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The literature on neonates with SARS-CoV-2 is mainly concerned with perinatal cases, and scanty data are available about environmentally infected neonates. To fill knowledge gaps on the course and prognosis of neonatal cases, we analyzed 1-year data from the Turkish Neonatal Society in this prospective cohort study of neonates with postnatal transmission. Data from 44 neonatal intensive care units (NICUs), of neonates with positive RT-PCR results at days 5–28 of life, were extracted from the online registry system and analyzed. Of 176 cases, most were term infants with normal birth weight. Fever was the most common symptom (64.2%), followed by feeding intolerance (25.6%), and cough (21.6%). The median length of hospitalization was 9 days, with approximately one quarter of infants receiving some type of ventilatory support. Myocarditis (5.7%) was the most common complication during follow-up. Among the clinical findings, cough (odds ratio [OR]: 9.52, 95% confidence interval [CI]: 4.17–21.71), tachypnea (OR: 26.5, 95% CI: 9.59–73.19), and chest retractions (OR: 27.5, 95% CI: 5.96–126.96) were associated with more severe clinical disease. Also, there were significant differences in the C-reactive protein level, prothrombin time (PT), partial thromboplastin time, international normalized ratio, and days in the NICU (p = 0.002, p = 0.012, p = 0.034, p = 0.008, and p < 0.001, respectively) between patients with mild-moderate and severe-critical presentations. A PT above 14 s was a significant predictor of severe/critical cases, with a sensitivity of 64% and specificity of 73%. Conclusions: Our data showed that late-onset COVID-19 infection in neonates who need hospitalization can be severe, showing associations with high rates of ventilatory support and myocarditis. Cough, tachypnea, and retractions on admission suggest a severe disease course. Trial registration: ClinicalTrials.gov identifier: NCT04401540.What is Known:• Neonatal cases of COVID-19 infection are mainly reported as perinatal COVID-19 cases.• Neonates with perinatal transmission have a mild course and favorable prognosis.What is New:• Among symptomatic neonates with late-onset COVID-19 infection, fever was the most common symptom, and almost one quarter of hospitalized cases needed some type of respiratory support. Myocarditis was the most common complication.• The presence of cough, tachypnea, retractions, and a PT above 14 s were associated with an increased risk of severe COVID-19. © 2022, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

Limited data are available on pregnant women with COVID-19 and their neonates. We aimed to evaluate the epidemiological and clinical characteristics of newborns born to women infected with COVID-19. A multicenter cohort study was conducted among newborns born to mothers with COVID-19 in 34 neonatal intensive care units (NICUs) in Turkey. Pregnant women (n = 125) who had a positive RT-PCR test and their newborns were enrolled. Cesarean section, prematurity, and low-birthweight infant rates were 71.2%, 26.4%, and 12.8%, respectively. Eight of 125 mothers (6.4%) were admitted to an intensive care unit for mechanical ventilation, among whom six died (4.8%). Majority of the newborns (86.4%) were followed in isolation rooms in the NICU. Four of 120 newborns (3.3%) had a positive RT-PCR test result. Although samples taken on the first day were negative, one neonate became positive on the second day and the other two on the fifth day. Sample from deep tracheal aspirate was positive on the first day in an intubated case. Conclusion: COVID-19 in pregnant women has important impacts on perinatal and neonatal outcomes. Maternal mortality, higher rates of preterm birth and cesarean section, suspected risk of vertical transmission, and low rate of breastfeeding show that family support should be a part of the care in the NICU. Trial registration:identifier: NCT04401540 What is Known: center dot The common property of previous reports was the conclusions on maternal outcomes, rather than neonatal outcomes. center dot Published data showed similar outcomes between COVID-19 pregnant women and others. What is New: center dot Higher maternal mortality, higher rates of preterm birth and cesarean section, suspected risk of vertical transmission especially in a case with deep tracheal aspiration during the intubation, and the possible role of maternal disease severity on the outcomes are remarkable findings of this study. center dot In contrast to recommendation for breastfeeding, parents' preference to formula and expressed breast milk due to anxiety and lack of information shows that family support should be a part of the care in the NICU. Trial registration: ClinicalTrials.gov identifier: NCT04401540

Objective. Infants with respiratory failure may require prolonged intubation. There is no consensus on the time of tracheotomy in neonates. Methods. We evaluated infants applied tracheotomy, time of procedure, and early complications in our neonatal intensive care unit (NICU) retrospectively from January 2012 to December 2013. Results. We identified 9 infants applied tracheotomy with gestational ages 34 to 41 weeks. Their diagnoses were hypotonic infant, subglottic stenosis, laryngeal cleft, neck mass, and chronic lung disease. Age on tracheotomy ranged from 4 to 10 weeks. Early complication ratio was 33.3% with minimal bleeding (1), air leak (1), and canal revision requirement (1). We discharged 7 infants, and 2 infants died in the NICU. Conclusion. Tracheotomy makes infant nursing easy for staff and families even at home. If carried out by a trained team, the procedure is safe and has low complication. When to apply tracheotomy should be individualized, and airway damage due to prolonged intubation versus risks of tracheotomy should be taken into consideration.

Giriş ve Amaç: Hipoksik iskemik ensefalopati (HİE) yenidoğan mortalite ve morbiditesinin en önemli nedenlerinden birisidir. Bu çalışmada HİE tanısıyla takip edilen yenidoğanların etiyolojik, klinik, laboratuar özelliklerini ve mortalite oranlarının belirlenmesi amaçlandı.Gereç ve Yöntem: Mart 2007–Mart 2008 tarihleri arasında Erzurum Nenehatun Kadın Doğum Hastanesi Yenidoğan Yoğun Bakım Ünitesi’nde izlenen 63 hipoksik iskemik ensefalopatili term yenidoğan retrospektif olarak değerlendirildi.Bulgular: Çalışma döneminde üniteye yatırılan term yenidoğanların %6.1’i HİE tanısı aldı. Hastaların 20’si (%31.7) kız, 43’ü (%68.3) erkek, ortalama gebelik yaşı 38.8±1.4 hafta, ortalama doğum ağırlığı 3265±561 gram, 15’i (%23.8) sezaryen, 48’i (%76.2) vajinal yolla doğmuştu. HİE etiyolojisinde rol oynayan faktörlerden %58.8’i zor doğum, kordon dolanması gibi doğuma ait nedenler, %12.8’i, intrauterin gelişme geriliği veya preeklampsi gibi gebeliğe ait nedenlerdi. Santral sinir sistemi dışında, karaciğer (%58.7), akciğer (%54) ve böbrek (%42.9) en çok etkilenen organlardı. Bebeklerin %61.9’unda ilk yedi günde konvülsiyon gözlendi. Sarnat ve Sarnat evrelemesine göre 17 olgu (%27) Evre I, 27 olgu (% 42.8) Evre II, 19 olgu (% 30.2) Evre III olarak değerlendirildi. Hastanede yatış süreleri ortalama 11.9±12.9 gün olarak saptandı. Bebeklerin 46’sı (%73) taburcu edilirken, 17 bebek (%27) eksitus oldu.Sonuç: Hipoksik iskemik ensefalopati tanı ve tedavideki ilerlemelere rağmen, halen yenidoğan yoğun bakım ünitelerinin, özellikle ülkemizin doğusunun, önemli bir sorunu olmaya devam etmektedir., Aim: Hypoxic ischemic encephalopathy (HIE) is one of the most important reason of morbidity and mortality in neonates. This study was aimed to review the etiology, clinical-laboratory features and mortality rate of neonates with HIE.Material and Method: Sixty-three full-term babies with HIE admitted to the Erzurum Nenehatun Obstetric and Maternity Hospital Neonatal Intensive Care Unit between March 2007 and March 2008 were evaluated retrospectively.Results: HIE was diagnosed in 6.1% of all patients observed in our unit in this period. There were 20 females (31.7%) and 43 males (68.3%). The mean gestational age was 38.8±1.4 weeks and the mean birth weight was 3265±561 gram. The ratio of neonates delivered by cesarean section was 23.8%, and by spontaneous vaginal delivery was 76.2%. The etiologic factors for hypoxic ischemic encephalopathy were intrapartum 58.8% and antepartum 12.8%. The most frequently affected organs were liver (58.7%), lung (54%) and kidney (42.9%), except central nervous system. The ratio of neonates who developed seizures within the first week of life was 61.9%. According to modified Sarnat and Sarnat staging, 17 (27%) patients were in Stage I, 27 (42.8%) in Stage II and 19 (30.2%) in Stage III. The mean hospitalization time was 11.9±12.9 days. The mortality rate was 27% (17), while 63% of neonates has been discharged.Conclusion: HIE still continues to be an important health issue in Neonatal Intensive Care Units, especially in the eastern Turkey, despite advances in diagnosis and treatment

Amaç: Yenidoğanlarda perinatal asfiksi sonucu oluşan metabolik asidoz dışında, geç metabolik asidoz ciddi hastalıklar nedeniyle oluşmakta ve geriye dönüşümsüz sonuçlara neden olabilmektedir.Metod: Yenidoğan ünitemize yatırılan, perinatal asfiksisi olmayan, gestasyon yaşı >35 hafta olup şok bulgularıyla başvuran yenidoğanlar retrospektif olarak değerlendirildi. Başvuru sırasında arteriyel pH≤7.30, HCO3≤16 mmol/L, baz açığı≥8 mmol/L olup NaHCO3 infüzyonu uygulananlar çalışmaya alındı. Etiyolojik nedenler, kan gazlarına NaHCO3 infüzyonunun etkisi ve prognozu etkileyen faktörler incelendi.Bulgular: Hastanemize Ekim 2009/Eylül 2010 tarihlerinde yatırılan 1284 yenidoğandan 32 term ve geç prematürede başvuruda şok bulguları olup geç metabolik asidoz nedeniyle NaHCO3 defisiti verilmişti. Hastaların hipovolemik, septik, kardiyojenik şok oranları sırasıyla %21.9, %28.1, %50; kompanse, dekompanse, geriye dönüşsüz şok evreleri ise %21.9, %37.5, %40.6 idi. Olgularda dissemine intravasküler koagülasyon (%43.8), çoklu organ yetmezliği (%28.1), akut böbrek yetmezliği (%21.9), karaciğer yetmezliğinin (%20.5) eşlik ettiği görüldü. Geç metabolik asidoz en sık doğumsal kalp hastalıkları [büyük damarların transpozisyonu, pulmoner atrezi, koarktasyon, kesintili arkus, kardiyomiyopati, atriyo-ventriküler kanal defekti; (%31.3)], sepsis (%28.1), akut böbrek yetmezliği (%18.8), doğuştan metabolizma hastalıkları [propiyonik asidemi, metil-malonik asidemi, sitrulinemi, galaktozemi, leprechaunism (%18.8)] nedenleriyle gelişmişti. NaHCO3 defisiti verildikten sonra serum pH, HCO3 ve baz fazlalığının düzeldiği saptandı (p, Background: Late neonatal metabolic acidosis except for metabolic asidosis secondary to perinatal asphyxia generally caused by severe diseases and results in irreversible adverse outcomes. Method: The findings of hospitalized neonates without perinatal asphyxia and with gestational age>35 weeks and clinical findings of shock were analysed retrospectively. At admission, the neonates with pH≤7.30, HCO3≤16 mmol/L, base excess≥8 mmol/L, and requirement of NaHCO3 infusion were included in the study. The etiology for metabolic asidosis, factors affecting prognosis, and the effect of NaHCO3 infusion on blood gases were investigated in this study. Results: Among 1284 newborns hospitalized in our hospital between October, 2009 and September, 2010; 32 neonates with significant metabolic acidosis and clinical findings of shock required NaHCO3 infusion. Hypovolemic, septic, and cardiogenic shock were determined in 21.9%, 28.1%, and 50% of neonates; retrospectively. The stages of shock were defined as compensated, decompensated, and irreversible shock in 21.9%, 37.5%, 40.6% of neonates; respectively. There were also accompanied disseminated intravascular coagulation (43.8%), multiple organ failure (28.1%), liver failure (20.5%), and acute renal failure (21.9%) in neonates with metabolic asidosis. The most common etiological disorders for development of late metabolic asidosis were congenital heart diseases [transposition of great arteries, pulmonary atresia, coarctation, aortic interruption, cardiomyopathy, atrio-ventricular canal defect (31.3%)], sepsis (28.1%), acute renal failure (18.8%), inborn errors of metabolism [propionic acidemia, methyl-malonic acidemia, citrullinemia, galactosemia, leprechaunism (18.8%)].After the infusion of NaHCO3; a statistically significant improvement was detected on parameters of pH, HCO3, and base excess (p

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.