Faculty of Medicine

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ASSOCIATION BETWEEN LOW BIRTH WEIGHT AND MODE OF DELIVERY IN TERM PREGNANCY
(Association of Albanian Medical Doctors in Macedonia, 2025-10)
Arta Islami Zulfiu
;
Nurdzan Asani Ajeti
;
Besa Islami Pocesta
;
Introduction: Low birth weight (LBW), defined as a birth weight of less than 2500 grams, regardless of gestational age. Globally, it is estimated that 15-20 % of all births, or 20 million newborns annually, are low birth weight infants. It remains a significant public health concern due to its association with increased neonatal morbidity and mortality. The mode of delivery is frequently influenced by fetal condition, maternal health, and the availability of institutional resources. Understanding the relationship between LBW and delivery method is essential because such cases are common, and decision making must balance clinical urgency with resource availability. 57 XXX Takim profesional mjekësor Aim: The aim of the study was to find out the association between low birth weight and mode of delivery in a term pregnancy. Material and methods: This was a cross-sectional study conducted at the Special Hospital for Obstetrics and Gynaecology “Mother Teresa”, Cair, Skopje, North Macedonia, from January 2024 to September 2024. Data were collected from the hospital register of pregnant women in our population who delivered full-term infants ( 37 0/7 - 41 0/7 weeks of gestation) with a birth weight of less than 2500 grams. The newborns were weighed immediately after birth. Results: During the study period from January 2024 to September 2024 total number of birth was 2677. 102 ( 3.8 %) newborns weighed less than 2500 g. Parity was less than two in 73 %. 50 % were primigravida. In 67% maternal age was from 18 to 24 years old. The majority (87%) of the mothers didn't have any comorbidity, 13% suffered from comorbidity. 61 babies were born by cesarean section (CS), and 41 were delivered by normal vaginal delivery. Of the total number of cesarean sections, 42 were primary cesarian section, 15 were with repeat cesarean section and 4 were with third cesarian section. Conclusion: Caesarean section should not be routinely recommended solely based on low birth weight. Delivery mode decisions must be individualized and guided by obstetric indications such as fetal distress, abnormal presentation, or maternal complications. This approach minimizes unnecessary surgical risks while ensuring optimal maternal and neonatal outcomes. Careful clinical assessment and resource considerations are essential in managing pregnancies complicated by low birth weight unless there are other obstetric indications.
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Thyroid Function of Pregnant Women and Perinatal Outcomes in North Macedonia
(Federação Brasileira das Sociedades de Ginecologia e Obstetrícia, 2021-10)
Avramovska, Maja
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Kostova, Neda Milevska
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Karanfilski, Borislav
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Hunziker, Sandra
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Objective Thyroid diseases are the second most common endocrine disorders in the reproductive period of women. They can be associated with intrauterine growth restriction (IUGR), preterm delivery, low Apgar score, low birthweight (LBW) or fetal death. The aim of the present study is to explore thyroid dysfunction and its relationship with some poor perinatal outcomes (Apgar Score, low birthweight, and preterm delivery). Methods Dried blood spot samples from 358 healthy pregnant women were analyzed for thyroid stimulating hormone (TSH), total thyroxine (TT4), and thyroglobulin (Tg). Neonatal data were collected upon delivery. Four groups were formed based on thyroid function tests (TFTs). Results Of the 358 tested women, 218 (60.72%) were euthyroid. Isolated hypothyroxinemia was present in 132 women (36.76%), subclinical hyperthyroidism in 7 women (1.94%), and overt hypothyroidism in 1 (0.28%). The perinatal outcomes IUGR (p = 0.028) and Apgar score 1 minute (p = 0.015) were significantly different between thyroid function test [TFT]-distinct groups. In the multiple regression analysis, TT4 showed a statistically significant inverse predictive impact on LBW (p < 0.0001), but a positive impact of Tg on LBW (p = 0.0351). Conclusion Thyroid hormones alone do not have a direct impact on neonatal outcomes, but the percentage of their participation in the total process cannot be neglected. Based on the regression analysis, we can conclude that TT4 and Tg can be used as predictors of neonatal outcome, expressed through birthweight and Apgar score. The present study aims to contribute to determine whether a test for thyroid status should become routine screening during pregnancy.
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NEONATAL HYPOGLYCEMIA: RISK FACTORS AND OUTCOMES
(Macedonian Academy of Sciences and Arts / Sciendo, 2017-03)
;
Elizabeta Petkovska
;
Snezana Jancevska
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Background and aims: Severe neonatal hypoglycemia (HG) leads to neurologic damage, mental retardation, epilepsy, personality disorders, impaired cardiac performance and muscle weakness. We aimed to assess the clinical characteristics of children with hypoglycemia in a random population of newborns. Patients, methods and results: We investigated 84 patients (M:F=35:48) born at the University Clinic for Gynecology and Obstetrics in Skopje (hospitalized in the NICU) who were found to have hypoglycemia. In total 89.25% of the babies were premature. The mean birth weight was 1795.95 +/596.08 grams, the mean birth length was 41.92+/- 4.62 cm, while the mean gestational age was 33.05±3.19 weeks. 32 children (38.08%) were very low birth weight (<1500g), 38 (45.22%) were low birth weight (1500-2500g), while there were 8 children (9.52%) appropriate for age BW and no high BW for age patients (>4000 g). HG duration was 2.42+/-2.41 hours. In the group as a whole, hypoxic-ischemic encephalopathy (HIE) was found in 3 children (3.57%), infections in 22 (26.18%), respiratory distress syndrome (RDS) in 9 patients (10.62%), intracranial haemorrhage in 2 patients (2.38%). There were no inborn errors of metabolism. There were two deaths (2.38%). Conclusion: Neonatal HG is a significant factor in the overall neonatal mortality. HG can also cause severe invalidity. We found that infections, LBW and low gestational age were most commonly associated with neonatal HG. However the Spearman test showed weak direct correlation, without statistical significance. Neonatal HG requires complex and team interaction of prenatal and postnatal approaches to reduce the incidence of seizures, their consequences and the overall mortality. Special consideration is to be taken in measures that avoid neonatal infections, HIE, LBW and low gestational age. Further studies on a larger population are needed to fully understand and prevent the phenomenon of HG in newborns.
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PREMATURITY AND LOW BIRTH WEIGHT PARTICIPATION IN NEONATAL DEATHS AT GYNAECOLOGY AND OBSTETRICS CLINIC IN SKOPJE IN THE PERIOD OF SEVEN YEARS
(Macedonian Association of Anatomists, 2020-12)
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Jasna Bushinoska
;
Jordancho Ivanov
Abstract Most of the neonatal deaths at NICU, in the neonatal period of life 0-28 days after delivery are results of preterm births and complications from prematurity. Preterm birth is a birth before 37 g.w. of pregnancy. Neonatal mortality is a death among live- born new-borns in the first four weeks of life after delivery. Prematurity and low birth weight significantly participate in neonatal deaths at NICU. The purpose of the study is to show the participation of prematurity and low birth weight in neonatal mortality, between new-borns admitted and treated at NICU at the GOC-Skopje, in the period of seven years. The retrospective analysis showed the participation of prematurity and low birth weight in neonatal mortality at NICU, at GOC- Skopje in the period of seven years- 2011-2017. The data was collected from the Data basis of NICU and medical histories of new-borns at NICU, during this period. In the period of seven years there were 36706 live-born new-borns at GOC-Skopje. 4810 of them or 13.18% were admitted and treated at NICU. Neonatal mortality at NICU in the seven years period was 912 new-borns, or 19% from all neonates admitted at NICU. Most of them 867, or 95% of neonatal deaths were preterm births or new-borns delivered before 37 g.w. of pregnancy. The leading causes for neonatal death in new-borns treated at NICU were complications due to prematurity and low birth weight in new-borns, in the period of seven years 2011-2017. Prematurity and low birth weight participate in the most of neonatal deaths at NICU and should be prevented in the future.

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