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Aim: Early postnatal discharge of newborns leads to the risk of hospital readmission, mostly due to neonatal hyperbilirubinemia. Therefore, early identification of newborns at high risk of hyperbilirubinemia is important. In this study, we aimed to evaluate whether cord blood red cell distribution width (RDW) levels could be used to identify newborns at high risk of developing hyperbilirubinemia. Material and methods: The data of all term infants who were born in our hospital between January and June 2017 whose cord blood samples were examined were reviewed retrospectively. Cord blood RDW, cord blood bilirubin, newborn/mother’s blood groups and direct Coombs’test (DCT) results were analyzed. Results: A total 175 newborns were included. Phototherapy was required 58 newborns in the first 48 hours postnatally. The mean cord blood RDW levels among newborns with hyperbilirubinemia was significantly higher compared to controls (18±1.6 vs. 16.4±1.0, p

Giriş-Amaç: Preterm bebeklere yenidoğan ünitesinde (YYBÜ) yatışları esnasında çoğu kez eritrosit süspansiyonu (ES) transfüzyonu (TF) yapılması gerekmektedir. Çok düşük doğum ağırlıklı (ÇDDA) bebeklerin %90 kadarına yaşamın ilk haftalarında bir veya daha fazla ES transfüzyonu yapılmaktadır.Çalışmamızda 34 gestasyonel haftanın (GH) altında doğan pretermlerde ES transfüzyonu ile ilişkili olabilecek risk faktörlerini değerlendirmeyi amaçladık. Materyal-Metod: Çalışmamıza YYBÜ’de takip edilen 34 GH altında doğan 68 bebeğin tıbbi kayıtları retrospektif olarak incelendi. Bebeklerin demografik verileri ve klinik verileri ile doğum sonrası alınan tüm kan örneklerinin sayısı kaydedildi.Bebekler TF yapılan ve yapılmayan grup olarak ikiye ayrılarak, istatistiksel olarak morbiditelerin oluşumu ve mortalite açısından kıyaslandı. Bulgular: Çalışmaya dahil edilen 68 olgunun 35‘ı kız (%51.4), 33’ü (%48.5) erkekti. Transfüzyon alan ve almayan olguların ortalama doğum tartıları ve gestasyon haftaları sırasıyla 1301 ± 402.8 g ile 1425 ± 462.3 g. (p>0.05) ve 30.0 ± 2.64 ile 30.8 ± 2.04 hafta idi (p>0.05). Olguların 25’ine (%36.7) çoklu TF tedavisi uygulanmıştı. TF olan grupta birinci, ikinci ve 3. TF günleri sırasıyla postnatal 21.4 ±10.9, 29.6±11.6 ve 32.83±8.9 gün idi. TF almayan ve alan grup kıyaslandığında doğum tartısı, gestasyon haftası, ventilatörde kalma süresi, hastanede yatış süresi, sepsis ve inotrop ihtiyacı açısından istatistiksel anlamlı fark bulundu (p0.05). Sonuç: Çalışmamızda TF alan bebeklerin doğum tartısı ve gestasyon haftasının daha düşük, ventilatörde kalma süresi,hastanede yatış süresi, sepsis görülme ve inotrop ihtiyacı sıklığının daha yüksek olduğunu saptadık.Özellikle ilk iki haftada alınan kan örnek sayısının fazla olması TF ihtiyacını arttırmakta idi. Pretermlerde ES TF ihtiyacının azaltılması için kan örneği alım sayısının azaltılması, mümkünse mikro yöntemlerin kullanılması ve invaziv olmayan monitörizasyon yöntemlerinin kullanılması gerekmektedir.

Introduction:Macrosomy is defined as birth weight being over 4000 grams. Neonatal complications are common in macrosomic infants. In this study, we aimed to compare macrosomic infants with normal weighed infants in terms of neonatal morbidities.Methods:Macrosomic infants born between 01.01.2015 and 31.08.2015 were included in the study. The study group consisted of 100 infants (group 1) with a birth weight above 4000 grams and the control group consisted of 100 infants (group 2) weighing between 2500-4000 grams. Antenatal, natal and postnatal data of macrosomic and normal weighed infants were recorded. Statistical analysis was performed using SPSS 22.0 for Windows.Results:Maternal age, macrosomic sibling history, prenatal body mass index (BMI), weight gain during pregnancy were found to be significantly higher in the macrosomic group (p=0.047, p=0.001, p=0.003, and p=0.007, respectively). Gestational week and male gender ratio of infants were higher in the macrosomic group. In the macrosomic group, 1-minute Apgar score was significantly lower, but there was no significant difference in 5-minute Apgar score. The rate of positive pressure ventilation was higher in the macrosomic group (p=0.04). The incidence of clavicle fracture, caput succadeneum and ecchymosis was higher in the macrosomic group (p=0.004, p=0.005 and p=0.022, respectively), but there was no significant difference in plexus brachialis paralysis and cephal hematoma. While hypoglycemia and pathological weight loss were significantly higher in the macrosomic group (p=0.03, p=0.038, respectively), there was no difference between the groups in terms of other variables.Conclusion:Maternal age, history of macrosomic birth, high prenatal BMI, excess weight gain during pregnancy and gestational diabetes in the mother constitute risk for macrosomic birth. Birth trauma, hypoglycemia and pathological weight loss are common in these infants. For this reason, it is very important to carry out the physical examination of macrosomic infants carefully after birth and to closely monitor them with blood sugar and weight control.

To evaluate the correlation between total serum and transcutaneous bilirubin and to determine the reliability of transcutaneous bilirubinometry for screening and monitoring of neonatal jaundice among preterms. Ninety nine infants with gestational ages ≤34 weeks were prospectively enrolled. Babies were classified into three groups as; 24–28, 29–31, and 32–34 weeks. Total serum bilirubin and simultaneous transcutaneous bilirubin were measured before the onset of phototheraphy, during and at 24 h after discontinuing phototherapy. Total serum bilirubin significantly correlated with transcutaneous bilirubin in the whole cohort (r = 0.867, p

Aim Pentraxin-3, high sensitive CRP (HsCRP) and adropin were investigated in cord blood of infants of mothers with gestational diabetes mellitus (IDM) to evaluate the exposure of fetus to inflammation and whether there is any correlation with clinical findings. Methods Forty IDM and forty three infants whose mother did not have diabetes were included in this prospective study. Adropin, pentraxin-3 and HsCRP levels were measured in the cord blood samples. Echocardiographic measurements were performed in the first three days of life. Results Adropin and pentraxine-3 levels were significantly lower and HsCRP levels were significantly higher in IDM group. Echocardiographic measurements of myocardial hypertrophy were negatively correlated with adropin. Conclusion Alterations in these markers in IDM supports the hypothesis of in utero fetal exposure to inflammation caused by gestational diabetes mellitus. Potentially, cord blood adropin might be used as a predictor for complications of diabetes.

Objective The present study aimed to assess the global oxidant and antioxidant status in infants born to preeclamptic mothers and their correlation with cardiac functions. Study Design We compared 40 infants born to preeclamptic mothers with 40 premature infants born to normotensive mothers. We assessed the relationship between echocardiographic measurements and total antioxidant capacity (TAC) and total oxidant status (TOS) values. Results In the study group, TAC, TOS, and oxidative stress index (OSI) levels were significantly higher in the cord blood (p = 0.03, 0.04, and 0.039, respectively) than in the control group. We did not observe any correlation between echocardiographic measurements and TAC, TOS, and OSI levels in infants born to preeclamptic mothers. Conclusion Compared with the control group, despite higher TAC levels in infants born to preeclamptic mothers, concurrent elevated OSI levels reveal that the oxidant–antioxidant balance is disturbed in favor of oxidants. Furthermore, the findings of this study suggest that echocardiographic parameters are unaffected by the oxidant status.

To examine the prokinetic effect of clarithromycin in very low birth weight (VLBW) preterm infants.VLBW preterm infants who have not achieved half of the full enteral feeding in the second week of life were enrolled in the study. The infants enrolled in the study were randomized. Twenty infants received oral clarithromycin (7.5 mg/kg, twice a day) and 20 control infants did not receive any treatment.Full enteral feeding was attained earlier in the clarithromycin group than in the control group [7 (6-9) versus 9 (9-11) days, respectively; p .001]. Duration of parenteral nutrition and number of withheld feeds were significantly lower in the clarithromycin group (p = .013 and p .001, respectively). Parenteral nutrition-associated cholestasis (n = 1 versus 3, p = .1) and length of hospital stay (50 versus 59 median days, p = .1) tend to be lower in the clarithromycin group without any statistical significance. We observed no adverse effect of clarithromycin therapy.Clarithromycin treatment in VLBW preterm infants resulted in better toleration of enteral feeding. Larger randomized controlled trials are needed to establish routine use of clarithromycin in the treatment of feeding intolerance.

Objective: To determine if near-infrared spectroscopy (NIRS), which is easier to obtain than Doppler ultrasonography (USG), may be used in accordance with Doppler USG to provide additional data for assessment of organ blood flow velocities in preterm infants with hemodynamically significant PDA. Study design: Thirty-one infants who were treated with ibuprofen for closure of PDA were monitored continuously with NIRS. Cerebral, mesenteric, and renal arterial blood flow velocities were measured with Doppler USG before and after the treatment. Results: While cerebral, mesenteric, and renal fractional oxygen extraction (FTOE) measurements decreased significantly (p = .042, p < .001, p < .001, respectively), NIRS measurements (p = .016, p < .001, p < .001, respectively) and mean blood flow velocities (p = .003, p = .011, p = .002, respectively) increased significantly after the treatment. There was a significant correlation between pretreatment cerebral and mesenteric FTOE and resistive index (RI) values (r = 0.45, p = .01, and r = 0.46, p = .01, respectively). However, no correlation was observed between renal FTOE values and renal RI (r = 0.33, p = .06). Posttreatment cerebral, renal, and mesenteric FTOE values correlated positively with corresponding RI (r = 0.41, p = .02; r = 0.39, p = .02; r = 0.65, p < 01; respectively). Pretreatment and posttreatment cerebral, mesenteric, and renal FTOE values and arterial mean velocities were inversely correlated (pretreatment: r = 0.69, p < .01; r = 0.72, p < .01; r = 0.77, p < .01; posttreatment: r = 0.54, p = .01; r = 0.69, p < .01; r = 0.38, p = .01; respectively). Conclusion: As Doppler and NIRS measurements correlated significantly, we concluded that NIRS might be used in monitoring organ blood flow in preterm infants with PDA, which may provide additional data for management of this condition.

Beslenme, anne karnindan baslayarak bireyin yasam boyu sagliginin korunmasi, gelistirilmesi ve yasam kalitesinde en onemli faktorlerden biridir. Ozellikle cocukluk caginda kazanilan saglikli, yeterli ve dengeli beslenme aliskanliginin yasamin programlanmasindaki rolu net olarak anlasilmistir. Ayrica, kronik hastaligi olan cocuklarda hastaliga ozgu dogru beslenme morbidite ve mortaliteyi azaltmakta , hatta bazi kronik hastaliklarda beslenme, tedavinin onemli bir parcasini olusturmaktadir.Eriskin sagligi icin anahtar rol oynayan cocukluk donemi beslenmesi ve kronik hastaligi olan cocuklarin beslenmesinin duzenlenmesinde aile hekimleri ve cocuk sagligi hekimleri onemli bir gorev ustlenmektedir. Bu kitabin amaci, saglikli ve kronik hastaligi olan cocuklarin beslenmesi ile konulari, pratikte sik karsilastiklari sorunlari ve cozumlerini sade ve anlasilir bir sekilde sunmaktir. Bu amacimizdaki basari bizim icin en buyuk mutluluk olacaktir.Kitabin hazirlanmasinda degerli zamanlarini ayirarak katkida bulunan tum yazarlara ve kitabin basimina kadar olan surec icinde katkilari nedeniyle Akademisyen Yayinevi’ne tesekkur ederiz.

Increasing epidemiologic evidence indicates that vitamin D deficiency is linked to a series of diseases, including cardiovascular disease. This prospective study was designed to determine the relationship between 25 hydroxyvitamin D (25(OH)D) level and aortic intima-media thickness (aIMT) and carotid intima-media thickness (cIMT) in term healthy neonates. A total of 135 term, healthy infants were included in the study. Ultrasonographic measurements were performed at 24-48 h after birth. Blood samples were obtained from the umbilical cord at birth. The neonates were divided into four groups according to serum 25(OH)D vitamin levels. For the entire cohort, the mean 25 hydroxyvitamin D level was found to be 15.17 ± 9.66 ng/mL. The mean values of cIMT and aIMT measurements were 0.386 ± 0.052 and 0.412 ± 0.076 mm, respectively. In group 4, mean and maximum aIMT measurements were significantly lower than the other groups (p = 0.001 and 0.001, respectively). We did not observe any significant difference between groups regarding cIMT measurements. Correlation was found between aIMT and 25 hydroxyvitamin D levels (r = 0.295 p = 0.001).Conclusion: We conclude that vitamin D deficiency may be associated with early relative intima-media thickening of the aorta already in the first week of life. What is Known: • Vitamin D deficiency is linked to a series of diseases, including cardiovascular disease. • Studies in adults and high-risk children have shown that the measurement of the intima-media thickness represents an excellent marker of subclinical atherosclerosis. What is New: • This is the first study evaluating the relationship between 25(OH)D vitamin level and intima-media thickness in term healthy neonates. • Vitamin D deficiency in neonates may induce atherosclerosis early in life and the aortic intima-media thickness measurements may be used as an early marker for detection.

A 22-day-old boy born to a 21-year-old gravida 1, para 1 mother was admitted to our hospital for routine newborn examination. On physical examination, any clinical abnormality or malformations were not observed except 1/6 systolic murmur. A well-demarcated membranous structure was confirmed by echocardiography which was starting from left ventricular apex, extending to the mitral chords including papillary muscles in apical four-chamber and parasternal long-axis examination. This structure was considered as a variant of left ventricular noncompaction. The patient is still being followed up in our pediatric cardiology department.

To compare the blood flow velocities of superior mesenteric artery (SMA) before versus after clarithromycin treatment for feeding intolerance in very low-birth weight infants.A prospective study was conducted in a group of infant1500 g with feeding intolerance who received clarithromycin 7.5 mg/kg/dose bid. Before and at the third day of the clarithromycin therapy, SMA blood flow velocity was measured with Doppler ultrasound.SMA peak systolic velocity (PSV) and mean systolic velocity (MV) on the third day of the treatment was found significantly higher than the initial measurement (p = 0.013 and p = 0.027, respectively). End diastolic velocity of the SMA did not change with clarithromycin therapy (p = 0.113). There were no significant changes about pulsatility and resistive index of SMA with regard to clarithromycin therapy.Clarithromycin effects the splanchnic circulation. The rise in PSV and MV in SMA is remarkable. These results suggest that the splanchnic blood flow increases significantly after clarithromycin usage.

It is known that use of several antiepileptic drugs (AED) during pregnancy has been associated with an increased risk of major congenital anomalies. Approximately one in 250 pregnancies is known to...

Aim: Recently, number of adolescent and advanced age pregnancies increased and became an important social issue. There are conflicting results on maternal and perinatal outcomes of those pregnancies. The objective of this study is to compare the short-term outcomes of ≤18 (adolescent) years old and ≥35 years old (advanced age) mothers’ infants with 19-34 years old (control group) mothers’ infants.Methods: Medical records of infants hospitalised in the neonatal intensive care unit of Zeynep Kamil Maternity and Children Research and Training Hospital between January 2011- January 2013 were evaluated retrospectively.Results: Overall, 20242 pregnancies in different age groups: 511 (2.5%) adolescent, 16840 (83%) control group, 2891 (14.5%) advanced age were included in the study. Sixteen percent (n=84), 17% (n=2262), and 14% (n=502) of infants of adolescent mothers, advanced age mothers, and control group mothers were hospitalised, respectively (p1, p2, p3=NS). Assisted reproductive technology, multiple pregnancy, gestational diabetes, and preeclampsia were more common in advanced age group (p, Amaç: Son yıllarda adölesan ve ileri yaş gebelikler artmış ve önemli bir sosyal konu halini almıştır. Bu gebeliklerin maternal ve perinatal sonuçları konusunda tartışmalı sonuçlar mevcuttur. Bu çalışmanın amacı hastanemizde gerçekleşen doğumlarda ≤18 yaş (adölesan) ve ≥35 yaş (ileri yaş) annelerin bebekleriyle, 19-34 yaşlarında (kontrol) olan anne bebeklerinin erken dönem sonuçlarının karşılaştırılmasıdırYöntem: Ocak 2011-Ocak 2013 arasında Zeynep Kamil Kadın ve Çocuk Hastalıkları Eğitim ve Araştırma Hastanesi’nde doğan ve yenidoğan yoğun bakım ünitesinde yatarak izlenen hastaların antenatal ve yenidoğan dönemi verileri retrospektif olarak incelendi.Bulgular: Çalışma süresince hastanemizde doğum yapan 511 (%2.5) adölesan (≤18 yaş), 16840 (%83) kontrol grubu (19-34 yaş), 2891 (%14.5) ileri yaş (≥35 yaş) gebe olmak üzere toplam 20242 olgu çalışmaya dahil edildi. Adölesan anne bebeklerinin %16’sı (n= 84),19-34 yaş arası anne bebeklerinin %14’ü (n=2262), ≥35 yaş anne bebeklerinin %17’sinin (n=502) YYBÜ’ne yatışı yapılmıştı (p1, p2, p3=NS). İleri yaş annelerde yardımcı üreme tekniği kullanımı, çoğul gebelik, gestasyonel diyabet ve preeklampsi sıklığı diğer gruplara göre daha fazlaydı (p

Recently, oxidative stress was suggested to play a role in maternal and fetal complications of diabetic pregnancies. The aim of this study is to evaluate the global oxidant and antioxidant status in infants of diabetic mothers (IDM) via measurement of total antioxidant capacity (TAC) and total oxidant status (TOS) and to determine their association with the clinical and cardiac manifestations of gestational diabetes on infants. Forty five infants constituted the IDM group, 51 infants born to non diabetic mothers served as the control group. Umbilical cord blood was drawn from IDM and controls for TAC and TOS measurement. Echocardiographic measurements were performed in the first three days of life. Infants of diabetic mother had significantly higher TAC (p=0.024), TOS (p=0.03) and oxidative stress index (OSI, p=0.04) levels compared to controls. Hemoglobin values were correlated to TOS (r=0.310, p=0.03) and OSI (r=0.310, p=0.03). Maternal HbA1c values were also correlated to TOS (r=0.576, p=0.001) and OSI (r=0.606, p

Introduction: Thanatophoric dysplasia (TD) and osteogenesis imperfecta (OI) are characterized with bone deformities. Cardiorespiratory failure leads to death mostly in the neonatal period. We presented two infants with TD and two infants with OI type II.Cases: Our first and second cases, with an antenatal diagnosis of skeletal dysplasia, were admitted to neonatal intensive care unit due to respiratory distress. First infant was born to a 30 years old mother at term with a birth wight of 2800 grams. Second case was born to a 24 years old mother at the 33th gestational week with a birth weight of 1900 grams. In physical examination both had a coarse facies, large fontanelle, low nasal bridge, narrow thoracic cage and their extremities were extremely short. Genetic consultation yielded a diagnosis of TD. Infants succumbed to respiratory failure in the 4th and 8th days of life respectively. Third and fourth cases lacked antenatal visits. They were hospitalized due to severe respiratory distress. Both infants were term SGA.They had large heads compared to trunk. Fontanelles were large and multiple fractures were palpable in the skull. Genetic consultation yielded a diagnosis of OI type II. Infants succumbed to respiratory failure in the 4th and3th days of life respectivelyConclusion: Identification of skeletal dysplasia is essential for genetic counselling. Postnatal physical examination and detailed radiologic investigation may be helpful for differential diagnosis., Giriş: Tanatoforik displazi (TD) ve Osteogenezis Imperfekta (OI) kemik deformiteleri ve solunum yetmezliği nedeniyle hayatın ilk yılında ölüm ile sonlanan iskelet displazileridir. Olgu Sunumu: İlk iki vaka prenatal takiplerinde TD’den şüphelenilen ve solunum sıkıntısı nedeniyle servisimize yatırılan bebeklerdi. Birinci olgu term appropriate for gestational age (AGA), 2. olgu ise preterm AGA idi. Göğüs kafesi, üst ve alt ekstremitelerinde ileri derecede kısalık mevcuttu. Genetik konsültasyonu sonucunda olgular TD tanısı aldı. Üçüncü ve dördüncü vakalar ise takipsiz gebelikler sonucunda doğmuş ve solunum sıkıntısı nedeniyle servisimize yatırılmıştı. Her iki bebek de term small for gestational age (SGA) idi ve başın gövdeye oranı artmıştı. Palpasyonla geniş fontanelleri mevcuttu. Kalvariumlarında irili ufaklı çok sayıda kıkırdak parçaları palpe ediliyordu. Genetik konsultasyonu ile OI tip 2 tanısı alan olgular postnatal 1. haftada solunum yetmezliği nedeni ile kaybedildiler. Sonuç: İskelet displazisi tiplerinin tanınması uygun genetik danışmanlık vermek için gereklidir. Postnatal fizik muayene ve detaylı radyolojik inceleme ayırıcı tanıda yardımcıdır. Anahtar Kelimeler: Antenatal tanı, İskelet displazisi, Osteogenezis imperfekta, Tanatoforik displazi