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Objective: This study aims to examine whether there is a relationship between neurodevelopmental outcomes with transition into early full enteral feeding and weight gain rates in preterm infants. Methods: Evaluated infants' gestational ages were less than 32 weeks, birth weights were between 800 and 1.200 grams, and corrected ages were 24th months. Patients were divided into two groups, of those with transition into full enteral feeding in less than two weeks (group E) and those with transition into full enteral feeding in longer than two weeks (group L). Two additional groups were also compared, of those with weight gain rates above 10 g/day (group 1) and below 10 g/day (group 2), in the first month of life. Differentiations in neurodevelopment scores [mental development index (MDI), psychomotor development index (PDI)] were evaluated. Results: The total number of assessed infants was 330. Among them, 137 were in group E and 134 were in group L. MDI comparison was 69 and 62, respectively. The PDI comparison was 79 and 73, respectively. Compared with group 1 (n=120), lower MDI and PDI were detected in group 2 (n=110). Accordingly, both factors of late transition into full enteral feeding and low daily weight gain rate were associated with neurodevelopmental impairment. With respect to weight gain, the RR was 2.26 (1.15-4.43), p=0.018. With respect to transition into full enteral feeding, the RR was 3.46 (1.84-6.49), p=0.001. Conclusion: In the early period of life, feeding difficulties and weight gain rates of preterm infants must be monitored delicately. Nutritional difficulties constitute a negative influence on neurodevelopment.

Objective: This study investigated relationship between early respiratory support and neurodevelopmental outcomes in extremely low birth weight infants. Methods: Our study included infants born before 32 weeks' gestation at a birth weight of 750-1000 g that were admitted to the neonatal intensive care unit and underwent a neurodevelopmental evaluation at the corrected age of 24 months. Two hundred-twelve infants were divided into 3 groups by determining the predominant type of respiratory support required in the first 3 days of life. Infants who received supplemental oxygen therapy group 1, those who received nasal continuous positive airway pressure and/or nasal intermittent mandatory ventilation were in group 2, and intubated infants were included in group 3. Differences between the groups and relationships between neurodevelopment scores [mental development index (MDI); psychomotor development index (PDI)] were examined. Results: The patients mean birth weight was 887+-73 g and mean gestational age was 27+-1.9 weeks. MDI and PDI values were below 70 in the intubated patient group (68 and 66, respectively). Patients who received noninvasive ventilation or supplemental oxygen therapy for the first 3 days of life had significantly higher MDI and PDI values. In terms of morbidities of prematurity, intubated infants had higher rates of bronchopulmonary dysplasia, patent ductus arteriosus, intraventricular hemorrhage, and retinopathy of prematurity. Conclusion: Restrictive invasive ventilation policies can be applied to preterm infants and may improve neurodevelopmental outcomes. The results of this study suggest that every additional day of invasive mechanical ventilation should be avoided if possible.

Aim:Neonatal bilirubin-induced neurologic dysfunction can present with a wide spectrum of symptoms from mild neurologic impairment to severe acute bilirubin encephalopathy. In this study, we aimed to determine the risk factors of unconjugated hyperbilirubinemia among hospitalized infants with serum total bilirubin levels ≥25 mg/dL and evaluate the effects of high serum bilirubin levels due to hemolysis on neurodevelopmental outcome at postnatal between 18 and 24 months.Materials and Methods:Thirty-six term infants were enrolled in the study. The patients were divided into two groups according to their condition of either hemolytic or nonhemolytic hyperbilirubinemia. Neurodevelopmental assessment with The Bayley scale of Infant Development-II at postnatal between 18 and 24 months was performed on all infants.Results:Fourteen infants (38.9%) were in the nonhemolytic group, while 22 (61.1%) were in the hemolytic group and there was no statistically significant difference between the groups in terms of the measured mean Mental Developmental index and Psychomotor Developmental index scores. All 4 patients who underwent exchange transfusion had subgroup incompatibility and their Psychomotor Developmental index scores were significantly lower (p

OBJECTIVE: This study aimed to compare the storage properties of red blood cell (RBC) concentrates of umbilical cord blood (UCB) and adult donor blood (ADB), and to evaluate the feasibility of UCB-RBC concentrate as an autologous source for blood transfusion in very low birth weight (VLBW) preterm neonates. METHODS: In all, 30 newborn (10 preterm, 20 full term) UCB and 31 ADB units were collected. RBC concentrates were stored and compared with regard to pH, potassium (K+), 2,3-biphosphoglycerate (2-3-BPG), adenosine tri-phosphate (ATP), plasma Hb, and bacterial contamination on d 1, 21, and 35 of storage. RESULTS: The K+ level increased with time and differed significantly between storage d 1 and 21, and between storage d 1 and 35 in both the UCB and ADB units. Initial and d 21 K+ levels were higher in the UCB units than in the ADB units. The 2,3-BPG level did not differ significantly between the UCB-PRC and ADB-PRC samples. After 35 d of storage both UCB-PRC and ADB-PRC samples exhibited significant differences from the initial free Hb, intracellular ATP, and pH values. Significant differences in intracellular ATP and pH were also observed between the UCB-PRC and ADB-PRC samples. CONCLUSION: The volume of harvested and prepared UCB-PRC can be used for some of the blood transfusions required during the neonatal period and thus may decrease the number of allogeneic transfusions, especially in preterm newborns. The hematological and biochemical changes that occurred in UCB during storage were comparable with those observed in ADB, and do not pose a risk to the immature metabolism of neonates. UCB-RPC prepared and stored under standard conditions can be a safe alternative RBC source for transfusions in VLBW newborns.

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Objective: The aim of this study was to determine the neurodevelopmental outcome of preterm infants born to mothers with preeclampsia and to compare them with preterm controls. Study design: This was a retrospective, observational study in a large, tertiary, neonatal intensive care unit. Neurodevelopmental evaluations using Bayley Scales of Infant Development II were performed in 226 two-year-old infants with birth weight ≤1500 g and gestational age ≤32 weeks who were born to mothers with preeclampsia and in 493 infants who were born after normotensive pregnancies, matched for gestational age and gender. Results: The mean gestational ages of the infants in the preeclampsia and control groups were 29.9±2.3 weeks and 28.7±4.1 weeks, respectively (p

Yalçın SS, Örün E, Mutlu B, Madendağ Y, Sinici İ, Dursun A, Özkara HA, Üstünyurt Z, Kutluk Ş, Yurdakök K. Why are they having infant colic? A nested case-control study. Paediatric and Perinatal Epidemiology 2010; 24: 584-596. We aimed to analyse infant (birth characteristics, feeding type, faecal enzyme activities) and environmental (maternal smoking, nutrition and psychological status, mother-child bonding, family structure, support for the mother, familial atopy) risk factors for infant colic and to follow infants with respect to physical growth, sleeping status up to 8 months of age in a nested case-control study. 660 mothers who delivered at Dr Zekai Tahir Burak Maternity Hospital, were enrolled within 3-72 h post delivery. Each infant with inconsolable persistent crying and four matched infants with no crying episodes were invited by phone to Hacettepe University Ihsan Doğramacı Children's Hospital at 30-45 days post partum. At 40-55 days, we examined the infants and gave mothers a questionnaire, including crying characteristics of the infants; 47 infants were diagnosed with colic and 142 as non-colic. When the infants were 7-8 months old, another interview was done. The colic group had higher proportions of less-educated (≤8 years) and smoking mothers, extended family and families with domestic violence than the non-colic group. The colic group of mothers had significantly higher rates of 'impaired bonding' in the Postpartum Bonding Questionnaire, higher scores on the Edinburgh Postnatal Depression Scale, higher scores for hostility subscales of the Brief Symptom Inventory and a more irregular sleep pattern than the non-colic group. No differences were revealed for faecal enzyme activities. At 7-8 months, the colic group was shorter than the non-colic group. Colic was associated with various perinatal factors (maternal education, smoking habits, cheese consumption, hostility scores and domestic violence) and having colic in infancy negatively affected the sleeping pattern and the height of the infant. [ABSTRACT FROM AUTHOR]

The purpose of this study was to investigate the effects of mothers' psychopathologies and sociodemographic characteristics on exclusive breastfeeding within postpartum 1-1.5 months. In a longitudinal study undertaken in Dr. Zekai Tahir Burak Maternity and Research Hospital between July-October 2006, 657 mothers voluntarily enrolled within 4 to 36 hours postpartum. In the first interview, the mothers completed a questionnaire including maternal, gestational, and neonatal characteristics and a Brief Symptom Inventory (BSI), an instrument used for psychopathological evaluations. Only 46% (n=302) of the mothers were reached by telephone between postpartum 1-1.5 months for the second interview. At 1-1.5 months of age, 64.2% of the infants were exclusively breastfed. Exclusively and partially breastfed infants had similar maternal scores of BSI subscales and indexes. Exclusive breastfeeding rate was lower among infants with low family income, employed mother, planned pregnancy, maternal smoking as well as in infants having health problems at birth and excessive crying. Maternal age, education level, maternal illness/anemia during pregnancy, maternal psychological problems within the last year, birth interval, newborn gender, gestational age, birth weight, and delivery method did not influence exclusive breastfeeding within postpartum 1-1.5 months. Overall, exclusive breastfed infants had less health and breastfeeding problems. Multivariate logistic regression analysis revealed that higher family income, maternal employment, planned pregnancy, excessive crying, health problems during the first three days of life, and breastfeeding problems had negative correlations with exclusive breastfeeding between postpartum 1-1.5 months. Sociodemographic characteristics of the family and mother should be regularly assessed for their influence on exclusive breastfeeding. [ABSTRACT FROM AUTHOR]