Page 286 - Abstract Book KONIKA 18

Neonatology

P-NEO-002
Congenital Toxoplasmosis Manifested as Subclinical Infection
in Preterm Infant with Intrauterine Growth Restriction

Yurika Elizabeth Susanti , Marcella Amadea Widjaja , Ahmad Kautsar , Rinawati Rohsiswatmo 2
1
1
2
1
Faculty of Medicine, Universitas Katolik Atma Jaya and Department of Child Health, Faculty of Medicine,
Universitas Indonesia/Dr. Cipto Mangunkusumo General Hospital , Jakarta, Indonesias
2
Abstract
Background Intrauterine growth restriction (IUGR) remains a serious problem which is associated with
increased morbidity among preterm infants. It is difficult to determine whether the small baby is classified
into IUGR or small for gestational age postnatally. Beside placental insufficiency, intrauterine infections
should be explored as the etiology of IUGR. Congenital toxoplasmosis (CT) is a serious parasitic infection
which can cause significant fetal and neonatal morbidities. It has wide spectrum of clinical manifestations
yet subclinical in approximately 75% of infected newborns. Objective To describe CT in IUGR infant and
emphasize the importance of retinal screening in subclinical infection. Case A 31-week female infant was
born by c-section due to preeclampsia. She weighed 1120 g and had growth restriction throughout pregnancy.
She had not been discharged due to feeding difficulty. Routine screening for retinopathy of prematurity was
done at 1 month of age revealed toxoplasmosis retinitis. Antibodies for IgM and IgG Toxoplasma were
positive. Head ultrasound showed no pathological findings. Lumbar puncture was not performed due to
pathognomonic eye pathology. The mother admitted that she had a series of mild fever during pregnancy
although she was tested negative for toxoplasma IgM and IgG antibodies but turned out positive after
delivery. Infant was treated with pyrimethamine, clindamycin and folic acid with favorable retina outcome.
Conclusion Congenital toxoplasmosis should be suspected as a risk factor of IUGR. Infant with positive
toxoplasma antibodies without overt clinical symptoms should undergone retinal examination screening.
Keywords: Intrauterine growth restriction; toxoplasmosis; screening; retinopathy, preterm

P-NEO-003
Perinatal Risk Factors of Cerebral Lesions in Preterm Neonates

Laras Puspa Nirmala, Dimas Tri Anantyo, Adhie Nur Radityo, Arsita Eka Rini, Gatot Irawan Sarosa
Departement of Child Health, Faculty of Medicine, Universitas Diponegoro/Dr. Kariadi Hospital,
Semarang, Central Java, Indonesia
Abstract
Background Infant mortality rate in Indonesia was 15/1000 live births in 2019. One of the causes of mortality
is prematurity. Premature neonates are vulnerable to both haemorrhagic and ischemic brain injuries. Cranial
ultrasonography is an inexpensive, noninvasive and non-ionizing examination, and useful for early diagnosis
of many etiologies of encephalopathy in neonates. Objectives To evaluate the association between perinatal
risk factors for cerebral lesions development in preterm neonates. Methods We reviewed medical records of
preterm neonates (<37 weeks) admitted to Perinatology Ward and NICU in Kariadi Hospital between January
2020-February 2021. The presence of cerebral lesions was detected using a cranial ultrasonography. We
used Odd’s ratio for statistical analysis. Results Ninety two preterms neonates were analysed, 65.2% were
with gestational age of < 32 weeks,and 34.8% were with gestational age of >32 weeks. Sixteen percent of
the subjects developed cerebral lesions, while 83.7% did not. Among the cerebral lesions, intraventricular
haemorrhage was the most common one (7.1%) followed by vetriculomegaly (3.1%), and intracranial
haemorrhage (1%). Neonatal infection increased the risk for developing cerebral lesions (OR 6.0; 95%CI
(1.11 to 34.1)). Other perinatal risk factors (gestastional age, birth weight, preeclampsia, premature rupture
of membrane, antepartum haemorrhage, asphyxia neonatorum, and neonatal seizure) did not increase the
risk for cerebral lesions development. Conclusion Intraventricular haemorrhage was the most common
cerebral lesions in our study. Neonatal infection is a significant risk factor for cerebral lesions development.
Cranial ultrasonography helps early detection, so as for early intervention to prevent preterm neonates from
further brain damage.
Keywords: preterm; cerebral lesion; cranial ultrasound

238 KONIKA XVIII Abstract Book