ObjectiveTo investigate the early neonatal outcomes of very-low-birth-weight (VLBW) infants discharged home from neonatal intensive care units (NICUs) in Turkey.Material and methodsA prospective cohort study was performed between April 1, 2016 and April 30, 2017. The study included VLBW infants admitted to level III NICUs. Perinatal and neonatal data of all infants born with a birth weight of ≤1500 g were collected for infants who survived.ResultsData from 69 NICUs were obtained. The mean birth weight and gestational age were 1137±245 g and 29±2.4 weeks, respectively. During the study period, 78% of VLBW infants survived to discharge and 48% of survived infants had no major neonatal morbidity. VLBW infants who survived were evaluated in terms of major morbidities: bronchopulmonary dysplasia was detected in 23.7% of infants, necrotizing enterocolitis in 9.1%, blood culture proven late-onset sepsis (LOS) in 21.1%, blood culture negative LOS in 21.3%, severe intraventricular hemorrhage in 5.4% and severe retinopathy of prematurity in 11.1%. Hemodynamically significant patent ductus arteriosus was diagnosed in 24.8% of infants. Antenatal steroids were administered to 42.9% of mothers.ConclusionThe present investigation is the first multicenter study to include epidemiological information on VLBW infants in Turkey. Morbidity rate in VLBW infants is a serious concern and higher than those in developed countries. Implementation of oxygen therapy with appropriate monitoring, better antenatal and neonatal care and control of sepsis may reduce the prevalence of neonatal morbidities. Therefore, monitoring standards of neonatal care and implementing quality improvement projects across the country are essential for improving neonatal outcomes in Turkish NICUs.
To investigate cord arterial blood sample and the relationship between birth stress and intraocular pressure in infants at 5 min after delivery. The IOP measurements were taken using Tonopen-Avia tonometer to 158 newborns (158 eyes) at 5th min after birth, in a university hospital. Cord blood was collected within 3 min after delivery. Intraocular pressure, gender, gestation period, mode of delivery, and birth weight of newborns were noted from medical records. Sixty-two babies were delivered by normal vaginal delivery (NVD) and 96 by cesarian section (C/S). Mean IOP of NVD and C/S groups were 19.56 ± 3.84 and 17.42 ± 3.50, respectively. There was significant difference of mean IOP between two groups. (p < 0.001) There were significant differences between two groups regarding APGAR score (p < 0.001) and cord blood adrenaline (p = 0.003), noradrenaline (p = 0.008), and cortisol (p < 0.001) levels. There was no difference between infant corneal thickness measurements (p = 0.698). In correlation analyses, there is a strong negative correlation between the labor type and postpartum measurements except corneal thickness. Correlation analyses of the 5th min intraocular pressure of the groups individually revealed significant correlation in the NVD group. The conclusion is that the intraocular pressure of newborn infants was higher in NVD delivery compare to C/S. Blood hormonal changes in different anesthesia types and physical stress was thought as the main reason of this result.
Background/aim We aimed to evaluate the association of the umbilical cord macrophage migration inhibitory factor (MIF) with the respiratory distress syndrome (RDS) in preterm infants. Materials and methods A total of eighty six preterm infants (38 with RDS and 48 without RDS) were involved in the study. ELISA is the technique assaying MIF values. Results The mean of the infants’ gestational ages and birth weights were significantly different (P = 0.0001). There were no significant differences in sex, delivery mode or exposure to antenatal steroid among the groups (P > 0.05). Umbilical cord MIF levels of the infants were not correlated with gestational age and birth weight (Spearman’s rho = –0.22 and 0.28 respectively, P > 0.05). There was no statistically significant difference in umbilical cord MIF levels of infants whether or not they were administered antenatal steroid (median:17.88 vs. median:17.60, Mann–Whitney U test, P = 0.42). Cord serum MIF levels were higher (mean, 17.09 ± 5.86 ng/mL) in the RDS group than in the non-RDS group (mean, 14.72 ± 4.18 ng/mL) (P = 0.005). Conclusion This study shows that, MIF level is higher in the cord blood of the infants with RDS than of the infants without RDS. This supports that MIF expression begins in prior to the birth of the preterm infants and MIF has enhancing impact on the lung development of premature babies. With future studies, the assessment of the cord MIF levels at the bedside may be beneficial for the diagnosis and treatment of RDS, and taking actions to prevent long-term consequences.
Cerebro-costo-mandibular syndrome is characterized by severe micrognathia with glossoptosis, short to cleft soft palate, bell-shaped small thorax with gaps between the posterior ossified rib and anterior cartilaginous rib and postnatal growth and mental deficiency. We present the clinical course and the early aggressive treatment of a newborn diagnosed as cerebro-costo-mandibular syndrome. The management of the patients with this syndrome is important over the morbidity and mortality. Most babies died due to respiratory distress. Although brain anomalies are uncommon in cerebro-costo-mandibular syndrome, hypoxia may cause neurodevelopmental disorders. In this case report, we emphasize the importance of proper ventilation and feeding in patients with cerebro-costo-mandibular syndrome to maintain normal development. Multidisciplinary approach is essential in monitoring of these patients.
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