controls (p=0.001). The triglycerides and VLDL were very high amongst cases as compared to controls (p=0.001). The atherosclerotic index which was determined by TC/HDL was high among cases as compared to controls (p=0.001). However there was no statistically significant difference between cases and controls as far as total cholesterol (p=0.089) and LDL cholesterol were concerned (p=0.105). Dyslipidemia was more evident after 10 years of age and also more evident in boys than girls. More number of cases had prehypertension and hypertension (p=0.004), excess junk food intake (p=0.001), sedentary lifestyle (p=0.001). 20.5% of cases had family history of IHD apart from parents. Except for increased BMI (p=0.016) there was no increased dyslipidemia in this group as compared to those without multiple family history of IHD.
Conclusion: Children of premature ischemic heart disease patients have significant incidence of dyslipidemia and risk factors like elevated BMI, excess junk food intake and sedentary life style with increased incidence of pre hypertension and hypertension.
Udayani Prabha Kumari
Ministry Of Health, Sri Lanka
Title: The prevalence of undernurition and associated factors among children aged one to five years in a rural area in Sri Lanka
Biography:
Abstract:
Introduction
High prevalence of child undernutrition is a well-known issue in rural areas. The objective of this study was to describe the prevalence and associated factors among children aged 1-5 years in Siyambalanduwa MOH area in Moneragala District.
Methods
A community based cross-sectional study was conducted among 421 child-mother pairs in Siyambalanduwa MOH area using two stage cluster sampling method with a cluster size of 36. Children of mothers who cannot communicate in Sinhala were excluded. Data were collected by pre tested interviewer administered questionnaire and conducting anthropometric measurements according to WHO guidelines. Statistical analysis was done using SPSS 20. The chi-square test was used, and P<0.05 was considered for statistically significant.
Results
Overall 41% of children aged 1-5 years were undernourished in Siyambalanduwa MOH area. Among the study subjects 24% were underweight, 25.7% were stunted, 16.4% were wasted,9.2% were both underweight &stunted, 6.8% were both, underweight & wasted ,0.5% were both, stunted & wasted and 9.9% were underweight & stunted &wasted. Only the low total monthly income (P<0.001) and low birth weight (P<0.001) were significantly associated with child undernutrition. Among parents or caregivers 18.6% had good knowledge, 35.6% had favorable attitudes and 12.6% had good practices related to child nutrition. None of the above three factors were significantly associated with child undernutrition.
Conclusions and recommendations
Prevalence of undernutrition among children aged 1-5 years is high and urgent efforts to reduce undernutrition should be a priority.Future studies should focus on assessing how to reduce the burden with low cost appropriate interventions.
Zahrah Khimani
Uraan – Paediatric Therapy Services, Pakistan
Title: Cognitive Insights into ADHD: Exploring the Relationship Between ADHD, Parent’s/School’s Knowledge, Dysfunctional Expectations and Beliefs, and Stigmatization in Pakistan
Biography:
Zahrah Khimani has completed her MSc in Clinical Neuropsychology from University of Bangor, UK. She is Master Neuro Linguistic Practitioner - Licensed (USA) and Specialised in Cognitive Behaviour Therapy (USA). At present she is working as a Senior Behaviour Therapist at Aga Khan University Hospital and Senior Clinical Psychologist at Karachi Vocational Training Centre. She ia also working as A-Level Psychology Faculty at Foundation Public School. She is the founder and and CEO of URAAN-Paediatric Therapy Services
Abstract:
Objective: In Pakistan, there is an extreme dearth of awareness about the developmental needs of children, especially those suffering with ADHD is sorely lacking. A comprehensive analysis of the published empirical research literature of Pakistan demonstrates that no studies so far have been conducted on the significance of parents and teachers knowledge of ADHD. This study is an initial step to create awareness and tolerance for all those children who are different. The primary purpose of this study is to explore the existing knowledge and understanding (if any) of parents and teachers about ADHD. Moreover to inquire, how their cognition and belief towards mental health services for ADHD influences their decision to seek psychological assistance and medical help for their child’s treatment.
Methods: Purposive sampling technique was used to select primary students (6-8 years) from lower middle class schools from three different towns of Karachi, Pakistan. Ten Focus group interviews were conducted to collect data from 150 (semi-literate) parents and teachers (untrained).
Findings: The findings of the study shows cognitive dysfunction of parents due to stigmatization of learning disabilities, societal pressure and rigid thinking (tunnel vision). There is a 2:1 ratio proportion of fathers & mother in laws hindering the treatment as compared to the mother. 80% of the mothers in the focus group outlined/suggested lack of decision making (especially in case of children) in a male dominant society. Moreover, mothers attributed lack of guidance/professional help/inclusive schools in Pakistan as compared to the west (developed nations) where ADHD treatment is much more common. While 45% of the fathers attributed lack of finances and overload of responsibilities. This concludes that parents disregard the needs of their child over societal needs.
Biography:
Manmeet Kaur is currently working as an Assistant Professor (Pediatrics) in Chitkara School of Health Sciences, Chitkara University, Punjab, India. She is currently perusing her PhD (Autistic Spectrum Disorder) in Health Sciences from the same organization. She has published in total 6 research articles in international journals. Also, she presented her 2 posters in 10th World Pediatric Congress 2017 held in Dubai, United Arab Emirates and 1 poster nationally. Her title registration form has been selected by the Campbell Collaborations, Norway and the project entitles “Interpersonal Psychotherapy for reducing symptom severity in Post-Partum Depression: A systematic Review which will be completed along with the expert team
Abstract:
Pregnancy is a time period from conception to a birth in which the egg is implanted in the uterus which develops into placenta and embryo and later into fetus. The life of fetus and physiological changes depends upon the transition from intrauterine life to extra uterine life which occurs after the birth. Placenta plays an important role in between the mother and fetus and enables respiratory gas exchange, transports nutrients, eliminates fetal waste products, and secretes peptide and steroid hormones. Amniotic fluid surrounds the unborn baby in womb and acts as a cushion to protect fetus from injury and push fluid out of lungs. After birth the fluid isn’t completely expelled out from the lungs due to which lungs unable work properly further leading to lack of oxygen in new-born. Due to inability to combat with vascular resistance and maintained respiratory exchange new-born resuscitation is required. About 10% of new-born requires resuscitation at birth to breath and less than 1% will require extensive resuscitation. Since, the health care providers play an important role in implementing the steps of Neonatal Resuscitation among the babies in a serious need to be resuscitated, the aim of the study is to assess the effectiveness of hands on training on the knowledge and practice regarding Neonatal Resuscitation Program among the Health care providers in the selected institute rendering Bachelor’s educational facilities. The major objectives of the pre-experimental study was to assess the level of knowledge ,mean pre-test and post-test knowledge and practice scores before and after hands on training and to find out the association of selected demographic variables with knowledge and practice scores on Neonatal Resuscitation Program among the health care providers. The study findings revealed that the mean post-test knowledge and practice scores were relatively higher than the mean pre-test knowledge and practice scores. Thus, the hands on training session of knowledge and practice on Neonatal Resuscitation Program was proved to be effective in improving overall knowledge and practice among the Health care providers.
Christina Oldfield
University of Colorado Health, USA
Title: Pediatric Differential Diagnosis: Is It Abuse or Not?
Biography:
Christina has been a nurse for nine years with an extensive background in the intensive care unit. Christina continued her journey in the forensic field in 2011 where she is now serving as the clinical team lead for the program. The program where she works sees over 1800 patients yearly. Christina has performed over 1000 exams on patients impacted by violence. She has taught at the State level for communities and provided over 75 educational classes for forensic nursing. Christina has also taught at the International level and taught in 3 sessions at the Colorado convention for the IAFN in 2016. Christina instructs the Colorado skills labs for new SANEs and has run the Indian health services clinical labs. Christina was the previous Colorado Chapter president of the IAFN in 2013 and has received the Ted T Lewis award in 2016 for her work done in the community. Christina sits on the elder abuse committee, along with the District 49 Academy of Health Sciences Advisory Committee. She is also actively involved in the community outreach programs. Christina will graduate in the spring of 2018 with her Bachelor’s degree and plans on continuing her education for her Masters.
Abstract:
Each year more than 3.6 reports are made of child abuse. On an average of 4-6 children die every day from child abuse or neglect. Children in their first year of their life have the highest rate of victimization. Four out of five abusers are the children’s parents. . Violence is a healthcare issue. Knowing how to accurately screen for abuse and recognize the red flags that increase abuse in the home can help save a child’s life. This presentation will go over the signs and symptoms of abuse along with the lack of visible injury seen with child abuse and neglect.
On average 20 people per minute are physically abused by an intimate partner. 1 in 3 women and 1 in 4 men have been victims of some sort of violence in their lifetime. Addressing the Danger Assessment tool and educating the lethality with the patient on the situation can assist with safety planning. Being able to recognize the signs and symptoms of abuse and addressing it in a sensitive appropriate way can assist with disclosure. Children that witness intimate partner violence are more susceptible to be victimized as an adult along with multiple negative health consequences. This portion of the presentation will allow for the audience to be able to verbalize the signs/symptoms along with the lack of signs of intimate partner violence. This will also show the correlation of being in a stressful environment and how this may affect the child’s future. The Adverse Childhood Experiences will be discussed along with case studies on actual patients that were seen in the hospital.
Narges Gholami
Shahid Beheshti University of Medical Sciences, Iran
Title: Lead poisoning in pediatrics in Loghman Hakim Hospital, Tehran, Iran.
Biography:
Narges Gholami is Pediatrician, Assistant professor of pediatrics, Loghman Hakim Hospital, Shahid Beheshti University of medical sciences, Tehran, Iran.
Abstract:
Phani krishna
AJ Institute of Medical Sciences, India
Title: Serial Estimation of the Severity of Multiple Organ Dysfunction Syndrome in Critically ill Children by Using Pelod – 2 Score
Biography:
He has been working as a Junior Resident in department of Pediatrics at AJ Institute of Medical Sciences, Mangalore India.
Abstract:
Aim and Objectives of the study:
To Validate the daily PELOD-2 score using the set of seven days as predictors of PICU death.
Material and methods:
Source of data : Prospective, Observational, Analytical, Cross sectional Design Patients admitted to the PICU of AJIMS, Mangalore from November 2015- November 2017 are considered.
All patients fulfilling the inclusion criteria will be included as study subjects after obtaining informed consent. PELOD-2 score will be used to predict the outcome of the patients.
This includes 11 variables as mentioned in below table. Patients baseline characteristics and calculated PELOD-2 score at days 1, 2, 5, 8, 12, 16 and 18 in PICU.
For each variable, the most abnormal value each day was used in calculating the PELOD-2 score.
Organ dysfunction was defined as a PELOD-2 score >0 for a given organ, and MODS as the simultaneous presence of two or more organ dysfunctions The PICU discharge status (death/survival) was used as the outcome dependent variable.
RESULTS :
A total of 106 children were analyzed. 52.8% patients survived and 47.2% expired. The overall mortality rate was 47.2 %. 66 were males, accounting for 62% and 40 were females, accounting for 38%. The male to female ratio was 1.6:1. Major cases had nervous system involvement., i.e.,43%, among which 48.8% expired and 51.2% survived. The next common system involvement was respiratory (31%) followed by cardiovascular (21%).71 patients had a score of >20 on day 1(i.e., day of admission),48 patients had a score of >20 on day 2, 26 patients on day 5, 15 patients on day 8 and 7 patients on day 12., and it correlated with the mortality (p <0.001). 90% cases where 4 organ systems were involved expired, as compared to only 4.8 % when it was single organ involvement.,confirming that mortality is directly proportional to the number of organ systems involved.
PELOD score of >20 was associated with higher mortality rate, being 60.6% (p=0.001).81.8% of the patients with a score of <10 survived in our study.
The correlation between high PELOD scores on admission and also high mortality was obtained and it was statistically significant . (p=0.001).
CONCLUSION:
The PELOD-2 scores increased significantly with increase in organ involvement.The best indicators of poor outcome in our study were number of organ dysfunction and PELOD-2 score.
Eng. Faisal Ashour
King Saud bin Abdulaziz University for Health Sciences, Saudi Arabia
Title: Virtual Reality (VR) Technology in the Absence of General Anaesthesia during Radiotherapy Procedure for Paediatric Oncology Patients
Biography:
Abstract:
VR is a three-dimensional (3D) computer-generated environment that enables the user to explore and interact within a different environmental perspective. It could be in the form of a realistic-artificial environment or a 3D imaging that is presented to the user as a real atmosphere with made-up information. The VR has-been considered as a non-pharmacologic form of analgesia through exerting attention processes on the body’s intricate pain system. It does so through profoundly immersing the body and mind by delivering enough sensory information to the extent where it suspense any disbelief that one is in a virtual environment. The aim of the study is to eliminate the General Anaesthesia (GA) procedure used on paediatric oncology patients undergoing multiple fractions of Radiotherapy. We aimed to utilise the VR technology as a replacement for the GA. Typically, the radiotherapy session under GA takes around 30 minutes from the machine time and that session can be repeated daily for several weeks. As a result, VR Technology was an excellent alternative in most of the patients treated with radiotherapy for non-Head/Brain Tumours. There were significant reductions on the number of the GA sessions. That reductions have a great impact on reducing side effect of GA and save more time on the Radiotherapy machine that can be used to treat more patients.
Biography:
Dr. Anita Patil has 20 year experience of working on children health and wellbeing. Looking after the health issues of the school going children, started working on the preventive aspects of the childhood obesity. She has formed the strategy plans in schools program to control the child obesity like healthy eating habits, physical activities etc. This preventive program also include yearly screening of the school going children to rule out overweight-obesity.
Abstract:
Statement of problem: Prevalence of childhood obesity has risen globally in recent years. Some studies like International Association for the Study of Obesity (IASO) and International Obesity Task Force (IOTF) have documented childhood obesity prevalence rate and its trend based on data of six countries. There is lack of national representative data on childhood obesity for India. However, nationally representing studies like Indian Academy of Pediatrics (IAP) have studied adolescent population in few thousand (n=87022). We attempted to find prevalence of overweight and obesity based on national registry data (District Level Household Survey). Also to find overweight children falling between 85th-95th percentile and obese >95th percentile of BMI in studied population.
Methodology & Theoretical Orientation: All children (5-8 Years) and adolescents (9-18 Years) from District Level Household Survey with valid records of height, weight, age and sex and locality were selected. BMI using Age and Sex of an individual were compared with standard growth charts recommended by IAP. BMI-Z score were calculated and compared with standard values and accordingly each individual were tagged as Severely-underweight, Underweight, Normal-weight, Overweight and Obese. Based on overall data, age-sex specific BMI percentile values were calculated for 3rd, 5th, 85th and 95th. Proportion of overweight and obese children across each state is represented using ArcGIS 2.0.
Findings: 255614 children data of 20 states from India were studied. 15% children and adolescents were found overweight and obese. Age wise decreasing pattern was seen in obesity, 17% obesity for 5 years to 13% in 18 years. Gender wise no significant difference was seen. Prevalence of obesity is seen high in some of southern states compared to eastern states.
Conclusion & Significance: Prevalence of obesity and overweight is found higher in urban than rural region. Higher obese-overweight prevalence adolescent were found in states like Goa, Kerala and Pondicherry.
Maged El Wakeel
National Research Centre, Egypt
Title: A Novel Predictor of Obesity-Related Complications in Children
Biography:
Dr/ Maged A. El Wakeel has completed his PhD in childhood studies at the age of 33 years from Ain-Shams University and was promoted to associate professor position at The National Research Centre, Cairo, Egypt. He has published more than 15 papers in reputed journals and has been serving as an reviewer in other journals.
Abstract:
Background and Aim: The rapidly increasing prevalence of childhood obesity has become a major burden on health worldwide, giving an alarm to healthcare clinicians and researchers. Adipocytes act as an active endocrine organ by releasing a plenty of bioactive mediators (adipokines) that play a vital role in regulating metabolic processes. Apelin is a newly discovered adipokine that is expressed in adipocytes. The present work aimed to study the association between serum apelin and childhood obesity and its related complications as hypertension and hyperglycemia
Method: 50 obese and 45 non-obese age- and sex-matched children were enrolled in our study with mean age of (9.5±2.1) and (8.7±1.3) respectively. Anthropometric measurements, blood pressure were assessed in all studied participants, we also determined the lipid profile, serum insulin, fasting blood glucose (FBG) level, HOMA-IR and serum apelin.
Results: Obese children had higher levels of FBG, HbA1c, serum insulin, HOMA-IR, triglycerides, total cholesterol, and low-density lipoprotein (LDL) and diastolic blood pressure (DBP Z-score); compared to controls (all p<0.05). Apelin was significantly higher in obese children versus controls and correlated positively with BMI Z-Score (p=0.008), DBP Z-Score (P= 0.02), cholesterol, TG (both p= 0.02), serum insulin (p=0.003), FBG and HOMA-IR (both p=0.001). Linear regression analysis showed that FBG was the most effective factor predicting the level of serum apelin (p=0.04)
Conclusion: This work supports the hypothesis that apelin may have a pivotal role in the pathogenesis of obesity-related complications in children including hypertension and insulin resistance and a higher risk of occurrence of metabolic syndrome.
Rania Nabil Sabry
National Research Centre, Egypt
Title: Urinary Bisphenol-A: its relation to food intake and packaging in Egyptian Children
Biography:
I am graduated from faculty of medicine, Cairo University in 1997, had PHD in child health and nutrition from faculty of postgraduate childhood studies in 2010, now I am associate professor , child Health Department, National Research Centre, Egypt.
Abstract:
Introduction: Bisphenol A (BPA) is a high production volume industrial chemical used in manufacturing of polycarbonate and other plastic products and epoxy resin that line food can. The aim of this study is to analyse whether increased consumption and packaging of different food types in a sample of Egyptian children will be associated with higher urinary levels of BPA or not. Subjects and methods: A random sample of 305 children and adolescents from 2-18 years old of different social levels were included. Three public and two private Egyptian Schools were chosen using a list of random numbers. Forty nine preschoolers were enrolled in the study. Personal history as well as anthropometric measurements including: weight, height, waist & hip circumference were taken. BMI was calculated. Urine samples were collected from 297 children and adolescents. Urinary BPA, was categorized into quartiles (<1.3 ng/mL, 1.3–< 2.6 ng/mL, 2.6–4.9ng/mL, >4.9 ng/mL). Results: Higher BPA levels were found in elder children ≥12 years (p=0.01). Increased different food types consumption or food packaging is not associated with increased urinary BPA levels. Chips consumption only is significantly associated with increased urinary BPA levels (p=0.046). There is no significant relationship between water usage or storage and urinary BPA levels. Conclusion: Food consumption have no effect on urinary BPA levels except for chips. Keywords: urinary BPA, food consumption, Egyptian children.
Teh-Ming Wang
Taichung-Veterans General Hospital, Taiwan
Title: Pulmonary Interstitial Emphysema in Newborn Infants
Biography:
A 30-year experienced physician is now specializing in neonatal & pediatric intensive care, neonatal and pediatric respiratory care.
Abstract:
Objective: Pulmonary interstitial emphysema (PIE) is a serious complication of mechanical ventilation and more frequent seen in PT babies with RDS. There is no standard treatment. Here, we reported 14 NB infants who had radiological evidence of PIE in a 4-year period and stress the effect of gentle mechanical ventilation. Method: This is a retrospective study. Total 14 NB were enrolled from Jan, 2012 to Dec, 2015 in our NICU. Aggressively reduced MAP to keep PaO2 around 45-60 mmHg and PaCO2 50-70 mmHg, as long as PH>7.25 within 24-72 hrs after PIE appeared on CxR. Other treatment modalities such as recruitment with Neopuff, on prong position and early extubation were also applied. If patients couldn’t tolerate the conventional ventilator, we switched to HFOV support.
Results: Collected radiological finding of PIE, including 11 PT babies mechanical-ventilated for RDS (78.6%) and 3 FT babies with the diagnosed of MAS (14.3%) or congenital pneumonia (7.1%). The average GA I 29.8±5.5 wks (24-39), and the average BBW is 1644.6±1088.2 gm (640-3675). PIE onset time: within the 1st 10 days of life, and 9 of 14 (64.3%) occurred within the 1st 3 days. There are 3 (21.4%) unil. PIE cases, and other 9 are bil.. Otherwise, 9 cases (64.3%) had concurrent other air-leaks such as pneumothorax and pneumomediastinum. When the PIE occurred, 3 infants were treated with NIPPV, and other 9 infants received intubation under conventional ventilator or HFOV support. The mortality rate was 21.4% (one died from NEC with perforation and two expired due to large PDA with massive pulmonary hemorrhage). All survival cases had complete radiological resolution of PIE and experienced successful extubation. Conclusions: Eearly detection of PIE, all patients could be extubated with complete radiographic resolution under gentle mechanical ventilation support. Further studies with larger sample size are needed.
2 Speaker slots are available. Please contact us at pediatriccongress@pediatricsconferences.org
Biography:
Manmeet Kaur is currently working as an Assistant Professor (Pediatrics) in Chitkara School of Health Sciences, Chitkara University, Punjab, India. She is currently perusing her PhD (Autistic Spectrum Disorder) in Health Sciences from the same organization. She has published in total 6 research articles in international journals. Also, she presented her 2 posters in 10th World Pediatric Congress 2017 held in Dubai, United Arab Emirates and 1 poster nationally. Her title registration form has been selected by the Campbell Collaborations, Norway and the project entitles “Interpersonal Psychotherapy for reducing symptom severity in Post-Partum Depression: A systematic Review which will be completed along with the expert team
Abstract:
Pregnancy is a time period from conception to a birth in which the egg is implanted in the uterus which develops into placenta and embryo and later into fetus. The life of fetus and physiological changes depends upon the transition from intrauterine life to extra uterine life which occurs after the birth. Placenta plays an important role in between the mother and fetus and enables respiratory gas exchange, transports nutrients, eliminates fetal waste products, and secretes peptide and steroid hormones. Amniotic fluid surrounds the unborn baby in womb and acts as a cushion to protect fetus from injury and push fluid out of lungs. After birth the fluid isn’t completely expelled out from the lungs due to which lungs unable work properly further leading to lack of oxygen in new-born. Due to inability to combat with vascular resistance and maintained respiratory exchange new-born resuscitation is required. About 10% of new-born requires resuscitation at birth to breath and less than 1% will require extensive resuscitation. Since, the health care providers play an important role in implementing the steps of Neonatal Resuscitation among the babies in a serious need to be resuscitated, the aim of the study is to assess the effectiveness of hands on training on the knowledge and practice regarding Neonatal Resuscitation Program among the Health care providers in the selected institute rendering Bachelor’s educational facilities. The major objectives of the pre-experimental study was to assess the level of knowledge ,mean pre-test and post-test knowledge and practice scores before and after hands on training and to find out the association of selected demographic variables with knowledge and practice scores on Neonatal Resuscitation Program among the health care providers. The study findings revealed that the mean post-test knowledge and practice scores were relatively higher than the mean pre-test knowledge and practice scores. Thus, the hands on training session of knowledge and practice on Neonatal Resuscitation Program was proved to be effective in improving overall knowledge and practice among the Health care providers.
- General Pediatrics | Pediatric Nutrition and Obesity | Pediatric Psychology | Neonatology | Pediatric Infectious diseases
Session Introduction
Mohammad Monir Hossain
Bangladesh Institute of Child Health & Dhaka Shishu Hospital
Title: Cause Specific Management of Shock in Neonate
Biography:
Abstract:
Shock is characterized by inadequate oxygen delivery to tissues to meet demand because of circulatory failure. The immediate aim of management of neonatal shock is to optimize perfusion and delivery of oxygen and nutrients to the tissues. Understanding the pathophysiology of neonatal shock helps to recognize and classify shock in the early compensated phase and initiate appropriate treatment. Hypovolemic shock in neonate is usually due to antepartum hemorrhage, post-natal blood loss iatrogenic, or secondary to disseminated intravascular coagulation or vitamin K deficiency, or excessive insensible water loss in extreme pre-terms. Cardiogenic shock in the neonate may be caused by myocardial ischemia due to severe intra-partum asphyxia, arrhythmias, primary structural heart disease, mechanical reduction of cardiac function or venous return secondary to tension pneumothorax or diaphragmatic hernia and disturbance of transitional circulation due to persistent pulmonary hypertension in newborn, or patent ductus arteriosus in premature infants. Distributive shock caused by Neonatal sepsis, vasodilation, myocardial depression, or endothelial injury and obstructive shock is caused from tension pneumothorax or cardiac tamponade. The immediate aim of management of neonatal shock is to optimize perfusion and delivery of oxygen and nutrients to the tissues. The American College of Critical Care Medicine estimates that 60 min is the average time needed to provide adequate circulatory support and block the development of shock. The first step in managing shock in the newborn during the first 5 minutes is to recognize cyanosis, respiratory distress and decreased perfusion. This should be followed immediately by airway access and ventilation to optimise oxygenation. Rapid peripheral, central venous, or intraosseus access is of primary importance in the initial management of the newborn in shock. Any baby with shock and hepatomegaly, cyanosis or a pressure gap between upper and lower limbs should be treated with prostaglandin within 10 min of birth until congenital heart disease is excluded. Inotropes like dopamine, dobutamine, epinephrine and norepinephrine are indicated via iv or io route before central access is achieved when myocardial contractility remains poor despite adequate volume replacement. Delay increases mortality 20-fold.
Chia Hui Ling
KK Women’s and Children’s Hospital
Title: Effective Correction of Ear Anomalies with Non-Surgical Ear Molding
Biography:
Abstract:
Background
One-third of infants have ear anomalies and less than one-third self-correct. Correction of ear deformities by molding exploits the plasticity of the auricular cartilage due to circulating maternal estrogen during early infancy.
Objectives
We assess the efficacy of non-surgical ear molding in the correction of ear deformities and determine the factors that affect its outcome.
Methods
This is a prospective study over a three-year period. Consecutive full-term infants who underwent ear molding were recruited. Primary outcome was successful correction of ear anomaly. Secondary outcomes included complications and maintenance of ear shape. Factors identified include type of anomaly, age and duration of application, and breastfeeding.
Results
Sixty-seven patients with a total of 105 ears were recruited. The anomalies were classified into deformations (66.7%) and malformations (33.3%). The median age group of presentation was zero to seven days old (67%). Average duration of application was 4.1 weeks. Successful correction was achieved in 86% of patients. Ear deformations achieved a significantly higher rate of successful outcome (98%) compared to malformations (64%) (p=0.01). Skin complications were common (46%) and attributed to our tropical climate. Patients with complications were of a higher mean age (22.1 days), compared to patients with no complications (10.6 days) (p=0.03).
Conclusion
Ear molding is an effective non-surgical option for the treatment of ear anomalies, especially in ear deformations where successful correction was achieved in 98% of infants. Type of anomaly is an important predictor of successful correction. Early initiation of ear molding has a crucial role in minimizing complications.
M R Savitha
Mysore Medical College and Research Institute, India
Title: Sharing 18 months of experience in free allergy asthma clinic in Mysore, India
Biography:
M R Savitha is currently working as Professor of Pediatrics at the Department of Pediatrics of Mysore Medical College and Research Institute, Mysore, India. She has 22 years of experience in the field of pediatrics. She has published 39 papers in various national and international journals. She has presented 41 papers in various states, national and international conferences. Her field of interest is allergy and asthma in children and lipid profile in children
Abstract:
Introduction: The prevalence and incidence of allergic diseases and asthma are on the raise globally, mostly in urbanized locales. Developing countries like India are undergoing rapid urbanization and prevalence of allergic diseases is surely on the raise. We are running a Free Allergy Asthma Clinic (Swaasha Clinic) at a major tertiary medical center with medical school and extensive hospital set up catering mainly to low and middle socioeconomic class patients.
Methods: Retrospective analysis of patients registered at the center from Jan 1 2017 through July 1 2018 was performed.
Results: A total of 240 patients were registered during this period. 165 patients (68.75%) belonged to low socioeconomic class, 62 (25.8%) belonged to middle class and only 13 patients belonged to upper class. Since the clinic is attached to the pediatric department, majority of patients were below 18 years of age. 58 patients were in less than 5 year age group, 118 patients were in 5-12 year age group, 45 patients were in 12-18 year age group and 19 patients were above 18 years age group. There were 142 males and 98 females (M:F=1.4:1). 176 patients had asthma of whom, 13 had intermittent asthma, 69 mild persistent asthmas, 76 moderate persistent asthmas and 18 severe persistent asthma. 52 patients had allergic rhinitis of which 15 had mild allergic rhinitis and 37 had moderate-severe allergic rhinitis. 15 children had allergic conjunctivitis, 8 children atopic dermatitis and 5 children had recurrent urticaria. Allergy Prick skin test was performed on 171 patients using the standard pediatric panel. Major sensitizations were found to house dust mite (DP, DF) in 36 patients (21%) and cockroach in 25patients (14.6%). Spirometry was done in 139 patients. It was normal in 72 patients (52%) and showed reversibility in 38 patients (27%). Follow up visits was seen in only 68 patients (28.3%) of which only 24 (10%) cases had more than 3 follow ups.
Conclusion: It can be concluded that most of our patients are suffering from mild and moderate persistent asthma with house dust mite being the most common allergen causing sensitization and there is a poor long term follow up of our patients even though services are provided free of cost. Hence, there is an urgent need to implement suitable intervention strategies for optimum management of asthma.
Biography:
Bhupinder K Girn is a graduate of Doctor of Medicine from Far Eastern University-Nicanor Reyes Medical Foundation, Institute of Medicine. She took her Post-Graduate Internship at Rizal Medical Center and Pediatric Residency Training in the same institution
Abstract:
Background: Estimation of disease severity and probability of death are essential in determining the prognosis. An objective measurement tool is necessary to accurately communicate prognosis of critically ill children to their parents.
Objective: This study aimed to analyze the prognostic value of Pediatric Logistic Organ Dysfunction (PELOD) score in the presence of organ dysfunction.
Design: It is a prospective observational cohort study.
Setting: Pediatric Intensive Care Unit (PICU) of tertiary government hospital in the Philippines.
Participants: All prospective admissions from term newborn to <19 years of age were included from July 15, 2016 to July 14, 2017. A total of 149 patients admitted; sixty six (66) excluded due to consent denial (n=20), incomplete diagnostic work-ups (n=12), death within 8 hours of admission (n=12) and prematurity (n=22). Eighty three (83) subjects were enrolled.
Main Outcome Measures: PELOD score was calculated in the first 24 hours of admission with outcome measures as survival or non-survival.
Results: Of the 83 patients, 51 (61%) were male and 32 (39%) were female; with a mean age of 5 years old and median length of stay of 5 days. Mortality rate was 43.4%. PELOD scores of non-survivors 25.4 (22.4) was significantly higher (p<0.001) than survivors at 4.9 (5.9). Fifty five percent (55%) had Multiple Organ Dysfunctions Syndrome (MODS) upon admission with 100% mortality rate for organ dysfunction of ≥4. ROC curve analysis for predicting death was 0.827 (95% CI, P<0.001) indicating a very good discriminatory ability. PELOD score of 15 correlated with 50% probability of death and risk ratio analysis (P<0.001) reveals the risk of dying of patients with PELOD score >15 is 3.3x that of with score ≤15.
Conclusion: PELOD score is a reliable prognostic predictor of mortality. Cardiovascular and neurologic dysfunctions were highly associated with mortality. Increasing number of organ dysfunction was correlated with increasing PELOD scores and mortality rate.
Lourdes Mary Daniel
KK Women’s and Children’s Hospital, Singapore
Title: Poverty, Development and the Brain
Biography:
Adjunct Associate Professor Lourdes Mary Daniel has been a pediatrician in Singapore for almost 30 years and a full-time Neonatologist for more than 20 years. She currently heads the Department of Child Development in KK Women’s and Children’s Hospital, the largest child development service in Singapore which sees more than 3000 new preschool children every year. She received her Child Development training at the Kennedy Krieger Institute in Johns Hopkins Hospital, Boston Children’s Hospital and the Harvard Graduate School of Education in the USA. The department and hospital provide clinic-based developmental assessments and interventions, pilot and/or run community-based developmental programs and collaborate extensively with government ministries and philanthropic organizations to enhance the developmental services available to both the general population of children as well as vulnerable children.
Abstract:
Children in poverty have worse cognitive, socio-behavioral and health outcomes than their more affluent peers. Poverty affects the brain in 4 main ways: language and reading, memory, executive functions (EF) and socio-emotional processing. Numerous studies have demonstrated differences in brain structure and function between children from high and low socio-economic status. Income and total hippocampal gray matter, which are important for learning and memory, have been shown to be correlated, as well as frontal and prefrontal regions which affect emotion and stress. Poor cognitive and academic performance among children in poverty has been shown to be mediated by a small hippocampus and frontal and temporal lobes, with the decrease in the latter 2 areas explaining as much as 15-20% of the achievement deficits. The relationship between poverty and the brain has been shown to be logarithmic and not linear. Income related most strongly to brain structure among the most disadvantaged children with the effect seen as early as 6-9 months of age. Children’s EF skills have been shown to be robustly predicted by chronic exposure to poverty and the associated environmental hazards. In adults, EF skills (which start developing in childhood) are core capabilities that are important for managing life, work and effective parenting. Bridging the achievement gap between children of low socio-economic status and their more affluent peers requires coordinated public policy measures. This is a huge challenge, but addressing it is necessary to protect these children from the long term effects of poverty. This talk will also summarize the effects of various intervention programs.
Abdulrahman Al-Frayh
King Saud University, Saudi Arabia
Title: A Nationwide Study of Allergy and Asthma Sensitizers in Homes of Saudi Arabia
Biography:
Abdulrahman Al-Frayh has his expertise in Paediatric Allergy and Pulmonology. He is a respected Professor and also a Consultant at the same time. His research interest involved Bronchial Asthma, Paediatric Allergy and Pulmonology, Promotion of Breast feeding and growth and nutrition/children in development countries. He has authored or co-authored, published and presented over 190 papers and meeting abstracts in the field of Allergy & Immunology in both national and international journals.
Abstract:
Statement of the Problem: Prevalence of asthma and other allergic symptoms has increased in the Pediatric populations in Saudi Arabia. Apart from traditional living in areas, the hot temperature force the families to spend more time indoors. Methodology & Theoretical Orientation: In order to evaluate the impact of indoor allergens in the community, a nationwide study of various allergy and asthma sensitizers and triggers, mainly inhabiting the indoor environment, was conducted simultaneously in several cities of Saudi Arabia in 2015-2016, including coastal and non-coastal regions. The project (RAC# 2170 023) was supported by NSTIP (13-BIO814-20) and approved by American Association for Advancement of Sciences (AAAS). This is the first ever simultaneous study of major indoor allergenic components nationwide. A total of 560 house dust samples from 164 patients and 396 control homes were collected from seven regions. Samples were sieved and extracted in PBS-PH-8 and analyzed by ELISA using different antibodies. The targeted allergens included Dermatophagoides pteronyssinus (Der p 1), Dermatophagoides farinae (Der f 1), Blattella germanica (Bla g 1 –group 1), Blattella germanica (Bla g 2 – group 2, Felis domesticus (Fel d1), Rattus norvegicus (Rat n1) and Blomia tropicalis (Blo t 5). Findings: The analyses of data between patients and controls and coastal verses non-coastal regions revealed quantitative variations in their threshold values. Chi-square test and odd ratio to test the association between cases and controls as well as detection rate in coastal and non-coastal cities were conducted. Significant levels for Bla g 1 in Makkah (p<.0001) and Riyadh (p<0.0006), Rat n 1 (p<.0001) and Blo t 5 (p<0.0038) for Riyadh were obtained. The results will help health care directorates, allergists and hospitals in selection of appropriate diagnostic test panels and their therapeutic and preventive approach on regional basis
Sema Yilmaz
Yeditepe University Faculty of Medicine, Turkey
Title: Polymorphism of hypoxia-inducible factor-1α gene in children with Acute Respiratory Distress Syndrome
Biography:
Sema Yilmaz has completed her Medical Education from Istanbul University, Cerrahpasa Medical Faculty, and Zeynep Kamil Maternity and Children's Hospital, Istanbul, Turkey. Currently she is working as Assistant Professor in Pediatric Hematology/Oncology department, Yeditepe University Faculty of Medicine, Turkey. She has published 23 articles in reputed journals and has Research Experience in Cancer Biology and Therapeutics Program, Harvard Medical School, USA. She has Volunteer Experiences in MD Anderson Cancer Center, Houston, Tx, USA, University of Texas, Hermann Hospital, Tx, USA, John Hopkin’s Children Hospital, Baltimore, USA and Istituto Giannina Gaslini, Italy.
Abstract:
Aim: To investigate hypoxia-inducible factor-1α (Hif-1α) polimorphism in children with Acute Respiratory Distress Syndrome (ARDS).
Objectives: ARDS may resulted in by pulmonary and extrapulmonary causes. In the present study, we examined whether hypoxia-inducible factor-1α (HIF-1α) polymorphisms are associated with the Acute Respiratory Distress Syndrome.
Subjects/ Methods: Twenty two patients with ARDS and 11 non-ARDS controls were examined in pediatric intensive care unit in Cukurova University Hospital. Blood samples were collected from subjects. Polymerase chain reaction-restriction fragment length polymorphism was used to assess the C1772T and G1790A polymorphisms in the HIF-1α gene, and differences in genotypes between the 2 groups were compared.
Results: C1772T polymorphism was not observed between pulmonary ARDS cases and non-ARDS controls. Particularly, G1790A polymorphism was significantly different in between pulmonary ARDS and non-ARDS cases. In addition, G1790A polymorphism was statistically related to the extensity of ARDS in lung parenchyma in ARDS patients (p<0,05).
Conclusion: Our results indicated that Hif-1α G1790A polymorphism was associated with an increased susceptibility to pulmonary ARDS in children. The investigating of G1790A polymorphism seen commonly could lead pediatricians to predict the extensity of ARDS early in lung tissue.
Ghada El Kassas
National Research Centre, Egypt
Title: Role of Procalcitonin as inflammatory marker in a sample of Egyption children and adolescent with simple obesity
Biography:
I have completed my PhD at the age of 30 years from Ain Shams Univesity. I have published more than 13 papers in reputed journals and have been serving as an editorial board member of four journals.
Abstract:
Obesity is a multifactorial disease, associated with metabolic disorders and chronic low-grade inflammation. Circulating procalcitonin (PCT) is produced by adipose tissue and several cell types following cytokine stimulation. Procalcitonin is well known as a biomarker of infection, sepsis and severe systemic inflammation. Recently it has a potential as a marker for chronic low-grade inflammation in obese population. We aim in the current study to evaluate the role of serum PCT as an inflammatory biomarker in diagnosis of obesity-related low-grade inflammation.
Method: In this case control study, 50 obese and 50 normal weight children and adolescents aged 6–16 years were enrolled. Anthropometric parameters and blood pressure were measured in all study subjects. The body composition was evaluated by Body mass index (BMI), body circumferences and skinfold thickness Fasting blood samples were collected for measurement of lipid profile, blood glucose, insulin, high sensitivity-CRP (Hs-CRP) and serum procalcitonin. Serum (PCT) levels were assessed using enzyme linked immunosorbent assay. Insulin resistance was represented as the homeostatic model assessment value (HOMA-IR).
Results:
Obese participants had increased (BMI) z-score, blood pressure, insulin resistance (HOMA-IR) and higher concentrations of serum PCT, total cholesterol, triglycerides, glucose and Hs-CRP than control group. On correlation analysis, procalcitonin had significant positive correlation with (BMI) z-score (P=0.03), waist circumference (WC) (P=0.05), Hs-CRP (P=0.02)), total cholesterol (P=0.04), triglycerides (P<0.001) and (HOMA-IR) (P<0.001) in obese group.
Conclusion:
The increased serum procalcitonin concentrations were closely related to measures of adiposity, Hs-CRP and insulin resistance, suggesting that PCT may be an excellent biomarker for obesity related chronic low-grade inflammation in children and adolescents.
Mercy Manyema
University of the Witwatersrand, South Africa
Title: Stress begets stress: The association between adverse childhood experiences with psychological distress in the presence of adult life stress
Biography:
Mercy Manyema is an early career public health researcher whose areas of interest include non-communicable disease prevention, childhood and adult obesity and early child development. She has been involved in several projects including the evaluation of the potential of a sugar-sweetened beverage tax to reduce obesity, diabetes and stroke in South Africa, and a study to map the gaps between expert, stakeholder, and public understandings of early childhood development in South Africa. She is currently studying for a PhD in Public Health focusing on the impact of adverse childhood events on adult health and well-being.
Abstract:
Statement of the Problem: Adverse childhood experiences (ACEs) have emerged as a significant public health problem in the past two decades, and are highly prevalent in high income countries. Literature suggests an increased risk of mental health problems in those who experience childhood adversity. The objectives of this study were to describe the distribution of retrospectively reported ACEs in a cohort of young adults and investigate the association between ACEs and psychological distress. Methodology & Theoretical Orientation: Data from the Birth to Twenty Cohort Plus were used to determine the prevalence of ACEs (retrospectively measured) and of psychological distress in young adults aged 22 years. Hierarchical regression was employed to determine the association between the two and the role of adult stress events in the relationship. Findings: 88% of the sample (n=1223) reported at least one ACE before the age of 18 years while 28% reported psychological distress. Compared to experiencing no ACEs, having 4 or more ACEs increased the risk of psychological distress five times, OR 5.45 (95% CI 3.10-9.57). The effect of ACEs attenuated after the addition of adult stress to the model signifying possible mediation of the association between ACEs and PD through adult stressors. Conclusion & Significance: Adverse childhood experiences are high in the cohort and are positively associated with psychological distress in young adulthood. Adult life stress may moderate the link between ACEs and psychological distress. Interventions to reduce the burden of poor mental health may need to not only address adult life stress but also the experience of childhood adversity.
Biography:
Elaine Joy O. Viernes graduated from pediatric residency training in a government hospital in the Philippines. She is from a rural town where pregnancy in adolescents is a norm. She hopes to contribute to the holistic care of pregnant adolescents thru her research.
Abstract:
Background of the study: Screening for antepartum depression is not routinely integrated in prenatal care despite its high prevalence rate and adverse maternal and neonatal outcomes.
Methods: A cross-sectional descriptive study of 143 pregnant adolescents age 12 to 18 years old was conducted at the OB-Gyne outpatient department of a tertiary hospital. Participants were enrolled to complete a self-administered socio-demographic and obstetric questionnaires and the validated Filipino version of the Edinburgh Postnatal Depression Scale. The presence of depression was assessed using the validated EPDS cut-off score of > 13.
Results: The prevalence of antepartum depression during the time of the study was 23.1%. The mean EPDS score among the depressed group is 15.12 + 0.918. Pregnant teens with low monthly household income were at an increased risk of antepartum depression. Conversely, those currently studying and in their third trimester were less likely at risk for depression during pregnancy.
Conclusion: A significant proportion of pregnant adolescents were at risk of developing antepartum depression. The lack of predisposing risk factors does not rule out the possibility of depression during pregnancy; thus, screening through a validated tool should be integrated in antenatal care. Early detection and appropriate intervention for depression in pregnant teenagers is crucial to prevent the associated adverse maternal and child outcomes.
3 Speaker slots are available. Please contact us at pediatriccongress@pediatricsconferences.org