Berna Hekimoğlu

Objective: Osteopenia of prematurity is an important cause of morbidity in preterm newborns. The aim of this study is to evaluate the clinical and laboratory findings and risk factors of osteopenia of prematurity in the newborns followed up in our unit. Method: This study was a retrospective, cross-sectional study. Newborns with a gestational age of ≤ 32 weeks, a birth weight of ≤ 1500g were included in the study. Results: The study included a total of 50 newborns. In patients with osteopenia of prematurity, invasive/noninvasive respiratory support, and duration of total parenteral nutrition (TPN) were longer, the incidence of necrotizing enterocolitis, red blood cell (RBC) transfusion rates, use of diuretics and proton pump inhibitors (PPI) were higher (p <0.05). Multiple regression analysis showed that prolonged duration of TPN was the most important risk factor for osteopenia of prematurity (OR: 1.484(1.009-2.182); p: 0.045). Conclusion: This study shows that osteopenia of prematurity remains to be an important health problem in premature newborns. Patients with prolonged TPN infusions are at risk of developing osteopenia of prematurity. Adjustment of mineral supplements in parenteral nutrition according to calcium and phosphorus levels should be started early in life, and enteral nutrition should be encouraged by reducing the duration of TPN use. Further studies are needed to increase our awareness of osteopenia of prematurity and to clarify the relationship between PPI use and RBC transfusion and osteopenia of prematurity.

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

Hypoxic ischemic encephalopathy (HIE) is an important cause of mortality and morbidity in newborns. Our study aimed to determine the neurodevelopmental outcomes, risk factors, and the relationship between risk factors and prognosis of cases followed up with HIE diagnosis and who were treated with hypothermia treatment. Medical records of 23 patients who were followed up with HIE diagnosis in the pediatric neurology outpatient clinic between January 1, 2018, and December 31, 2021, and treated with therapeutic hypothermia in the newborn period were retrospectively reviewed. Denver Developmental Screening Test II was used in the developmental evaluation. Neurodevelopment was normal in 12 (52.2%) of 23 cases and retarded for age in 11 (47.8%) cases. Variables such as Sarnat encephalopathy score in the neonatal period, need for prolonged ventilation, presence of severe acidosis at birth, Apgar scores at the 1st and 5th minutes, and abnormal cranial magnetic resonance (Mrg) findings were determined to be major factors in determining neurodevelopmental prognosis in asphyxic cases. The male gender was found to be riskier in terms of prognosis. Of the patients with HIE, retardation was determined for fine motor skills in 52.2%, speaking in 39.1%, gross motor skills in 26.1%, and personal development in 21.7%. Epilepsy, cerebral palsy, and speech disorders were the most common chronic period problems in patients with HIE. Despite therapeutic hypothermia treatment, neurodevelopmental problems are still observed in newborns with HIE. We found that male gender, low Apgar score, severe acidosis, and abnormal cranial Mrg findings in the neonatal period are risk factors in determining the neurodevelopmental prognosis of newborns with HIE. Monitoring and supporting the development of HIE cases with risk factors from the first months of life and intervening in developmental problems promptly are crucial in order to improve long-term outcomes.

Objectives To determine the prevalence and risk factors of vitamin D deficiency in pregnant women and their infants at birth (cord blood) and at six months of age in Turkey, as well as to assess the compliance rates of families with vitamin D supplementation. Methods Serum 25-hydroxyvitamin D [25(OH)D] level was measured of the mothers before delivery and of the infants both at birth (cord blood) and at six months of age. Infants who received and did not take regular vitamin D supplements were compared in terms of 25(OH) levels. Independent risk factors were determined by multiple logistic regression analysis. Results The study included a total of 140 pregnant women and their infants. Vitamin D deficiency was found in 95.7% of the mothers. The prevalence of vitamin D deficiency was 87.1% in infants at birth but decreased to 5.8% at sixth month. 65.7% of infants received vitamin D supplements regularly. Despite regular vitamin D use, it was determined that 2.2% of the infants in the supplementation compliant group had vitamin D deficiency. Maternal age, maternal education level, and the number of siblings were determined to be determining factors on infants’ 25(OH)D levels at six months (p < 0.05). Conclusions In Turkey, vitamin D deficiency still exists in both pregnant women and infants. Healthcare professionals and the public need to be more educated about the importance of regular supplementation. Serum 25(OH)D levels of infants should be tested periodically and personalized vitamin D supplementation planning is required based on test results.

Bilgi üreten Üniversiteler, mütemadiyen güncelledikleri bilgi ile eğitimlerini sürdürmekte; dolayısıyla bir yandan toplumun refahına katkı sağlarken diğer yandan da kendi geleceklerini güvence altına almaktadır. Bilginin güncellenmesi yeni ve derinlikli araştırmalarla mümkündür. Derinlikli araştırma ise alan hakimiyetine ve bilimsel araştırma yeteneğine bağlıdır. Bu imkanı sağlayacak olanlar ise biritecrübeli bilim insanı, diğeri de alan hakimiyetini kolaylaştıracak olan temel bilgi kitaplarıdır.Dünyanın Covid-19 pandemisiyle uğraştığı bir dönemde hekimlerimizin yükü katlanarak artmıştır. Görev ve sorumluluk bilinciyle kendilerini korumayı ikinci planda değerlendiren hekimlerimizin, bu yoğun iş yükü altında akademik metin üretimine zaman ayırmaları ve tıp camiasında başvuru kitabı olarak işlev üstlenecek böyle bir eseri literatüre kazandırmaları her türlü takdirin üstündedir. Eserinortak bir çalışmanın ürünü olarak gün yüzüne çıkmış olması, daha nitelikli eserlerin habercisi olarak değerlendirdiğimiz için, gelecek açısından bizi ümitledirmektedir.

Objective: Hyperbilirubinemia is one of the common problems in newborns. If not diagnosed and treated in time, high bilirubin levels can cause kernicterus and permanent brain damage. Therefore, early detection of hyperbilirubinemia development risk in newborns is important. Our aim is to determine whether the cord blood bilirubin level and the direct coombs test can be used as determinant parameters in order to predict babies with a high risk of developing hyperbilirubinemia requiring treatment. Material and Method: During the process of creating a hyperbilirubinemia follow-up protocol at Ordu University Training and Research Hospital, 300 babies born between January -June 2014with a birth weight ≥ 2500 g and gestational week ≥ 37 weeks were included in the study. The results of the cord blood bilirubin in of these babies, direct coombs test, maternal and infant blood groups and serum bilirubin levels of those who were hospitalized for phototherapy treatment within the first 24 hours were analyzed retrospectively. Results: Phototherapy was given to 35 of 300 (11.7%) newborns included in the study within the first 24 hours after birth. Direct coombs test was positive in 25 of them (8.3%). Phototherapy was given to 80% (n: 20) of the cases whose direct coombs test was positive. ABO incompatibility was found in the etiology of 51.5% of the cases with hyperbilirubinemia. It has been observed that patients with positive direct coombs test have a high rate of hospitalization (p<0.001). Cord blood bilirubin levels were found to be statistically higher in cases who received phototherapy (2.7±1.0 and 1.8±0.6, respectively, p<0.01). In determining the need for phototherapy, sensitivity was 77.1%, specificity was 77.0%, and negative predictive value was 96% for the cut off value of 2.0 mg/dl of cord blood bilirubin. Conclusion: Cord blood bilirubin level and direct coombs test are useful in predicting the possibility of pathological hyperbilirubinemia and hospitalization in newborns. Thus, detection of risky newborns with a noninvasive method within a few hours after birth will prevent early discharge and provide close follow-up and early treatment.

Journal of Neonatal Surgery is a peer-reviewed and open-access electronic journal. Only a few journals are being published on Neonatal Surgery especially from a developing country, which justifies the need of a new journal on this subject.