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ObjectiveTo investigate the early neonatal outcomes of very-low-birth-weight (VLBW) infants discharged home from neonatal intensive care units (NICUs) in Turkey.Material and methodsA prospective cohort study was performed between April 1, 2016 and April 30, 2017. The study included VLBW infants admitted to level III NICUs. Perinatal and neonatal data of all infants born with a birth weight of ≤1500 g were collected for infants who survived.ResultsData from 69 NICUs were obtained. The mean birth weight and gestational age were 1137±245 g and 29±2.4 weeks, respectively. During the study period, 78% of VLBW infants survived to discharge and 48% of survived infants had no major neonatal morbidity. VLBW infants who survived were evaluated in terms of major morbidities: bronchopulmonary dysplasia was detected in 23.7% of infants, necrotizing enterocolitis in 9.1%, blood culture proven late-onset sepsis (LOS) in 21.1%, blood culture negative LOS in 21.3%, severe intraventricular hemorrhage in 5.4% and severe retinopathy of prematurity in 11.1%. Hemodynamically significant patent ductus arteriosus was diagnosed in 24.8% of infants. Antenatal steroids were administered to 42.9% of mothers.ConclusionThe present investigation is the first multicenter study to include epidemiological information on VLBW infants in Turkey. Morbidity rate in VLBW infants is a serious concern and higher than those in developed countries. Implementation of oxygen therapy with appropriate monitoring, better antenatal and neonatal care and control of sepsis may reduce the prevalence of neonatal morbidities. Therefore, monitoring standards of neonatal care and implementing quality improvement projects across the country are essential for improving neonatal outcomes in Turkish NICUs.

Aim:The mydriatics that used for pupil-dilation in the examination of retinopathy-of-prematurity (ROP) may cause some side-effects in the neurological, gastrointestinal, cardiovascular systems by absorption from the nasal mucosa, cornea, conjunctiva, skin. In order to minimize these side-effects, it’s recommended to prepare mydriatics in appropriate concentrations, combinations, and to apply pressure on the naso-lacrimal canal by closing the eyes after the application. In this study, we aimed to evaluate the systemic side-effects in the early period of using 0.5% cyclopentolate-1% phenylephrine combination for pupil-dilatation before the ROP-examination and with the protocol we applied after drip in our unit.Materials and Methods:Thirty-three ROP examinations of 17 cases were included in the study, which was planned retrospectively. After instillation of eye drops containing 0.5% cyclopentolate-1% phenylephrine combination in accordance with our ROP-bundle-protocol, the eye was closed, pressure was applied to the naso-lacrimal canal for 1-2 minutes, and the excess part that had leaked into the skin was wiped off. Oxygen saturation (SaO2), the amount of oxygen given, blood pressure arterial (TA), heart rate were recorded before and after the drop at 10., 30., and 60. minutes. In addition, patients were followed up for 24 hours in dimensions of gastric-residue, distention, apnea and other side-effects.Results:The mean-week of gestation, body weight of 17 newborns, 35.3% (6) of whom were boys, 64.7% (11) of girls, were found to be 27.6±3 weeks, 1025±389 g, respectively. In 33 evaluations made before and after mydriatic in 17 cases; distension developed in two cases, apnea in one, and pallor of the skin in one patient. Although there was a statistically significant difference only in SaO2 and 60th minute systolic TA-measurements between pre- and post-treatment measurements, hemodynamic changes were not evaluated as clinically significant.Conclusion:In-order-to reduce the side-effects that may develop due to mydriatics, it’s necessary to standardize the practices before and after the ROP-examination, close follow-up of the cases after the ROP-examination in terms of early intervention.