Page 299 - Abstract Book KONIKA 18

Neonatology

P-NEO-025
Neonatal Referral Profiles and Outcomes during the Covid Pandemic:
Experience of Tertiary Hospital in Kalimantan

Pricilia Gunawan H., Pudji Andayani, Ari Yunanto
Department of Child Health, Faculty of Medicine, Universitas Lambung Mangkurat/Ulin General Hospital,
Banjarmasin, South Borneo, Indonesia

Abstract
Background Covid-19 pandemic impact all sectors of health services, including neonates. One important
issue is the neonatal referral process to tertiary hospital, especially during the large-scale social restrictions
period. Objective To compare neonatal referral profiles and outcomes in Kalimantan’s tertiary hospital before
and during Covid-19 pandemic. Methods A Retrospective study which described the neonatal referred cases
in Ulin General Hospital from 2019 to 2020. Results Total referred cases in 2019 was 308 patients and 182
patients in 2020. In 2019, most leading referral cases consisted of 133 (43.18%) low birth weight babies, 93
(30%) asphyxia and respiratory distress, and 82 (26%) surgical cases, with a total 55 deaths (17.86%). In
2020, referral cases consisted of 83 (45.6%) low birth weight babies, 44 surgical cases (24.1%), 40 (21.9%)
asphyxia and respiratory distress, 15 (8.2%) probable Covid, with total 44 deaths (24.18%). There was marked
reduction (56,8%) of the total number neonatal referral cases during Covid-19 pandemic. We found there
was no significant difference of mortality rate in our center (P= 0.09; OR 0.68; 95%CI 0.43 to 1.06). Local
clinic and general hospital from South and Central Kalimantan had the most frequent referrals. Conclusion
Marked reduction in neonatal referrals pointing to the fact that the referral system was jeopardized during
the Covid-19 pandemic. The proper selection of cases, neonatal transport system, and optimal care is still
running properly in South Kalimantan during Covid-19 pandemic. However, data about neonatal deaths in
the local primary healthcare facilities should be investigated further.
Keywords: neonatal; referral; Covid-19 pandemic

P-NEO-026
Neonatal Intestinal Dysbiosis: A New Emerging Condition in Premature Infant

Putri M. T. Marsubrin, Rinawati Rohsiswatmo, Maya Yulindhini, Agus Firmansyah†
Department of Child and Health, Faculty of Medicine Universitas Indonesia/
Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
Abstract
Background Alteration in intestinal microbiota (dysbiosis) in neonatal period can influence infant’s morbidity
acutely as well as contribute to disease process later in life. Very premature or very low birth weight infants
(VLBW) are susceptible to have alteration of intestinal microbiome. Dysbiosis could lead to lack of commensal
microbiota and excessive growth of pathogenic microbiota. Objective To demonstrate the incidence of
neonatal dysbiosis in very preterm and VLBW infants and documented associated well-known risk factors.
Methods Forty-three very preterm and VLBW infants were enrolled at the time of delivery and evaluated
th
at 7 day of life. Faecal examination was performed at 7th day of life to seek intestinal commensal and
pathogen bacteria using real-time polymerase chain reaction (PCR). Four bacterial genera (commensal
and pathogen), which are Bifidobacteriaceae, Lactobacillaceae, Enterobacteriaceae, and Clostridium are
selected to be investigated. Dysbiosis was evaluated using the proportion of commensal and pathogen
bacteria. Results Of 43 infants were included in this study, all infants were proven to have dysbiosis.
No Bifidobacteria (commensal) found in all subjects. A total of 90.7% infants born through C-section,
97.7% infants use antibiotic from early life, and 62.8% infants exposed to maternal antibiotic. During 7th
day of life, infants feeding profile was as follow: 4.7% infants were full total parenteral nutrition, 67.4
% had breast milk/donor human milk, 25.6% had mix breast/ formula milk, and 2.3% breast milk only.
Conclusion All very preterm or VLBW infants have dysbiosis. Risk factors associated with neonatal dysbiosis
need to be further investigated.
Keywords: neonatal dysbiosis; very premature, VLBW

KONIKA XVIII Abstract Book 251