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The aim of this study is to investigate the TyG index and TG/HDL-C ratio and their relationships with insulin resistance in LGA infants.A prospective controlled study was conducted including 65 LGA and gestational age, gender-matched appropriate for gestational age (AGA) neonates. Serum TG, total cholesterol (TC), high-density lipoprotein-cholesterol (HDL-C), insulin and glucose levels were measured within two hours after birth, TyG index and HOMA-IR values were calculated.TyG index and TG/HDL- C ratio were higher in LGA neonates compared to AGA ones (p = 0.03; p = 0.00, respectively). Compared with AGA newborns, LGA newborns had higher levels of insulin and HOMA-IR (p = 0.00; p = 0.00, respectively). TyG index and TG/HDL-C ratio showed moderate correlation with HOMA-IR (r = 0.59 R

Aim: Viruses including respiratory syncytial virus, parainfluenza virus, rhinovirus are the primary etiologic agents in acute lower tract infections in neonates. We aimed to evaluate the clinical and demographic characteristics of newborns with acute lower tract infections. Material and Method: Data was recorded from patients' medical records admitted between January 2013 and April 2016. Results: The study population consisted of 43 neonates (19 girls, 24 boys). Mean gestational age and birthweight were 32 ± 4.4 weeks and 1735 ± 820 g, respectively. On admission, mean postnatal day and postmenstrual ages were 61 ± 48 days and 41 ± 4.3 weeks. Respiratory syncytial virus (n:8), rhinovirus (n:3), parainfluenza-3 virus (n:3) and adenovirus (n:3), respiratory syncytial virus and parechovirus (n:1), respiratory syncytial virus and adenovirus (n:1), rhinovirus and human bocavirus (n:1) were detected by polymerase chain reaction 20 patients in total. Siblings in the house (n:31), viral infection in the family (n:23), insufficient breastfeeding (n:15), bronchopulmonary dysplasia (n:13), siblings attending school (n:10) and being twin or triplet (n:7) were leading risk factors. Median hospital stay was 9 (1-60) days. Prematurity, fever, rales, respiratory support and feeding difficulty were statistically more common in polymerase chain reaction positive patients. Patients with the respiratory syncytial virus had higher gestational age, birth weight, less respiratory distress syndrome, surfactant use and patent ductus arteriosus, and lower postnatal day on admission than patients with other viruses (p

Aim The aim of this study is to determine the incidence of metabolic bone disease (MBD) and assess the risk factors for development radiologic evidence of MBD. Methods Preterm infants with gestational age ≤32 weeks and birth weight ≤1500 g were included in this prospective study. Metabolic bone disease was defined as hypophosphatemia (phosphorus levels 450 U/L, or radiologic findings of MBD at four weeks of age. Results The study included 254 infants (gestational age: 29 (27–30) weeks, birth weight: 1130 g (960–1300)). Metabolic bone disease was diagnosed in 96 patients (37%); 48 infants had only radiologic evidence of MBD, 24 infants had only biochemical diagnosis of MBD, and 24 infants had both radiologic evidence of MBD and biochemical diagnosis of MBD. Conclusions Our results showed that radiologic evidence of MBD existed in some infants with normal biochemical results. That finding may guide further development of screening programs for MBD.

Papillorenal syndrome, also known as renal coloboma syndrome, is characterised by congenital optic disc anomalies and renal abnormalities. Mutations in the PAX2 gene, which plays a critical role in embryogenesis, cause this syndrome. Other related anomalies are less commonly observed. To our knowledge, this is the first case reported in the literature in which Papillorenal syndrome accompanied various dysmorphic features.

OBJECTIVE To determinate the effects of bilirubin and phototherapy on oxidative stress in newborns. STUDY DESIGN A case-control study. PLACE AND DURATION OF STUDY Third level Newborn Intensive Care Unit, Ankara Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Turkey, from May to August 2017. METHODOLOGY Blood samples of 62 term newborns were grouped as control, before and after phototherapy. Total and native thiol, disulfide and ischemia modified albumin values in expressed blood samples were measured. Disulfide-native thiol ratio, disulfide-total thiol ratio and native thiol-total thiol ratio values were computed. RESULTS Bilirubin levels were positively correlated with native and total thiol levels and negatively correlated with ischemia modified albumin levels (r=0.409 p= 0.001, r= 0.328 p

Background/aim Turkey accepts refugees from many countries, principally Syria. More than 2.7 million refugees live in Turkey.We evaluated the neonatal outcomes of refugees. Materials and methods We retrospectively reviewed the clinical and demographic characteristics of refugee infants born in our hospital between August 2013 and September 2016. Results Refugees (718 Syrian, 136 Iraqi, 32 Afghani, and 21 of other nationalities) accounted for 907 of 49,413 births. The mean refugee maternal age was lower than that of Turkish women, whereas the gestational age (GA) and birthweight were similar. Refugees required fewer cesarean sections but exhibited greater small- and large-for-GA rates (P < 0.05). Refugee and Turkish infant mortality rates did not differ significantly (0.8 vs. 0.4%). Eighty-nine (12.3%) refugee neonates and 6682 (13.5%) Turkish neonates were admitted to our neonatal intensive care unit (NICU). Jaundice and perinatal asphyxia were significantly more common in refugees, whereas respiratory distress syndrome, GA ≤32 weeks, and infant birthweight

Objective Health care associated infections (HAIs) in the neonatal intensive care unit (NICU) are a significant cause of neonatal morbidity and mortality. Enterobacter aerogenes, a gram-negative bacterium, rarely causes HAI in the pediatric and NICUs. We report the case of a HAI outbreak of E. aerogenes in an NICU and discuss the clinical spectrum and outcome of the affected preterm newborns and successful prevention measures. Materials and Methods A retrospective study was conducted in a level III NICU of Etlik Zubeyde Hanım Women's Health Teaching and Research Hospital. The infants with blood cultures positive for E. aerogenes during the outbreak were enrolled. Perinatal risk factors, laboratory findings, symptoms, treatment, and prognosis were recorded. Clinical applications and prevention measures were identified. Results A preterm infant of 27 weeks of gestation who was diagnosed on the eighth postnatal day was the initial case of the reported outbreak of health care associated E. aerogenes infection. Subsequently, 12 more infants were diagnosed in the next 3 months. Infants' mean gestational age was 27.1 ± 2.3 weeks, and mean birthweight was 902 ± 161 g. The clinical symptoms at presentation were respiratory distress, sclerema, circulatory failure, and shock, which appeared at a mean age of 7.6 ± 5.8 days. Analysis of E. aerogenes strains revealed that all strains were of the same clonal type. Eight patients died in follow-up due to E. aerogenes septicemia during this outbreak. The mean interval between the onset of symptoms and death was 1.5 ± 1 days. Conclusion Outbreaks of health care associated E. aerogenes infection result in a high mortality rate among very low birthweight infants. Awareness of adjustable risk factors and preventive measures to control the outbreak decreases both morbidity and mortality.

Developments in perinatal and neonatal care have increased the survival rate of high-risk newborns but led to a rise in chronic diseases seen in these infants. A significant number of them attend primary and secondary health care centers after discharge; however, there are very few standard protocols for the long-term follow-up of these babies. Therefore, we aimed to establish a follow-up guideline that emphasizes on universal screening schemes and takes into consideration national data. The guide presented here provides brief recommendations for physicians in light of evidence-based data for the follow-up of high-risk newborn infants. The steps taken to monitor and solve the problems of all high-risk infants may vary. We hope the use of such a standard approach in evaluating each infant in daily routine will improve the life quality of these high-risk infants.Perinatal ve neonatal bakım alanındaki gelişmeler sonucunda riskli yenidoğanların yaşam oranı yükselmiş, ancak beraberinde bu bebeklerde görülen kronik hastalık oranı da artmıştır. Taburcu edildikten sonra birinci ve ikinci basamak sağlık merkezlerine başvuran hastaların önemli bir oranını oluşturmaya başlayan bu bebeklerin uzun süreli izleminin nasıl olması gerektiği ile ilgili ne yazık ki standart protokoller pek azdır. Bu nedenle evrensel izlem şemalarına ağırlık verdiğimiz ve ulusal verilerin de göz önüne alındığı bir izlem rehberi oluşturmayı amaçladık. Burada özetini sunduğumuz yüksek riskli bebek izlem rehberi uygulayıcıya kanıta dayalı veriler ışığında öneri niteliğinde bilgileri sunmaktadır. Tüm riskli bebekler için izlem ve sorunların çözümü için atılacak adımlar farklılıklar gösterebilir. Her bebeğin ayrı ayrı değerlendirildiği standart yaklaşımların güncel uygulamalarda kullanılmasının yüksek riskli bebeklerin yaşam kalitelerini artıracağını ummaktayız.

Objective The average time for umbilical cord separation in term neonates is 7 to 10 days. Prematurity, phototherapy, prolonged duration of antibiotic treatment, and parenteral nutrition are other factors which were demonstrated to delay cord separation. In the previous studies including greater premature infants, the time of separation of the umbilical cord was shown to vary 2 to 3 weeks. We aimed to determine the cord separation time and associated factors in very-low-birth-weight (VLBW) infants. Study Design In this retrospective study, VLBW infants (birth weight [BW] Results The study included 130 infants (GA: 29 ± 2 weeks, BW: 1,196 ± 243 g). Mean cord separation time was 14 ± 5 days, while 95th percentile was 22nd day of life. A positive correlation was demonstrated between duration of antibiotic treatment and cord separation time (p Conclusion The 95th percentile for cord separation time was 22nd day. Sepsis might be either the reason or the consequence of delayed cord detachment. The exact contribution of low serum FT3 levels to the process of cord separation should be investigated in further studies. Key Points

Bevacizumab may affect preterm infants' ongoing organogenesis with its antiangiogenic effects. We aimed to compare neurodevelopmental outcomes (NDO) of preterm infants treated for retinopathy of prematurity (ROP) with laser photocoagulation (LP), intravitreal bevacizumab (IVB) or both treatments, and to find out the effects of IVB on NDO.Medical records of preterm infants with ROP treatment and evaluation for NDO were retrospectively collected between 1 January 2017 and 31 June 2019. Primary outcome was Bayley Scales of Infant and Toddler Development 3rd Edition (Bayley-III) scores including cognitive, language, and motor scores. Secondary outcomes were neurodevelopmental impairments (NDIs) classified as the presence of any of cerebral palsy (CP), sensorineural/mixed hearing loss, visual impairment, and developmental delay with any Bayley-III score85. Severe NDI (sNDI) was defined as presence of any of CP with a Gross Motor Function Classification Scale of 3, 4, or 5, requirement for hearing aids or cochlear implants, bilateral visual impairment or severe developmental delay with any Bayley-III score70.LP, IVB, and IVB + LP groups included 32, 12, and 10 patients, respectively. Patent ductus arteriosus treatment rates were as 68.7, 75, and 90% in groups, respectively (Patients treated with bevacizumab should be carefully monitored for neurodevelopmental problems, although the frequency of grades 3 and 4 IVH in the bevacizumab group is thought to contribute to higher rates of sNDI and Bayley-III score70.

In this study, we aimed to compare the clinical outcomes of Premature Preterm Rupture of Membranes (PPROM) cases diagnosed by classical speculum examination and by placental alpha microglobulin-1 protein (PAMG-1) assay. The medical records of all patients with singleton pregnancies that were diagnosed with PPROM were retrospectively reviewed. Singleton pregnancies with PPROM diagnosis that was confirmed either by direct visualisation of amniotic fluid leaking through the cervix or by placental alpha microglobulin-1 protein (PAMG-1) assay if no amniotic fluid leakage was documented were included in the study. Demographics, prenatal and postnatal characteristics were reviewed from the medical charts and were recorded. The study included 138 pregnancies with PPROM; 111 patients in clinical speculum examination group and 27 in PAMG-1 assay group. There were no significant differences in maternal and pregnancy characteristics between the clinical speculum examination and PAMG-1 assay groups. Foetal outcomes were comparable between clinical speculum examination and PAMG-1 assay groups. In the clinical speculum examination group, there were nine (8.1%) chorioamnionitis cases, however, there were no chorioamnionitis cases in the PAMG-1 assay group during the latency period (

Due to immaturity of immune function and the possibility of mother-fetal vertical and aerosol transmissions, neonates are particularly susceptible to the new coronavirus (SARS-CoV-2). Perinatal-neonatal departments should cooperate closely and take integrated approaches, and neonatal intensive care units (NICU) should prepare emergency plans for the coronavirus disease 2019 (COVID-19) as far as possible, so as to ensure the optimal management and treatment of potential victims. During the epidemic of COVID-19, the emergency response plan for the NICU should be based on the actual situation, including diagnosis, isolation, and treatment, as well as available equipment and staffing, and take into account the psychosocial needs of the families and neonatal care staff. In this context of the COVID-19 pandemic, the Turkish Neonatal Society has proposed a protocol with the evidence available at the time of preparation to handle neonates with SARS-CoV-2 infections and outbreaks in NICUs. We hope that this proposal can provide valuable information so medical workers do not have to enter the battlefield alone. At this moment, sharing resources, experiences and lessons, regardless of who you are, is our only chance to win.

Retinopathy of prematurity is a pathophysiological condition that occurs in relation to abnormal proliferation in the retinal vessels in premature babies. Its exact pathogenesis is not known. In Turkey, the increased chance of survival in premature babies with much younger gestational age and much lower birth weight in parallel with the developments in neonatal care causes retinopathy of prematurity, which has led to vision problems and blindness to emerge as a more frequent problem. Early diagnosis and timely and appropriate treatment of retinopathy of prematurity contributes to the developmental process and increases the quality of life by preventing vision loss. It should be kept in mind that retinopathy of prematurity may also lead to serious medicolegal problems.Prematüre retinopatisi erken doğan bebeklerde retinal damarların anormal proliferasyonuna bağlı oluşan ve patogenezi tam olarak bilinmeyen fizyopatolojik bir durumdur. Ülkemizde yenidoğan bakımındaki gelişmelere paralel olarak gebelik yaşı ve doğum ağırlığı çok daha küçük prematüre bebeklerin yaşama şanslarının artması görme sorunlarına ve körlüğe neden olabilen prematüre retinopatisinin daha sık bir sorun olarak karşımıza çıkmasına neden olmaktadır. Prematüre retinopatisinin erken tanınması, zamanında ve uygun şekilde tedavisi görme kaybını engelleyerek çocuğun gelişimsel sürecine katkıda bulunmakta ve yaşam kalitesini artırmaktadır. Prematüre retinopatisinin ciddi medikolegal sorunlara da neden olabileceği unutulmamalıdır.

Background: Thiols are organic compounds containing sulfhydryl groups which exert antioxidant effects via dynamic thiol–disulfide homeostasis. The shift towards disulfide indicates the presence of ...

Noroglial heterotopiler nadir gorulen konjenital kitlelerdir. Nazal heterotopiler nazal glial heterotopi veya nazal gliom olarak adlandirilir. Ayirici tanida hemanjiom, dermoid / epidermoid kistler, ensefalosel ve tumorler bulunmaktadir. Cerrahi eksizyon tedavi secenegidir. Burada literaturde ilk kez tanimlanan cok dusuk dogum agirlikli bebekte nazal gliom sunulmustur. ABSTRACT Neuroglial heterotopias are rare congenital masses. Nasal heterotopies are termed as nasal glial heterotopia or nasal glioma. The differential diagnosis includes hemangioma, dermoid/epidermoid cysts, encephalocel and tumors. Surgical excision is the treatment of choice. We report an extremely low birth weight infant with nasal glioma as firts time in the literature.

Background/aim: This study aimed to compare the incidence of any stage of retinopathy of prematurity (ROP) and type 1 ROP between extremely preterm multiple- and single-birth infants. Materials and methods: In this retrospective study, we included extremely preterm infants who were ≤27 weeks of gestational age at birth. The screened infants were divided into two groups: single and multiple births. The incidence of any stage of ROP and type 1 ROP was compared between the groups. Results: This study included 301 infants; 225 were in the single-birth group and 76 were in multiple-birth group. The incidences of any stage of ROP and type 1 ROP among all infants were 70.7% (213 of 301) and 16.6% (50 of 301), respectively. Regression analysis showed that lower birth weight (OR = 0.99, P = 0.004) and longer length of stay in hospital (OR = 1.02, P = 0.002) were significantly correlated with any stage of ROP. Compared to single-birth infants, the risk of any stage of ROP and type 1 ROP did not statistically increase for multiple-birth infants (P > 0.05). Conclusion: This study showed that multiple birth had no significant correlation with ROP development in extremely preterm infants.

There exists evidence that phototherapy can disturb the oxidant/antioxidant balance in favor of oxidants. If phototherapy is continued during tube feeding in preterms, expressed human milk is subjected to phototherapy lights for about 20 min per feeding. We aimed to investigate the effects of phototherapy lights on oxidative/antioxidative status of expressed human milk.Milk samples of 50 healthy mothers were grouped as control and phototherapy and exposed to 20 min of day-light and phototherapy light, respectively. Total antioxidant capacity (mmol-Trolox equiv/L) and total oxidant status (mmol-HLevels of antioxidant capacity of the expressed human milks in the phototherapy group were lower than those of the control group [mmol-Trolox equiv/L; median (interquartile-range): 1.30 (0.89-1.65) and 1.77 (1.51-2.06), p: .001]. Levels of oxidant status were similar in both groups.We demonstrated that phototherapy decreased antioxidant capacity of expressed human milk without any alteration in oxidative status. We think that this observation is important for the care of very low birth weighted infants who have limited antioxidant capacity and are vulnerable to oxidative stress. It may be advisable either to turn off the phototherapy or cover the tube and syringe to preserve antioxidant capacity of human milk during simultaneous tube feeding and phototherapy treatment.

Ischemia-modified albumin (IMA) is used to determine tissue hypoxia. We aimed to evaluate the serum IMA levels in preterm infants requiring transfusion due to anemia of prematurity, a clinical condition to cause tissue hypoxia.This prospective study was performed in Etlik Zubeyde Hanim Hospital, Turkey. Preterm infants with birth weight less than 1500 g and born between 25 and 32 weeks were included during assessment for anemia of prematurity. The transfused infants with anemia of prematurity formed the "transfusion group", the control group consisted of gender, gestational and postnatal age-matched infants without transfusion requirement. Serum samples of control group and pre-transfusion and post-transfusion samples of transfusion group were analyzed for IMA (ABS unit). Serum IMA levels were compared between control group and pre-transfusion samples of transfusion group and were also evaluated for the significance of change after transfusion.Sixty-two infants were included (transfusion group: 31, control group: 31). The pretransfusion serum IMA levels were higher than that of infants in the control group [ABS unit; transfusion group; pre-transfusion: 1.00 (0.76-1.09) and control group: 0.81 (0.52?1.04); p = .03]. Serum IMA levels decreased significantly to 0.79 (0.59-0.95) after transfusion; p = .007. Infants with hematocrit higher than 30% had lower IMA levels [0.69 (0.54-0.96)] than infants with lower hematocrit [0.96 (0.75-1.05)]; p = .002.Clinicians may bear in mind that serum IMA levels could be utilized as a marker in deciding on erythrocyte transfusion in premature anemia.

We examined the morbidities and oxidative stress statuses in preterms receiving either SMOFlipid or ClinOleic.This observational study was performed in Etlik Zubeyde Hanim Hospital, Turkey. Infants received SMOFlipid (5 months) or ClinOleic (7 months). Two hundred and twenty seven infants (SMOFlipid: 93, ClinOleic: 134) very low birth weighted infants were included. The oxidative stress status was evaluated in infants at low risk of oxidative stress by total antioxidant capacity (TAC) and total oxidant status (TOS) and oxidative stress index (OSI; TAC/TOS/100) at baseline, first week and third week.Parenteral nutrition was given for a median of 7 days in both groups. There were statistically insignificantly higher rates of retinopathy of prematurity (9.4 versus 11.7%) and chronic lung disease (4.7 versus 6.7%) in ClinOleic group compared with SMOFlipid group. The TAC, TOS and OSI decreased significantly in ClinOleic group after 1 week, and although the results were not statistically significant, the TAC increased while the TOS and OSI decreased in SMOFlipid group. In both groups, the TAC, TOS and OSI were lower than baseline after 3 weeks.SMOFlipid and ClinOleic result in similar oxidative stress statuses after they were stopped, and we detected no statistically significant differences in morbidity rates.

Objective: The objective of this study is to evaluate if echocardiographic examination causes any pain response in term and preterm infants.Methods: Term and preterm neonates who admitted to Neonatal Intensive Care Unit at Gazi University Hospital and Etlik Zubeyde Hanim Training and Research Hospital and were performed echocardiography for any reason were included into the study. Neonates were evaluated before, during and 10minutes after the examination. Vital signs (heart rate, respiratory rate, blood pressure, transcutaneous oxygen saturation) were recorded. All subjects were also evaluated with Neonatal Infant Pain Scale during the examination.Results: In this study, we evaluated 99 newborn infants. Five infants who received fentanyl treatment were excluded. The heart rate (p=0.000), respiratory rate (p=0.000), diastolic blood pressure (p=0.001) and oxygen saturation (p=0.000) during the examination were significantly different than the values before and 10minutes after the examination. Infants whose gestational age 32 weeks (n:20) have significantly higher NIPS scores (meanSEM=3.3 +/- 0.4) than the infants whose gestational age is greater than 32 weeks (n:71) (mean +/- SEM=2.4 +/- 0.2).Conclusions: Echocardiographic examination which is known as noninvasive and painless causes significant pain in preterm infants.

Yenidoğan hemolitik hastalığı (YHH) nedenleri içerisinde minör kan grubu uygunsuzluğunun önemi giderek artmaktadır. Major kan grubu uygunsuzluğu bulunmayan ve hemolitik hastalığı olan yenidoğanlarda minör kan grubu uyuşmazlığı da düşünülmelidir. Minör kan grubu uyuşmazlığı olgularında subklinik hemoliz bulgularından aktif hemoliz ve kan değişimi gerektiren yenidoğan sarılığına kadar değişkenlik gösteren tablolar görülebilir. Rh sistemi içinde yer alan C antijenine karşı gelişmiş anti-C antikorları hafif seyirli anemi ve hiperbilirubinemi ile seyreden izoimmünizasyona neden olur. Burada hafif- orta şiddette izoimmunizasyon gösteren, hayatının ikinci haftasında fototerapi gerektiren hiperbilirubinemi ve transfüzyon gerektiren anemisi olan bir olgu sunulmuştur.

Amaç: Buçalışmada hastanemizde Yenidoğan bebeklerini terk eden annelerinsosyodemografik özelliklerinin araştırılması ve terk ediş sebeplerininbelirlenmesi amaçlandı. Gereç ve Yöntemler: Ocak2008 ve Aralık 2015 tarihleri arasındaki periyotta hastanemizde terk edilenyenidoğanların ve terk eden annelerinin tıbbi kayıtları, sosyodemografiközellikler ve terk edişlerinin belirtilen sebepleri açısından retrospektifolarak gözden geçirildi. Kayıtlar, IBM SPSS Statistics for Windows (IBM Corp.,Armonk, NY, USA, version 20) kullanılarak analiz edildi. Bulgular ve Tartışma: Belirlenenzaman diliminde terk edilmiş 67 bebek (%55,2’i kız) saptandı ve çalışmaya dahiledildi. Terk edilen bebeklerin sayısının yıllar boyunca kademeli olarak arttığıgözlemlendi (2008’de n=1 ve 2015’te n=17). Annelerin çoğunluğunun (%74,6)eğitim seviyesi düşüktü (ortaokul ve altı). Annelerin %73,1’i evli değildi ve %62,7’siçalışmıyordu. Gebeliklerin %28,4’inin tecavüz ve %4,5’inin ensest ilişki sonucuolduğu görüldü. Terk edişlerin birincil sebepleri sosyal sebepler (%62,7) idive bu sosyal sebepler arasında en sık (%78) görüleni çevre baskısı (gebeliğiaile bireylerinden saklamak) idi. Annelerin eğitim seviyeleri azaldıkçabebeklerin terk edilme oranının arttığı gözlemlendi (p, Objective: The present study aimed to investigate thesociodemographic characteristics of the mothers who abandoned their babieslegitimately in our hospital and to determine the reasons behind theabandonment. Material and Method: Medical records of the newborn babies who wereabandoned in the period between January 2008 and December 2015 in our hospital andof their mothers were reviewed retrospectively for sociodemographiccharacteristics and reasons behind abandonment. Records were analyzed by usingIBM SPSS Statistics for Windows (IBM Corp., Armonk, NY, USA, version 20). Results: Sixty-seven abandoned babies (girls 55.2%) were documented in thespecified period and included in the study. The number of abandoned babies wasobserved to be increasing gradually in years (n=1 in 2008 and n=17 in 2015). Mostof the mothers (74.6%) had a low education level (secondary school or less). Ofthe mothers, 73.1% were unmarried and 62.7% were not working. Pregnancy was dueto rape in 28.4% and due to incest in 4.5% of the cases. The primary reasons ofabandonment were social reasons (62.7%), among which peer pressure (trying tokeep the family members unaware of the pregnancy) was the most frequent (78%). Itwas observed that the rate of baby abandonment increased as the educationallevels of the mothers decreased (p

Purpose Since twin pairs with discordance have equal gestational age (GA), discordant twins may constitute an appropriate group to investigate the specific effect that birth weight (BW) has on the development of retinopathy of prematurity (ROP). The present study aims to investigate the effect of BW on any and severe stages of ROP development in twin pairs. Methods Fifty-two discordant twin pairs (104 preterms) born ≤32 gestational weeks, who were diagnosed with a minimum of 18% discordance between their BWs, were retrospectively analyzed. Twin pairs were separated into two groups based on the BW of each pair. The rate of any stage of ROP, Type 1 ROP, and perinatal risk factors were compared statistically among twin pairs. Results The rate of any stage of ROP and Type 1 ROP was 24.0% and 4.8% in the whole group, respectively. A statistically significant difference was shown between lower and higher BW groups at any stage of ROP development (34.6% vs. 13.4%, P = 0.02). However, no difference was observed in Type 1 ROP development (7.7% vs. 1.9%, P = 0.17). No significant differences were found between twin pairs regarding neonatal morbidities. The number of small GA (SGA) infants in the smaller twin group was statistically higher than larger group and regression analysis showed that being SGA had significant correlation with any stage of ROP (odds ratio: 4.98, P = 0.02). Conclusion This study showed that BW serves an effective role at any stage of ROP development in discordant twin pairs; however, no significant difference in terms of Type 1 ROP.

Objective A temporal relationship has been reported between necrotizing enterocolitis, anemia, and red blood cell transfusion (RBCT) in preterm neonates. However, the mechanism underlying this association is not clearly defined. Intestinal (I-) and liver (L-) fatty acid binding proteins (FABPs) have been proposed as plasma markers for the detection of acute intestinal injury. This study aimed to investigate the effect of anemia and RBCT on intestinal injury in preterm neonates by measuring serum I-FABP and L-FABP levels. Study Design A prospective cohort study including preterm neonates with gestational age Results In total, 39 infants transfused for anemia and 20 controls were enrolled. L-FABP levels were significantly higher in neonates with anemia compared with controls (p Conclusion Anemia is associated with intestinal injury documented by increased L-FABP levels in preterm infants, and this injury is more severe with lower hemoglobin levels.

Giriş:Metisilin dirençli Staphylococcus Aureus(MRSA) infeksiyonları, yenidoğan yoğun bakım ünitesi (NICU)’ndeki hastalar içinönemli bir morbidite ve motalite nedenidir. MRSA enfeksiyonlarının gelişiminezemin hazırlayan risk faktörlerinin belirlenmesi, enfeksiyonların önlenmesiaçısından son derece önemlidir.Bu çalışmada, MRSAenfeksiyonlarına ait risk faktörlerini saptamayı amaçladık.Gereçve Yöntemler: Bu retrospektif çalışma,1 Ocak 2011 – 31 Aralık 2015 takvim yılları arasında üçüncü basamak bir NICU’dayapıldı. Çalışmaya, kan kültürülerinde StaphylococcusAureus (S. aureus) izole edilen tüm hastalar alındı. Antibiyogram sonucunagöre, hastalar iki gruba ayrıldı: MRSA ve metisilin duyarlı S. aureus (MSSA). Hastaların demografiközellikleri ile klinik ve laboratuvar bulguları dökümente edildi.Bulgular:NICU’ya kabul edilen 9864 hastanın 54’ünde S.aureus enfeksiyonu saptandı. S.aureus enfeksiyonları, 1500 gr altındaki infantlarda (35 of 1542 infants),1500 gr ve üzerindeki infantlara (19 of 8322 infants) göre daha sık görülmekteidi [p, Objective: Methicillin-resistant Staphylococcus aureus (MRSA) infectionsare significant causes of morbidity and mortality for the patients in neonatalintensive care unit (NICU). The identification of risk factors that lead up tothe development of MRSA infections is of utmost importance in terms of preventinginfections.In this study, weaim to determine the risk factors of MRSA infections.Material and Methods: This retrospective studywas conducted in a tertiary NICU between 1stJanuary 2011 and 31stDecember2015. All patients with S. aureusisolated from blood cultures were included in the study. According to theantibiogram pattern, the patients were separated into two groups: MRSA andmethicillin-susceptible Staphylococcus aureus(MSSA). Results: S.aureus infections were more frequent in infantsunder 1500 g (2.27%) than in infants of 1500 g and above (0.23%) [OR=10.149,CI: 5.790-17.790, p

Background Preterm infants are scheduled to receive total feeding amount in either 3-hour or 2-hour intervals. A gavage feeding may be required if the scheduled amount is not completed orally. Feedings every 2 hours are one-third smaller than feedings every 3 hours. Thus, if the volume of each feed is reduced by decreasing the feeding interval from 3 to 2 hours, the likelihood that the infant completes each volume orally increases, and the probability of requiring gavage feeding decreases. The impact of feeding with 2-hour or 3-hour intervals on time to achieve full oral feeding in preterm infants was investigated. Methods Infants on full enteral gavage feedings were randomized into 2 groups to receive feedings in either 3-hour or 2-hour intervals. The time to achieve full oral feeding and the duration of feeding transition from gavage to oral feedings were investigated. Data were presented as median (interquartile range). Results The study included 100 infants (gestational age: 29 [28-31] weeks, birth weight: 1205 [1040-1380] g) with 50 in each group. The postmenstrual age to achieve full oral feeding was 35 (35-37) weeks in the 3-hour-interval group and 35 (34-36) weeks in the 2-hour-interval group; P = 0.131. The duration of feeding transition was similar between groups. Conclusions Feeding every 2 hours caused no improvement in the time to achieve full oral feeding. The 3-hour-interval feeding is appropriate for the neonatal units, where less handling of preterms and decreased workload of nurses are valuable.

Beken, Serdar/0000-0002-8609-2684; BAS, AHMET YAGMUR/0000-0002-1329-2167; Bulbul, Ali/0000-0002-3510-3056; Karatekin, Guner/0000-0001-7112-0323, WOS: 000534242500056, PubMed: 31851725, Objective To investigate the early neonatal outcomes of very-low-birth-weight (VLBW) infants discharged home from neonatal intensive care units (NICUs) in Turkey. Material and methods A 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. Results Data 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. Conclusion the 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., Turkish Neonatal Society [2-2016]; Turkish Neonatal Society, This study was supported by the Turkish Neonatal Society, http://www.neonatology.org.tr, number 2-2016, received by AYB. Turkish Neonatal Society funded the study's online registry system. the funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Introduction The incidence and risk factors for inguinal hernia (IH) is not a thoroughly evaluated issue of preterms. Prematurity is the single most important risk factor. There exists no study in our country which reported the incidence of IH in preterms. The purpose of this study is to investigate the incidence and time of diagnosis of IH in very low-birth-weight (VLBW) infants. Patients and Methods This retrospective case–control study was conducted in Etlik Zubeyde Hanim Women's Health Training and Research Hospital and included discharged VLBW infants with gestational age less than 32 weeks. Control group included gender, birth weight, and gestational age matched VLBW infants without IH. Results The incidence of IH was 10.1% in VLBW infants (70/693) and 16.1% in extremely low-birth-weight infants (19/174). Male/female ratio was found as 3.4:1. Most IH appeared as bilateral (40.0%). Time of diagnosis was 39 (37–42) weeks of postmenstrual age while 68.6% of infants were diagnosed after discharge. IH development increased by 2.3-folds by having respiratory distress syndrome and by 4.5 folds by achieving full enteral feeds on or after the 10th day. Conclusion Preterms with respiratory distress syndrome and those reach full enteral feeding on or after the 10th day should be monitored carefully for IH development. Bearing in mind that a significant amount of IH cases exhibit symptoms after discharge, neonatologists should inform the parents of premature infants of the issue and close attention should be paid in postdischarge follow-up examinations.

Objectives: To investigate the incidence, severity and risk factors of retinopathy of prematurity (ROP) in triplets. Materials and Methods: The medical records of consecutive premature triplets who had been screened for ROP in a single maternity hospital were analyzed and presence and severity of ROP; birth weight, gender, gestational age of the infant; route of delivery and the mode of conception were recorded. Results: A total of 54 triplets (40 males, 14 females) who were screened for ROP between March 2010 and February 2013 were recruited for the study. All triplets were delivered by Caesarean section and 36 (66.7%) were born following an assisted conception. During follow-up, seven (13%) of the infants developed ROP of any stage and two (3.7%) required laser photocoagulation. The mean gestational age of triplets with ROP was 27.6±1.5 (27-31) weeks whereas it was 32.0±1.5 (30-34) weeks in those without ROP (p=0.002). The mean birth weights of triplets with and without ROP were 1290.0±295.2 (970-1600) g and 1667.5±222.2 (1130-1960) g, respectively (p

Nitric oxide (NO), synthesized from the amino acid L-arginine by the action of NO synthases (NOS), is a pulmonary vasodilator. Asymmetric dimethylarginine (ADMA) is an endogenous inhibitor of NOS. Preterm infants have higher plasma ADMA concentrations than term infants which could cause inhibition of NO synthesis and deterioration in pulmonary functions. We aimed to investigate the relationship between serum ADMA and L-arginine levels of preterm infants and respiratory distress syndrome (RDS), requirement of surfactant treatment, duration of mechanical ventilation, oxygen treatment, and development of bronchopulmonary dysplasia (BPD).A prospective cohort study was conducted including 80 preterm infants born with gestational age (GA) ≤ 32 weeks and birth weight (BW) ≤ 1500 g. Blood samples were obtained from all infants immediately after birth, and at postnatal 28th day of age. The relationship of first-day serum ADMA and L-arginine levels and surfactant requirement, duration of mechanical ventilation, oxygen treatment was investigated. Serum ADMA and L-arginine levels at 1st and 28th days were compared at patients with and without BPD. The role of serum ADMA levels at postnatal 28th day of age to predict the requirement of oxygen at postmenstrual 36 weeks of age was also investigated.Eighty preterm infants (42 male, 38 female) were enrolled in the study. Mean BW and GA for the total cohort was 1144.81 ± 220.44 g and 28.3 ± 1.8 weeks, respectively. Sixty-one infants were diagnosed as RDS and 44 infants treated with surfactant. The first-day ADMA levels were significantly higher in infants with surfactant requirement (1.14 ± 0.23 versus 0.86 ± 0.37, p 0.01). First-day L-arginine levels were lower in infants with surfactant requirement compared to infants without surfactant requirement (22.32 ± 2.33 versus 23.75 ± 2.42, p 0.05) but not significantly. Serum ADMA and L-arginine concentrations at first day were not different among infants with and without BPD (p 0.05). ADMA concentrations at 28th day was significantly higher in infants with BPD (1.00 ± 0.25 versus 0.81 ± 0.25, p 0.05). The cutoff level of 0.875 μmol/L for ADMA at 28th day offered the best predictive value for oxygen requirement at postnatal 36 weeks of age with a sensitivity of 88% and a specificity of 54%. Conclusıon: Serum ADMA and L-arginine levels are related to pulmonary morbidities in newborn. The results of this study show that increased ADMA levels are associated with poor pulmonary outcomes in preterm infants.

Hyperglycemia commencing within the first 6 months of life requires exogenous insulin therapy and, if the condition persists for >2 weeks, is termed neonatal diabetes mellitus (NDM). This rare illness is of two types: transient and permanent NDM. Most cases come to medical attention because of nonspecific symptoms, including intrauterine growth retardation, dehydration, difficulties in feeding and inadequate weight gain. In the present article, we describe an infant who smelt of ketones during examination and who was diagnosed with transient NDM caused by a ZFP57 mutation, accompanied by ketoacidosis. This is the first report of such a condition.

Background The complete blood cell count (CBC) and peripheral blood smear were the most commonly ordered tests for the diagnosis of neonatal sepsis. Delta neutrophil index (DNI) shows leucocyte differentiation and calculated while CBC is performed. Aims We aimed to evaluate the value of DNI in neonatal sepsis. Study design DNI was measured with Siemens Advia 2120 and 2120i devices. DNI was calculated as (neutrophil and eosinophil count in myeloperoxidase channel)-(polymorphonuclear leucocyte count in nuclear lobularity channel). Results Study population included 141 and 87 neonates in sepsis (110 proven, 31 clinical) and control groups. Demographic characters were similar between groups. Proven sepsis group had lower birthweight and higher late-onset sepsis rate than clinical sepsis and control groups. Median DNI (16.3 vs 1,4) and CRP (6.8 vs 0,03 mg/dl) were significantly higher in sepsis group. Proven sepsis group had significantly higher DNI level than clinical sepsis group (20.8 vs 9.1). Cut-off level of DNI was 4.6 with 85% sensitivity and 80% specificity. Cut-off level of CRP was 0.58 mg/dl with 81% sensitivity and 82% specificity. Combination of DNI and CRP gave 98% sensitivity and 76% specificity. Mortality rate in sepsis group was 39%. Median DNI level in patients with mortality was significantly higher (30.1 vs 9.6). Cut-off level of DNI for mortality prediction was 16.1 with 75% sensitivity and 65% specificity. Follow-up levels of DNI was significantly decreased in 6–10 days to normal levels (16.3 to 4.2). Conclusions DNI was found to be useful in the diagnose, follow-up and mortality prediction of neonatal sepsis without extra blood to CBC.

Introduction The objectives of this study were to determine the role of a fall in pre-calving body condition score (BCS) in postpartum metabolic status and reproductive outcomes, and gauge the indicativeness of blood metabolites during the transition period. Material and Methods Cows were grouped based on BCS loss between days −14 ±3 and 0 relative to calving. Cows that lost no BCS were the BCS control group (BCS-C), cows that lost 0.25 BCS points the low BCS loss group (BCS-L), and those that lost 0.5 points or more the high BCS loss (BCS-H) group. Blood was taken on days −14 ±3, 3, 14, and 30 ±4 for determination of comprehensive metabolic panel biomarker levels. Beta-hydroxybutyric acid (BHBA) levels were quantified on postpartum examination days. Vaginal discharge scores, ovarian activity on day 30 ±4, and subsequent fertility parameters were evaluated. Results The BCS-H cows had lower mean Ca concentrations before calving and on day 3, when the group’s BHBA and CK were higher (P < 0.05); on day 14 they had higher AST concentrations (P < 0.05). The BCS-L cows had greater bilirubin levels (P < 0.05). The BCS-H cows had lower cyclicity and higher endometritis rates. First service pregnancy rates were 50%, 50%, and 61.9%, open days 96.8, 95.75, and 89.2, and overall pregnancy rates 56.25%, 65%, and 80.95 % in the BCS-H, BCS-L, and BCS-C groups, respectively. Conclusion Prepartum BCS loss of ≥ 0.5 points could be associated with Brown Swiss cow low Ca and BHBA concentrations early postpartum, and with subsequent uterine health and overall pregnancy rate. Prepartum Ca concentration might be a prognostic biomarker for postpartum metabolic status and reproductive outcomes.

The present study aimed to determine the alterations in pre- and postpartum immune function, superoxide dismutase (SOD) activity, and serum metabolite changes in Brown Swiss cows with or without retained placenta (RP). Peripheral blood was sampled at -10 ± 4 days antepartum and 10 ± 4 days postpartum for the assessment of neutrophil phagocytic and oxidative burst activities by using flow cytometry. SOD activity, beta hydroxybutiric acid (BHB), nonesterified fatty acids (NEFA), calcium (Ca), phosphorus, aspartate aminotransferase (AST), alkaline phosphatase (ALP), alanine aminotransferase (ALT), creatinine kinase (CK), gamma-glutamyl transferase (GGT), lactate dehydrogenase, bilirubin, cholesterol, glucose, urea, albumin, total protein, and triglyceride concentrations were also measured from serum samples collected at -10 ± 4, 3 ± 1, 10 ± 4, and 30 ± 4 days relative to parturition. All data were analyzed using the MIXED procedure of SPSS. Neutrophil phagocytic and oxidative burst activities, phagocytic and oxidative fluorescence intensity, and phagocytic and oxidative indexes were similar among the groups (P 0.05). However, serum SOD activity was 30 ± 4 IU/ml and 17 ± 2 IU/mL for cows that subsequently developed RP and healthy cows at -10 ± 4 days antepartum, respectively (P 0.05). Body condition scores were similar in both groups (P 0.05). All investigated serum metabolic parameters varied significantly over time (P 0.001). Cows affected with RP had subclinical hypocalcemia (8.06 ± 0.3 mg/dl) and had significantly higher BHB levels (1027 ± 137.9 mmoL/l) at 3 ± 1 days postpartum. Furthermore, these cows had greater AST and NEFA concentrations around calving (P 0.05). In conclusion, retained placenta had no prolonged effect on the measures of neutrophil function during the postpartum period. On the other hand, increased antepartum SOD activity might be a predisposing factor and can be used as a predictive biomarker for retained placenta.

Neonatal arrhythmias (NAs) are defined as abnormal heart rates in the neonatal period. They may occur as a result of various cardiovascular, systemic and metabolic problems.A retrospective chart review was performed on newborns who were diagnosed with NA during hospitalization in a neonatal intensive care unit (NICU), or who were admitted to the NICU because of an arrhythmia diagnosis in two NICUs in Turkey from May 2011 to June 2013.Seventeen neonates with arrhythmias were identified. The incidence of NA was 0.4% and 0.3% in the two NICUs, and was 0.37% in the study population as a whole. Mean gestational age was 37 (29-40) weeks. Nine of the infants (53%) were diagnosed with fetal arrhythmia (FA) during the last week of gestation. The distribution of NA types was as follows: six (35%) supraventricular tachycardia (SVT), six (35%) premature atrial contractions (PACs), two (11%) premature ventricular contractions (PVCs), two (11%) multiple arrhythmias such as SVT + PAC and AV block + PVC, and one (5%) AV block. Wolff-Parkinson-White syndrome was present in one patient. An association of NA with congenital heart malformations was identified in five cases.Cardiac arrhythmias are important causes of infant morbidity, and an occasional cause of infant mortality if undiagnosed and untreated. It is important for the physician to be aware of the etiology, development and natural history of arrhythmias in the fetal and neonatal period.

Ozcan B, Kavurt AS, Aydemir O, Gencturk Z, Bas AY, Demirel N. SNAPPE-II and risk of neonatal morbidities in very low birth weight preterm infants. Turk J Pediatr 2017; 59: 105-112. Illness severity scores were described to estimate the mortality and morbidity risks based on data obtained shortly after admission to an intensive care unit. The aim of this study is to evaluate Scores for Neonatal Acute Physiology-Perinatal Extension-II (SNAPPE-II) as a predictors of neonatal morbidities such as bronchopulmonary dysplasia (BPD) and retinopathy of prematurity (ROP). A retrospective cohort study was conducted between October 2011- 2012. A total of 278 preterm infants born with gestational age (GA) < 32 weeks and birthweight (BW) < 1,500 g were given SNAPPE-II scores based on data collected within the first 12 h of admission to ICU. The main outcomes were the development of BPD and ROP. The main variable was the SNAPPE-II obtained at admission. Logistic regression and receiver-operating characteristics (ROC) curve were calculated for SNAPPE-II. The mean GA and mean BW of the whole cohort were 29.2 weeks (± 2.15) and 1,323 g (±331,4), respectively. The median SNAPPE-II value was significantly higher among patients with BPD and ROP. After logistic regression the SNAPPE-II was independent risk factor for BPD and ROP. The best discriminative cutoff value for BPD was 14.5 (sensitivity 92%) and for ROP was 23.5 (sensitivity 80%). The present study reviewed an association between SNAPPE-II and neonatal morbidities including ROP and BPD.

Objective: Long bone fractures are rare in the newborn period. In this study, we aimed to determine the clinical characteristics and the incidence of long bone fractures in neonates. Material and Methods: A retrospective chart review was performed on newborns who were diagnosed with long bone fractures from 2012 to 2016. Results: Fifteen neonates with long bone fractures were identified. There existed eight cases with humerus fracture, four cases with femur fracture, two cases with bilateral femur fracture and one case with intrauterine femur and concomitant postnatal humerus fracture. The incidence of long bone fracture was identified as 0.19 in 1000 live births in general and 0.11 in 1000 live births for humerus fracture and 0.07 in 1000 live births for femur fracture. The probable risk factors were identified as birth trauma in eight cases (53%) and metabolic-genetic diseases in seven cases. Conclusion: Long bone fractures are one of the complications of delivery and can be attributed to maternal and/or fetal causes or maneuvers during delivery. Although long bone fractures are often associated with assisted delivery, it must be kept in mind that caesarian section does not exclude the risk in the presence of co-existing neonatal diseases.