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Objectives In this article, we aimed to evaluate the most recent information on the impact of the COVID-19 pandemic on the health of mothers and their babies. Methods We conducted a literature search by utilizing online sources. Scientific papers that were written in English on the effects of COVID-19 on both mother and their newborn were assessed. Results COVID-19 can be fatal, especially in pregnant women with accompanying chronic diseases. The timing and mode of delivery should be decided by the status of the mother and fetus instead of SARS-CoV-2 positivity in pregnant women. At the nursery, routine separation of SARS-CoV-2 positive mothers and their infants is not recommended. However, it is important to take preventive measures to reduce the risk of transmission. The advantages of breastfeeding seem to outweigh the potential dangers of viral transmission. Neonatal COVID-19 infections may cause different clinical pictures from asymptomatic infections to life-threatening diseases. International health authorities specifically recommend that pregnant and lactating women get vaccinated to diminish the risk of transmission of the virus to the mother and fetus, not giving preference to a certain vaccine. It is prudent to apply universal screening only in populations with a high prevalence of COVID-19. Conclusions Healthcare professionals should carefully manage the perinatal period during the COVID-19 outbreak, using the most up-to-date information to protect and promote maternal and newborn health. Further scientific studies are needed to clarify the early and long-term effects of the COVID-19 pandemic on maternal-neonatal morbidity and mortality.

© 2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited., Summary of recommendations Corticosteroids should be administered to women at a gestational age between 24+0 and 33+6 weeks, when preterm birth is anticipated in the next seven days, as these have been consistently shown to reduce neonatal mortality and morbidity. (Strong-quality evidence; strong recommendation). In selected cases, extension of this period up to 34+6 weeks may be considered (Expert opinion). Optimal benefits are found in infants delivered within 7 days of corticosteroid administration. Even a single-dose administration should be given to women with imminent preterm birth, as this is likely to improve neurodevelopmental outcome (Moderate-quality evidence; conditional recommendation). Either betamethasone (12 mg administered intramuscularly twice, 24-hours apart) or dexamethasone (6 mg administered intramuscularly in four doses, 12-hours apart, or 12 mg administered intramuscularly twice, 24-hours apart), may be used (Moderate-quality evidence; Strong recommendation). Administration of two “all” doses is named a “course of corticosteroids”. Administration between 22+0 and 23+6 weeks should be considered when preterm birth is anticipated in the next seven days and active newborn life-support is indicated, taking into account parental wishes. Clear survival benefit has been observed in these cases, but the impact on short-term neurological and respiratory function, as well as long-term neurodevelopmental outcome is still unclear (Low/moderate-quality evidence; Weak recommendation). Administration between 34 + 0 and 34 + 6 weeks should only be offered to a few selected cases (Expert opinion). Administration between 35+0 and 36+6 weeks should be restricted to prospective randomized trials. Current evidence suggests that although corticosteroids reduce the incidence of transient tachypnea of the newborn, they do not affect the incidence of respiratory distress syndrome, and they increase neonatal hypoglycemia. Long-term safety data are lacking (Moderate quality evidence; Conditional recommendation). Administration in pregnancies beyond 37+0 weeks is not indicated, even for scheduled cesarean delivery, as current evidence does not suggest benefit and the long-term effects remain unknown (Low-quality evidence; Conditional recommendation). Administration should be given in twin pregnancies, with the same indication and doses as for singletons. However, existing evidence suggests that it should be reserved for pregnancies at high-risk of delivering within a 7-day interval (Low-quality evidence; Conditional recommendation). Maternal diabetes mellitus is not a contraindication to the use of antenatal corticosteroids (Moderate quality evidence; Strong recommendation). A single repeat course of corticosteroids can be considered in pregnancies at less than 34+0 weeks gestation, if the previous course was completed more than seven days earlier, and there is a renewed risk of imminent delivery (Low-quality evidence; Conditional recommendation).

Many methods are used in the treatment of coronavirus disease 2019 (COVID-19), which causes acute respiratory distress syndrome (ARDS), and there are conflicting reports in the literature regarding the results of mesenchymal stem cell (MSC) therapy, which is one of those methods. The aim of our study is to evaluate the effect of MSC treatment applied together with standard treatments on survival.This retrospective case-control study evaluates the survival effect of MSC treatment administered to patients treated in intensive care after the development of ARDS due to COVID-19 between March 2020 and March 2021. The age, gender, comorbid disease status, APACHE II score, and overall and comorbidity-based survival rates were compared between patients who received standard medical treatment (SMT) and patients who received MSC treatment together with SMT.There were 62 patients in the group receiving only SMT and 81 patients in the group receiving SMT and MSC. No difference was observed between the groups in terms of age, gender, presence of comorbid diseases, or APACHE II scores. There were also no differences according to Kaplan-Maier analysis for the survival statuses of the groups. There was no serious adverse effect due to MSC treatment among these patients.Our study presents the largest case series in the literature, and it was observed that MSC treatment may not significantly affect overall survival or comorbid disease-based survival, in contrast to many other studies in the literature.Akut solunum sıkıntısı sendromuna (ARDS) neden olan koronavirüs hastalığı 2019 (COVID-19) tedavisinde birçok yöntem kullanılmakta olup, literatürde mezenkimal kök hücre (MSC) tedavisinin sonuçları ile ilgili çelişkili yayınlar bulunmaktadır. Çalışmamızın amacı standart tedavilerle birlikte uygulanan MSC tedavisinin sağkalım üzerine etkisini değerlendirmektir.Bu retrospektif olgu kontrol çalışması, Mart 2020 ile Mart 2021 arasında COVID-19’a bağlı ARDS gelişmesi sonrası yoğun bakımda tedavi edilen hastalara uygulanan MSC tedavisinin sağkalım etkisini değerlendirmektedir. Çalışmada, standart medikal tedavi (SMT) alan hastalar ile SMT ile birlikte MSC tedavisi alan hastalar arasında yaş, cinsiyet, komorbid hastalık durumu, APACHE II skoru, genel ve komorbiditeye dayalı sağkalım oranları karşılaştırıldı.Sadece SMT kullanan grupta 62 hasta, SMT ve MSC kullanan grupta 81 hasta vardı. Gruplar arasında yaş, cinsiyet, eşlik eden hastalık varlığı, Apache II skorları açısından fark gözlenmedi. Ayrıca grupların hayatta kalma durumları için Kaplan-Maier analizine göre herhangi bir farklılık yoktu. Hastalar arasında MSC tedavisine bağlı ciddi bir yan etki görülmedi.Çalışmamız literatürdeki en geniş olgu serisine sahip olup, literatürdeki birçok çalışmadan farklı olarak MSC tedavisinin hem genel sağkalıma hem de komorbid hastalık temelli sağkalıma anlamlı bir etkisi olmadığı görülmüştür.

Kadına ve erkeğe cinsiyetleri ile ilişkili olarak yüklenen kişilik özellikleri, sosyal roller, davranış kalıpları ve görevler toplumsal cinsiyet olarak tanımlanmaktadır. Kültürün içerisinde sosyal olarak inşa edilen toplumsal cinsiyet ve toplumun bu bağlamdaki beklentileri, kadın aleyhinde eşitsiz bir durum oluşturmaktadır. Toplumsal cinsiyet eşitliğinin hâlen tam olarak sağlanamamış olması, insanların ev ve iş yaşantıları başta olmak üzere birçok alanı olumsuz yönde etkilemektedir. Meslek gruplarında ve meslek statülerinde cinsiyet kaynaklı oluşan farklılıklar, kadının ve erkeğin günlük yaşam kalitesini önemli bir ölçüde farklılaştırmaktadır. Kadın aleyhinde oluşan bu farklılaşmalar, günlük yaşam pratiklerini bozan sıradışı durumlar söz konusu olduğunda daha da belirginleşmektedir. Salgın hastalıklar ve özellikle pandemiler, kadın ve erkek arasındaki eşitsizliği derinleştiren durumlara iyi bir örnek oluşturmaktadır. Bu çalışmanın amacı, öncelikle toplumsal cinsiyet eşitsizliği ile ilişkili olan unsurları genel bir çerçevede derlemek ve ardından COVID-19 pandemisinin toplumsal cinsiyet eşitliği üzerindeki olumsuz etkilerini irdelemektir. Bu amaç doğrultusunda, kadınların erkeklere kıyasla günlük yaşamlarında ekonomik ve iş gücü olarak nasıl daha çok etkilendikleri, güvenilir veriler ve bilimsel araştırmalar ışığında sunulmaktadır.

Objectives To evaluate the relationship between Coronavirus Disease 2019 (COVID-19) in pregnancy and adverse perinatal outcomes. The secondary aim is to analyze the diagnostic value of hematologic parameters in COVID-19 complicated pregnancies. Methods The current study is conducted in a high volume tertiary obstetrics center burdened by COVID-19 pandemics, in Turkey. In this cohort study, perinatal outcomes and complete blood count indices performed at the time of admission of 39 pregnancies (Study group) complicated by COVID-19 were compared with 69 uncomplicated pregnancies (Control group). Results There was no significant difference between the obstetric and neonatal outcomes of pregnancies with COVID-19 compared to data of healthy pregnancies, except the increased C-section rate (p=0.026). Monocyte count, red cell distribution width (RDW), neutrophil/lymphocyte ratio (NLR), and monocyte/lymphocyte ratio (MLR) were significantly increased (p Conclusions The study revealed that, pregnancies complicated by COVID-19 is not related with adverse perinatal outcomes. MLR may serve as a supportive diagnostic parameter together with the Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) in assessment of COVID-19 in pregnant cohort.

Aim of this study is to investigate the effectiveness of different batterer intervention programs in reducing violence for male IPV perpetrators. The Cochrane Handbook for Systemic Reviews of Interventions guidelines for the process of conducting systematic reviews and meta-analysis were followed. Pooled together, overall these various intervention programs are effective in reducing violence for male perpetrators of IPV comparing post to pre-intervention [(pooled estimate = -0.85; 95% Confidence Interval (CI) (-1.02 to -0.69)]. Exploratory subgroup analysis revealed that incorporating substance abuse or trauma components to the interventions yielded better results (substance abuse: CI = -3.20 to -1.08 and trauma: CI = -2.63 to -0.30) as compared to programs that did not have these components. Gender-role based batterer intervention programs yielded mixed results. Analysis of the three controlled studies with 223 participants comparing batterer programs to a minimal control group showed mixed effects. In conclusion, treatment strategies that are addressing highly comorbid issues such as substance abuse and trauma issues may work more effectively in preventing violence.

Background: healthcare-acquired infections (HAIs) in the neonatal period cause substantial morbidity, mortality, and healthcare costs. Our purpose was to determine the prevalence of HAIs, antimicrobial susceptibility of causative agents, and the adaptivity of the Centres for Disease Control and Prevention (CDC) criteria in neonatal HAI diagnosis. Methods: a HAI point prevalence survey was conducted in the neonatal intensive care units (NICUs) of 31 hospitals from different geographic regions in Turkey. Results: the Point HAI prevalence was 7.6%. Ventilator-associated pneumonia (VAP) and central line-associated bloodstream infections (CLABSI) and late onset sepsis were predominant. The point prevalence of VAP was 2.1%, and the point prevalence of CLABSI was 1.2% in our study. The most common causative agents in HAIs were Gram-negative rods (43.0%), and the most common agent was Klebsiella spp (24.6%); 81.2% of these species were extended spectrum beta-lactamase (ESBL) (+). Blood culture positivity was seen in 33.3% of samples taken from the umbilical venous catheter, whereas 0.9% of samples of peripherally inserted central catheters (PICCs) were positive. In our study, 60% of patients who had culture positivity in endotracheal aspirate or who had purulent endotracheal secretions did not have any daily FiO2 change (p = 0.67) and also 80% did not have any increase in positive end-expiratory pressure (PEEP) (p = 0.7). On the other hand, 18.1% of patients who had clinical deterioration compatible with VAP did not have endotracheal culture positivity (p = 0.005). Conclusions: neonatal HAIs are frequent adverse events in district and regional hospitals. This at-risk population should be prioritized for HAI surveillance and prevention programs through improved infection prevention practices, and hand hygiene compliance should be conducted. CDC diagnostic criteria are not sufficient for NICUs. Future studies are warranted for the diagnosis of HAIs in NICUs., NA

Objective Respiratory syncytial virus (RSV) is one of the most prevalent causes of lower respiratory tract infection (LRTI). The primary objective of this study is to provide the risk modelling of confirmed RSV infection in children who were born preterm at 29 to 35 weeks of gestational age and presented with LRTI. Study Design This prospective, multicenter study was performed between October 2015 and March 2017. Premature infants born with gestational age between 29 and 35 weeks that were ≤2 years of age at the beginning of the RSV season and admitted to the hospital with clinical findings of LRTI during the season were included. RSV-positive and -negative infants were compared in terms of demographic features, risk factors, and requirement of hospitalization. Results RSV positive group was lower than RSV negative group and ratio of ≤3 months age at admission was significant higher in RSV (+) group. RSV-positive infants were found to be significantly born during or 3 months prior to RSV season. The rate and duration of hospitalization and need for mechanical ventilation were significantly higher in RSV positive infants. The rate and duration of hospitalization in RSV positive patients was related to the chronological age. Conclusion This study showed that preterm infants with RSV-associated LRTI significantly needed more hospitalization, intensive care admission, and mechanical ventilation. In addition need of hospitalization and duration of hospitalization were significant higher in ≤3 months of age. Therefore, we suggest the importance of palivizumab prophylaxis in infants ≤ 3 months chronological age, especially during the RSV season.

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.

BACKGROUND: Coronavirus disease 2019 (COVID-19) primarily affects adults and spares children, whereas very little is known about neonates. We tried to define the clinical characteristics, risk factors, laboratory, and imagining results of neonates with community-acquired COVID-19. METHODS: This prospective multicentered cohort study included 24 neonatal intensive care units around Turkey, wherein outpatient neonates with COVID-19 were registered in an online national database. Full-term and premature neonates diagnosed with COVID-19 were included in the study, whether hospitalized or followed up as ambulatory patients. Neonates without severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) via reverse transcriptase-polymerase chain reaction testing or whose mothers had been diagnosed with COVID-19 during pregnancy were excluded. RESULTS: Thirty-seven symptomatic neonates were included. The most frequent findings were fever, hypoxemia, and cough (49%, 41%, 27%, respectively). Oxygen administration (41%) and noninvasive ventilation (16%) were frequently required; however, mechanical ventilation (3%) was rarely needed. Median hospitalization was 11 days (1-35 days). One patient with Down syndrome and congenital cardiovascular disorders died in the study period. C-reactive protein (CRP) and prothrombin time (PT) levels were found to be higher in patients who needed supplemental oxygen (0.9 [0.1-8.6] vs. 5.8 [0.3-69.2] p = 0.002, 11.9 [10.1-17.2] vs. 15.2 [11.7-18.0] p = 0.01, respectively) or who were severe/critical (1.0 [0.01-8.6] vs. 4.5 [0.1-69.2] p = 0.01, 11.7 [10.1-13.9] vs. 15.0 [11.7-18.0] p = 0.001, respectively). CONCLUSIONS: Symptomatic neonates with COVID-19 had high rates of respiratory support requirements. High CRP levels or a greater PT should alert the physician to more severe disease.

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.

Amac: Yenidogan bebeklerde postnatal ilk gunlerde asiri kilo kaybi onemli bir sorundur. Biz bu calismada emzirmeyi degerlendirme araclarindan LATCH, IBFAT ve BSES-SF’in postnatal erken donemde asiri kilo kaybinin tahmininde kullanisli olup olmayacagini arastirmak istedik. Gerec ve Yontem: Dogumdan sonra 150 anne ve bebek cifti emzirme sirasinda izlendi ve emzirme basarilari dogumda, 12, 24 ve 48.saatlerde LATCH, IBFAT emzirme araclari ile degerlendirildi. Es zamanli olarak annelerin emzirme ozguven skorlari belirlendi. Postnatal donemde bebeklerin kilolari dogum agirligina ulasana kadar izlendi ve %10’dan fazla ve %10’dan az kilo kaybeden bebeklerin emzirme skorlari karsilastirildi. Bulgular: IBFAT, LATCH ve BSES-SF skorlari %10’dan fazla kilo kaybeden bebeklerde %10’dan az kilo kaybeden bebeklere gore anlamli derecede dusuktu(p

BACKGROUND: Volume-controlled ventilation modes have been shown to reduce duration of mechanical ventilation, incidence of chronic lung disease, failure of primary mode of ventilation, hypocarbia, severe intraventricular hemorrhage, pneumothorax, and periventricular leukomalacia in preterm infants when compared with pressure limited ventilation modes. Volume-guarantee (VG) ventilation is the most commonly used mode for volume-controlled ventilation. Assist control, pressure-support ventilation (PSV), and synchronized intermittent mandatory ventilation (SIMV) can be combined with VG; however, there is a lack of knowledge on the superiority of each regarding clinical outcomes. Therefore, we investigated the effects of SIMV +VG and PSV+ VG on ventilatory parameters, pulmonary inflammation, morbidity, and mortality in preterm infants. METHODS: Preterm infants who were born in our hospital between 24-32 weeks gestation and needed mechanical ventilation for respiratory distress syndrome were considered eligible. Patients requiring high-frequency oscillatory ventilation for primary treatment were excluded. Subjects were randomized to either SIMV + VG or PSV + VG. Continuously recorded ventilatory parameters, clinical data, blood gas values, and tracheal aspirate cytokine levels were analyzed. RESULTS: The study enrolled 42 subjects. Clinical data were similar between groups. PSV +VG delivered closer tidal volumes to set tidal volumes (60% vs 49%, P = .02). Clinical data, including days on ventilation, morbidity, and mortality, were similar between groups. Chronic lung disease occurred less often and heart rate was lower in subjects who were ventilated with PSV + VG. The incidence of hypocarbia and hypercarbia were similar. Interleukin-1 beta in the tracheal aspirates increased during both modes. CONCLUSION: PSV + VG provided closer tidal volumes to the set value in ventilated preterm infants with respiratory distress syndrome and was not associated with overventilation or a difference in mortality or morbidity when compared to SIMV + VG. Therefore, PSV + VG is a safe mode of mechanical ventilation to be used for respiratory distress syndrome.

More information is needed on “low-risk” preterm infants’ neurological outcome so that they can be included in follow-up programs. A prospective study was performed to examine the regional brain volume changes compared to term children and to assess the relationship between the regional brain volumes to cognitive outcome of the low-risk preterm children at 9 years of age. Subjects comprised 22 preterm children who were determined to be at low risk for neurodevelopmental deficits with a gestational age between 28 and 33 weeks without a major neonatal morbidity in the neonatal period and 24 age-matched term control children term and matched for age, sex, and parental educational and occupational status. Regional volumetric analysis was performed for cerebellum, hippocampus, and corpus callosum area. Cognitive outcomes of both preterm and control subjects were assessed by Weschler Intelligence Scale for Children Revised (Turkish version), and attention and executive functions were assessed by Wisconsin Card Sorting Test and Stroop Test TBAG version. Low-risk preterm children showed regional brain volume reduction in cerebellum, hippocampus, and corpus callosum area and achieved statistical significance when compared with term control. When the groups were compared for all WISC-R subscale scores, preterm children at low risk had significantly lower scores on information, vocabulary, similarities, arithmetics, picture completion, block design, object assembly, and coding compared to children born at term. Preterm and term groups were compared on the Stroop Test for mistakes and corrections made on each card, the time spent for completing each card, and total mistakes and corrections. In the preterm group, we found a positive correlation between regional volumes with IQ, attention, and executive function scores. Additionally, a significant correlation was found between cerebellar volume and attention and executive function scores in the preterm group. Low-risk preterm children achieve lower scores in neurophysiological tests than children born at term. Preterm birth itself has a significant impact on regional brain volumes and cognitive outcome of children at 9 years of age. It is a risk factor for regional brain volume reductions in preterm children with low risk for neurodevelopmental deficits. The significant interaction between cerebellar volume reduction and executive function and attention may suggest that even in preterm children at low risk can have different trajectories in the growth and development of overall brain structure.

Objective: Nitric oxide plays a preventive role in the development of necrotizing enterocolitis. Oral nitrite and nitrate intake has gained importance with the discovery of the conversion of nitrite to nitric oxide in acidic medium out of the synthesis of nitric oxide from L-arginine. Objective of this study was to examine the breast milk concentrations of nitric oxide and asymmetric dimethylarginine which is a competitive inhibitor of nitric oxide and to compare these concentrations in terms of gestational age and maturity of breast milk. Study Design: Forty-one women were included in the study. Milk samples were collected from 3 groups of mothers as term, late preterm and preterm on the postpartum days 3, 7 and 28. Results: When breast milk concentrations of nitric oxide were compared according to the postnatal day of the milk independently from gestational age; nitric oxide concentration was higher in the colostrum than in the transition milk and mature milk (p=0,035; p=0,001; respectively). For the comparison of asymmetric dimethylarginine concentrations among these groups and days; no statistically significant difference was observed in terms of gestational age and maturity of the milk (p=0.865, p=0.115; respectively). Conclusion: The highest nitric oxide concentration was found in the colostrum, suggesting that colostrum is a valuable food for newborns. Plasma concentrations of asymmetric dimethylarginine were negatively correlated with nitric oxide and did not show a correlation with breast milk, suggesting that asymmetric dimethylargininedoesn’t make nitric oxide inhibition in breast milk.

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.

Citrullinemia type 1 (CTLN1) is a rare inherited urea cycle disorder, which resulted from the deficiency of argininosuccinate synthetase enzyme. We presented an infant who was hospitalized because of acute losses of tonus and cyanotic hypoventilation attacks lasting approximately 4-5 min. The physical and neurological examinations were normal. Ammonia level was in the normal range. Citrulline levels increased in both blood and urine. The blood sample was sent to mutation analysis, which showed one novel and one known mutation on ASS1 gene sequencing: a heterozygous novel mutation p.A94V (c.281C>T) and a heterozygous mutation p.W179R (c.535C>T). Urea cycle disorders should be considered in the differential diagnosis of unexplained brief apnea or hypoventilation attacks, even though those symptoms do not lead to hyperammonemia during infancy and childhood as seen in our patient. This is the first case in terms of atypical clinical presentation with a new mutation for CTLN1.

AIM Most of the preterm infants are transfused at least once during their stay in the neonatal intensive care unit (NICU). The aims of this study were to demonstrate if packed red blood cell (pRBC) transfusion modulates regional (cerebral, abdominal, renal) tissue oxygen saturation measured by near-infrared spectroscopy (NIRS) and to demonstrate if we can use NIRS to guide transfusion decisions in neonates. METHODS A multi-probe NIRS device was applied to anaemic preterm infants of gestational age

Introduction: Most important factors in retinopathy of prematurity (ROP) are prematurity and oxygen toxicity although blood transfusions, insulin like growth factor-1 ( IGF-1), insulin like growth factor binding protein 3 (IGFBP-3) and vascular endothelial growth factor (VEGF) also have important roles. The objectives of this study were, to measure IGF-1 and IGFBP-3 levels in preterm newborns before and after blood transfusion and assess if the effect of transfusion in development of ROP is via these mediators, and to investigate whether IGF-1 and IGFBP-3 levels measured at 32 and 33 gestational age (GA) were different in preterm newborns with and without ROP. Material and Methods: Preterm newborns with gestational age ≤34 weeks were included and blood samples were obtained before and after red blood cell (RBC) transfusion. Results: Thirty newborns were included, 17 of whom had ROP ( stage 1: n=11, stage 2: n=5, stage 3: n=1). IGF-1 and IGFBP-3 levels did not change after RBC tranfusion. Excluding the patient with stage 3 ROP all ROP patients were referred as mild ROP. No difference was observed between IGF-1 and IGFBP-3 levels of the patients with and without mild ROP. Patients with mild ROP had significantly more number of transfusions. Conclusions: Erythrocyte transfusion increased the frequency of ROP, whereas IGFBP-3 and IGF-1 were not associated of ROP.

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.

Thyroid functions in the fetus and newborn carry importance in terms of the baby's health and development of the central nervous system. Maternaliodine deficiency, exposure to iodine, thyroid diseases (Hashimoto thyroiditis, Graves') and drugs used by the mother affect thyroid functions in the fetus. Reflections of these effects are observed immediately after delivery. Investigation of the mother in terms of thyroid diseases during pregnancy, recognition and appropriate assessment of the required conditions, screening of all newborns in the first days of life in terms of congenital hypothyroidism, timely and appropriate evaluation of the screening results, early diagnosis and appropriate treatment of cases of congenital hypothyroidism, assessment and management of cases of transient thyroid hormone disorders and close monitoring of the thyroid functions and development of patients in whom treatment has been initiated with a diagnosis of hypothyroidism are crucial in terms of developmental outcomes of the babies who have thyroid function disorders or hypothyroidism. This guideline was written with the objective of guiding pediatricians, neonatologists and pediatric endocrinologists in the issue of assessment, diagnosis and management of thyroid function disorders and thyroid diseases concerning the fetus and baby during gestation and neonatal period.Fetus ve yenidoğanda tiroid fonksiyonları bebek sağlığı ve merkezi sinir sisteminin gelişimi açısından önem taşımaktadır. Annede iyot eksikliği, iyoda maruziyet, tiroid hastalıkları (Hashimoto tiroiditi, Graves’ hastalığı), annenin kullandığı ilaçlar fetusun tiroid işlevlerini etkiler. Doğumdan hemen sonra da bu etkilerin yansımaları görülür. Gebelikte annenin tiroid hastalıkları açısından incelenmesi gereken hallerin tanınması ve sağlıklı değerlendirilmesi, tüm yenidoğanların yaşamın ilk günlerinde konjenital hipotiroidi için taranması, tarama sonuçlarının zamanında ve sağlıklı değerlendirilmesi, konjenital hipotiroidili olguların erken tanısı, erken ve yeterli tedavisi, geçici tiroid hormon bozukluklarının değerlendirilmesi ve yönetimi, hipotiroidi tanısı ile tedavi başlanan hastaların tiroid fonksiyon ve gelişimlerinin yaşamın ilk yıllarında yakın izlemi bu dönemde tiroid fonksiyon bozuklukları ya da hipotiroidisi olan bebeklerin gelişimsel sonuçları açısından son derece önemlidir. Bu kılavuz çocuk hekimleri, yenidoğan ve çocuk endokrinoloji uzmanlarına gebelik ve yenidoğan döneminde fetus ve bebeği ilgilendiren tiroid fonksiyon bozuklukları ve tiroid hastalıklarının değerlendirilmesi, tanısı ve yönetimi konusunda yol göstermek amacıyla kaleme alınmıştır.

Microcirculation is an important component of hemodynamic physiology. It can be assessed simply by clinical scores or by a variety of techniques including sidestream dark field (SDF) imaging and peripheral perfusion index (PI) measurements. Mode of delivery may have affects on microcirculation during transitional period. The aim of this study was to compare skin microcirculation in newborns born via vaginal delivery (VD) or cesarian section (C/S).Term healthy newborns not requiring NICU admission were included. Vital signs were recorded. Skin microcirculation was determined by clinical scoring including capillary refill time, skin color, warmth of extremities, by SDF imaging where capillary density and microvascular flow is determined and by PI measurements where pulsatile and nonpulsatile capillary flow is measured. Assessments were done at 30 min and 24 h of life. Results were compared between VD and C/S groups and overtime.There were 12 newborns in VD group and 25 newborns in C/S group. No difference was observed in microcirculation assessments between groups. However VD group had increased hyperdynamic flow overtime.In healthy term newborns microcirculation does not seem to be affected by mode of delivery, however results may differ in sick or preterm newborns.

To compare interleukine-10 (IL-10) and total antioxidant capacity (TAC) levels after breast milk storage by studying premature and term mothers’ colostrum and mature milk and by analyzing those levels relative to gestational week.Fifty-four colostrum and mature breast milk samples were collected from both premature and term mothers. The samples were divided into three groups based on the time of analysis: fresh milk, at +4 °C for 72 h, and at -20 °C for 14 d. The IL-10 and TAC levels were measured quantitatively.Fresh colostrum and mature milk had similar IL-10 levels. Term mothers’ fresh-colostrum TAC levels were higher than their mature milk. The mature milk of the premature mothers’ had higher TAC levels than that of term mothers. Storage did not affect the IL-10 levels of breast milk, but fresh milk antioxidant capacity halved after 72 h and 14 d. Colostrum IL-10 and TAC levels did not correlate with gestational week. Mature milk IL-10 levels did not correlate with gestational week, but TAC levels negatively correlated with gestational week (r: -0.61: p 0.01).The milk stored for 72 h at +4 °C and for 14 d at -20 °C did not maintain the same TAC levels as the fresh samples. This should be considered especially for sick infants who need more antioxidant capability in neonatal units.

Background Perfusion index (PI) is becoming a part of clinical practice in neonatology to monitor peripheral perfusion noninvasively. Hemodynamic and respiratory changes occur in newborns during the transition period after birth in which peripheral perfusion may be affected. Tachypnea is a frequent symptom during this period. While some tachypneic newborns get well in less than 6 h and diagnosed as “delayed transition”, others get admitted to intensive care unit which transient tachypnea of newborn (TTN) being the most common diagnosis among them. We aimed to compare PI of neonates with TTN and delayed transition with controls, and assess its value on discrimination of delayed transition and TTN. Methods Neonates with gestational age between 37 and 40 weeks who were born with elective caesarian section were included. Eligible neonates were monitored with Masimo Set Radical7 pulse-oximeter (Masimo Corp., Irvine, CA, USA). Postductal PI, oxygen saturation and heart rate were manually recorded every 10 s for 3 min for two defined time periods as 10th minute and 1st hour. Axillary temperature were also recorded. Newborn infants were grouped as control, delayed transition, and TTN. Results Forty-nine tachypneic (TTN; 21, delayed transition; 28) and 30 healthy neonates completed the study. PI values were similar between three groups at both periods. There were no correlation between PI and respiratory rate, heart rate, and temperature. Conclusion PI assessment in maternity unit does not discriminate TTN from delayed transitional period in newborns which may indicate that peripheral perfusion is not severely affected in either condition.

Angiogenesis is an important process after birth for neonates. Vascular endothelial growth factor is a potent proangiogenic protein, which stimulates endothelial cell proliferation, survival, and migration. For vessel maturation, all components have to move together. Angiopoietins (ANG) are very important signal proteins for pericytes and have not yet been determined in human breast milk. The aim of this study was to show whether there were ANG in human breast milk.Human breast milk samples were collected from 9 mothers of preterm (≤33 weeks) and 17 mothers of term and late preterm (33 weeks). Milk samples were collected on 3rd, 7th, and 28th days from delivery. We analyzed ANG-1 and ANG-2 levels in human milk and compared these levels considering the gestational age and day of lactation from delivery.There was a significant difference between the ANG-1 levels of the two groups of gestational age (p = 0.008), while ANG-2 levels were not significantly different (p = 0.821), without considering the days of lactation from delivery. ANG-1 and 2 levels of milk samples of 3rd, 7th, and 28th days from lactation showed no significant difference in both gestational age groups.The presence of ANG in human breast milk was proved with this study and ANG-1 levels were found to be lower in preterm group. These results may be important for neonates in terms of angiogenesis and also lymphangiogenesis.

Amaç: Bu çalışmanın amacı fetal ve erken postnatal serum endoglin düzeylerinin fetal büyümedeki rolünü ve maternal preeklampsinin endoglin düzeylerine olan ilişkisini araştırmaktır.Materyal ve Method: Bu çalışmaya 55 yenidoğan prospektif olarak çalışmaya dahil edildi ve 4 gruba ayrıldı:1)Normal gebelik ve gebelik haftasına göre düşük doğum ağırlıklı yenidoğanlar (n:13,small for gestational age:SGA) 2)normal gebelik ve gebelik haftasına göre fazla doğum ağırlıklı yenidoğanlar (n:19, large for gestational age:LGA) 3)Preeklamptik anneden doğan gebelik haftasına göre normal ağırlıklı yenidoğanlar (n:12, appropriate for gestational age:AGA)) 4)kontrol grup: preeklampsi ve herhangi bir hastalığı olmayan anneden doğan gebelik haftasına göre normal ağırlıklı yenidoğanlar (n:11).Kanlar umblikal kordondan ve postnatal 4.saatte periferal venden toplandı. Serum endoglin düzeyleri ELISA kit kullanılarak ölçüldü.Bulgular: Endoglin çalışılan tüm umblikal kord ve yenidoğan serumlarında saptandı. Fetal ve erken postnatal serum endoglin düzeyleri arasında SGA, LGA, preeklamptik ve kontrol grupları bakımından fark saptanmadı. Fetal ve erken postnatal serum endoglin düzeyleri SGA grupta AGA gruptan yüksek saptandı.Sonuçlar: Fetal ve erken postnatal serum endoglin düzeyleri yenidoğanlarda değişmemektedir. SGA yenidoğanlarda serum endoglin düzeyleri farklılık göstermektedir. Sonuçlarımız artan endoglin düzeylerinin SGA patofizyolojisinde rol oynayabileceğini düşündürmektedir.Normal ve komplike gebeliklerden doğan yenidoğanlarda endoglinin fetal büyümedeki rolünu belirlemek için geniş serili çalışmalara ihtiyaç vardır., Aim: The aim of the present study was to evaluate the role of fetal and early postnatal serum endoglin levels in fetal growth and to investigate the association between neonates of preeclamptic mothers and endoglin levels.Material and Methods: Fiftyfive neonates were prospectively enrolled into the study and divided into four groups: 1) Normal pregnancy and small for gestational age (SGA) neonates (n:13), 2) normal pregnancy and large for gestational age (LGA) neonates (n:19), 3) appropriate for gestational age (AGA) neonates of preeclamptic mothers (n:12), and 4) control group: AGA neonates born to mothers without preeclampsia or any other disease (n:11). Blood was collected from umbilical cords (UC) with both ends clamped, and from peripheral vein in the postnatal 4th hour. Serum endoglin levels were measured by employing an ELISA kit.Results: Endoglin was detectable in the serum of all studied umbilical cord and neonates. No statistically significant differences were found between fetal and early postnatal serum endoglin levels in SGA, LGA, preeclamptic and control groups. Fetal and early postnatal serum endoglin levels of SGA group were significantly higher than the values of AGA group.Conclusion: Fetal and early postnatal serum endoglin levels seem to be unchanged in neonates.We showed that SGA neonates are characterized by a alterations in serum endoglin levels.Our results suggest that increased endoglin levels may play a role in the pathophysiology of SGA. Further studies with larger patient series are required to determine the role of endoglin in fetal growth in normal neonates and in neonates born after a complicated pregnancy.

Background: The aim of the present study was to determine language levels in twins and singletons born after at least 34 weeks gestation and without identifiable neurological abnormality and to evaluate whether in vitro fertilization (IVF) affects language development in twin pregnancies. Methods: A prospective study of a large cohort of all children born between 1 January 2001 and 31 December 2003 was carried out at Gazi University Hospital. All live-born twin pairs in which both twins survived were identified, and a comparable sample of families with pairs of singletons were chosen. The Stanford–Binet Intelligence Scale Form and the translated Turkish form of the Peabody Picture Vocabulary Test were completed at 60 months. Results: Even after excluding the most premature twins and those with diagnosable neurological damage, twins performed worse than singletons on language development tests. Twin girls had better scores than twin boys. A statistically significant difference was found between the scores of term and preterm twins. No significant difference was noted when compared according to birth order. Appropriate for gestational age (AGA) twins did better than small for gestational age (SGA) twins in the test scores. All twin girls did not differ from singleton girls, but all twin boys performed worse than singleton boys. Term twins had similar results with term singletons, but preterm twins had lower scores than preterm singletons. SGA singletons had better scores than SGA twins, while AGA twins and singletons did not differ. When the children were compared with regard to method of conception, IVF children had significantly lower scores on the tests than those in the spontaneous conception group. Conclusion: It is hoped that the present findings could lead to a more precise assessment of children for speech impairment and, above all, to more efficient preventive intervention. Whatever mechanisms are involved, the present results indicate that twins born as a result of IVF, are at a disadvantage in terms of language development in comparison with spontaneously conceived twins.

DNA repair plays a key role in prevention of carcinogenesis and one of the most important DNA repair mechanisms is nucleotide excision repair (NER) pathway. This pathway includes a number of genes such as excision repair cross-complementing group 1 (ERCC1) gene which are responsible for the 5′ incision of damaged DNA. A reduced DNA repair capacity associated with ERCC1 mRNA level has been observed in lung carcinogenesis. Two single nucleotide polymorphisms (SNPs) in ERCC1 gene, T19007C (rs11615) and C8092A (rs3212986), reportedly predict to affect the mRNA of ERCC1 in non-small cell lung cancer (NSCLC). To examine the role of two common SNPs in ERCC1 gene further, we conducted this study where 80 cases histopatologically diagnosed as NSCLC were genotyped. Genomic DNA was extracted from formalin-fixed, paraffin embedded tissues and two SNPs were analyzed using real-time PCR. The distributions of TT, TC, and CC genotypes of the T19007C SNP were 40, 44 and 16%, respectively. Significantly increased frequency of the patients carrying at least one 19007C allele was observed in early stage compared to advanced stage (P = 0.002). And also, the frequency of TC and CC genotypes significantly increased in younger patients compared to older patients (P = 0.035). Regarding C8092A SNP, the distribution of CC, CA, and AA genotypes was 38, 51 and 11%, respectively. There was no significant difference in the genotype distribution between C8092A SNP and clinicopathological parameters. This study indicated that harboring at least one 19007C allele may have protective effect in NSCLC. © 2011 Springer Science+Business Media B.V.

Background: Generalised oedema is a frequent finding during neonatal sepsis, but its aetiology remains uncertain. Objective: The objective of this study was to measure functional C1 inhibitor (fC1 inh) levels in newborns with culture-proven sepsis, compare the results with age- and gestational age (GA)-matched controls and correlate the results with the clinical course of the patients during infection, with regard to vascular leak and oedema formation. Methods: Newborns with blood culture-proven sepsis were included and samples for C1 inh levels were obtained before the beginning of antibiotic therapy and on the 3rd day of treatment. Body weight, urine output and other treatment modalities including volume boluses were recorded. Oedema formation as a sign of vascular leak was determined by calculating percent weight change over time. Age- and GA-matched newborns without infection were used as controls. Results: No difference was observed between the patient and the control groups concerning fC1 inh levels. Percent weight change in the patient group was not correlated with the C1 inh levels. Conclusion: Despite studies suggesting the role of C1 inhibitor deficiency in vascular leak during sepsis in adults, there is no information in the literature regarding the C1 inh levels of healthy or septic newborns to date. In this study, fC1 inh levels were no different than controls, necessitating the consideration of other factors causing vascular leak and oedema during neonatal sepsis.

Objective: Free radical production is increased by the administration of total parenteral nutrition (TPN) and may be linked to its adverse effects. Some of the complications of TPN can be ameliorated by partial enteral feeding. In the present study, we investigated plasma nitrate/nitrite (NO2/NO3) levels in newborns under parenteral and enteral plus parenteral nutrition (PN). Study Design: Six categories of patients were studied: (1) 10 term infants receiving enteral feeding, (2) 10 term infants receiving PN plus enteral feeding, (3) 10 term infants receiving TPN, (4) 10 preterm infants receiving enteral feeding, (5) 10 preterm infants receiving PN plus enteral feeding, and (6) 10 preterm infants receiving TPN. Plasma nitrate/nitritelevels were measured in all infants initially and in infants receiving TPN and PN plus enteral feeding on the 1st and 5th days, 3 h after the lipid infusion. Results: There was a statistically significant difference in the weighs of infants between the term and preterm groups. There was no difference in NO2/NO3 levels between the term and preterm groups. When the groups of term (groups 1, 2, 3) and preterm (groups 4, 5, 6) infants were compared separately within the groups, no statistically significant difference was found in any parameters. We also made comparison among the six groups’ gestational ages, and we found a difference between all term groups and all preterm groups except between groups 1 and 2; groups 1 and 3; groups 2 and 3; groups 4 and 5, and groups 5 and 6 (p < 0.05). Furthermore, the baseline, 1st and 5th days NO2/NO3 levels were compared in the term and preterm groups receiving PN. Plasma NO2/NO3 levels before TPN were significantly lower in the term infants receiving parenteral fluids compared with NO2/NO3 levels of 1st day of TPN (p < 0.05). In preterm infants receiving TPN the NO2/NO3 levels before TPN were significantly lower than the levels on the 5th day of PN (p < 0.05). There was no significant difference among other NO2/NO3 levels of the patients at baseline, 1st and 5th days in the term and preterm groups. Partial enteral feeding did not change the levels of NO2/NO3 in term and preterm infants on PN. Conclusion: This study shows that TPN has some impact on nitric oxide (NO) production in newborn and partial enteral nutrition does not reduce this effect. However, since the numbers are very small these findings need to be verified by larger groups of patients.

Background: Nutrition of very low-birth-weight newborns is important for a good physical and neurologic outcome. Body composition assessment, together with anthropometric measurements, is considered necessary to monitor adequate nutrition and growth. Objectives of this study were to assess body fat changes in newborns

Objective: To examine the utility of the Bayley Infant Neurodevelopmental Screener (BINS) for the neurodevelopmental follow up of high-risk preterms. Methods: The study group consisted of 122 preterm infants of the gestational ages between 26 and 37 weeks. Medical factors such as; mean birth weight, gestational age, gender, birth place and type, number of multiple pregnancy, days of hospitalization and oxygen therapy, use of antenatal steroids, and occurence of sepsis for each patient were evaluated. The neurodevelopmental examination and BINS administration was made at each visit to the patients whose ages were adjusted for prematurity. Results: At the corrected age of 7-10 months patients at 26-29 GA had significantly lower total means of BINS scores when compared to those of the other two groups at 30-32 and 33-37 GA (P < 0.01 and P < 0.001). At the corrected age of 3-4 months, the total means of the BINS scores of the patients at 30-32 GA were lower than that of the patients at 33-37 GA (P < 0.009). at 7-10 months the scores of the items defining the expressive and cognitive functions of the patients at 26-29 GA were lower than those of the patients at 30-32 GA (P < 0.05) and 33-37 GA (P < 0.05). At 16-20 months the mean scores of the items of expressive functions were significantly lower in patients of the 26-29 GA compared to those of the patients of 33-37 GA (P < 0.03). Conclusion: As data accumulates, BINS will turn out to be a quick way of determining infants at risk of developmental delay in many aspects of neurologically high risk conditions. (c) 2005 Elsevier B.V. All rights reserved.

Cardiac tamponade is a rare but life-threatening complication of umbilical venous catheterization in the newborn. Most complications from central venous catheters are related to incorrect position of the catheter and it is emphasized to confirm the position of the catheter tip after placement in order to avoid possible complications. We present an unusual complication of cardiac tamponade because of umbilical venous catheterization in a term newborn which is extremely rare with correct location of the catheter tip at the junction of inferior vena cava and right atrium. We suggest that correct position never guarantees uneventful catheterization in the newborn. In any infant with a central venous catheter in situ who deteriorates clinically, pericardial effusion/cardiac tamponade must be considered and appropriate action taken.

The study was designed to investigate the cerebrospinal fluid and serum levels of neuron-specific enolase, along with cranial ultrasonography, magnetic resonance imaging (MRI), and electroencephalography (EEG), for predicting the clinical state and neurologic outcome of 26 asphyxiated term newborns. The babies were graded according to the Sarnat and Sarnat classification. Cerebrospinal fluid neuron-specific enolase levels of the 18 babies in the whole hypoxic-ischemic encephalopathy group were higher than the 8 babies in the “no encephalopathy” group. Cerebrospinal fluid neuron-specific enolase levels of 13 cases in the hypoxic-ischemic encephalopathy grade 2 and 3 groups (high-risk group) were higher than both the no encephalopathy and hypoxic-ischemic encephalopathy grade 1 groups when pooled. Cerebrospinal fluid neuron-specific enolase levels of the 7 newborns in the hypoxic-ischemic encephalopathy grade 3 group were also significantly higher than the 5 in the hypoxic-ischemic encephalopathy grade 1 group. The findings of cranial MRI, EEG, and cerebrospinal fluid neuron-specific enolase levels were correlated with each other and the clinical grade of the patients and also were predictive of the neurologic outcome at 1 year of age. Cerebrospinal fluid neuron-specific enolase levels, cranial MRI, and EEG are predictive of outcome of hypoxic-ischemic brain damage in asphyxiated newborns, and this predictivity would increase with the combination of these diagnostic parameters. ( J Child Neurol 2002; 17: 824—829).

Lipids are the main source of calories and considered very important in infant growth. We aimed to compare fatty acid composition of term and preterm breast milk. This is the first study that compares the fatty acid levels of preterm and term breast milk in Turkish women.Breast milk samples were obtained from mothers of term (n = 15) and preterm (n = 15) infants on postnatal days 3, 7, and 28. Fatty acid composition of human breast milk was determined longitudinally by gas-chromatography/mass spectrometry.There Were 31 fatty acids measured in the milk samples. In the first month, 17 fatty acid levels had significant differences. In group comparison, some fatty acids (C14:0, C16:0, C18:1 and C20:5) had significantly increased in the preterm group (P = 0.041, P = 0.046, P = 0.027, P = 0.033, respectively), whereas myristoleic acid (C14:1) and eicosanoic acid (C20:0) had significantly increased in the term group (P = 0.015, P = 0.048, respectively).Term and preterm milk have different compositions of fatty acids. Breast milk composition changes over time. As a general conclusion, breast milk provides the lipid requirements of infants.