#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Early neonatal outcomes of very-low-birth-weight infants in Turkey: A prospective multicenter study of the Turkish Neonatal Society


Autoři: Esin Koc aff001;  Nihal Demirel aff002;  Ahmet Yagmur Bas aff002;  Dilek Ulubas Isik aff003;  Ibrahim Murat Hirfanoglu aff001;  Turan Tunc aff004;  Fatma Nur Sari aff005;  Guner Karatekin aff006;  Ramazan Ozdemir aff007;  Huseyin Altunhan aff008;  Merih Cetinkaya aff009;  Beyza Ozcan aff010;  Servet Ozkiraz aff011;  Sebnem Calkavur aff012;  Kadir Serafettin Tekgunduz aff013;  Ayhan Tastekin aff014;  Ferda Ozlu aff015;  Banu Mutlu Ozyurt aff016;  Ahmet Ozdemir aff017;  Bilin Cetinkaya aff018;  Yasar Demirelli aff019;  Esad Koklu aff020;  Ulker Celik aff021;  Nuriye Tarakci aff022;  Didem Armangil aff023;  Emel Okulu aff024;  Fatma Narter aff025;  Birgul Mutlu aff026;  Mustafa Kurthan Mert aff027;  Ali Bulbul aff028;  Huseyin Selim Asker aff029;  Ozgun Uygur aff030;  Ilker Sait Uslu aff031;  Sabahattin Ertugrul aff032;  Cumhur Aydemir aff033;  Hasan Tolga Celik aff034;  Kazim Kucuktasci aff035;  Selda Arslan aff036;  Hacer Ergin aff037;  Aysegul Zenciroglu aff038;  Sadik Yurttutan aff039;  Aysen Orman aff040;  Oguz Tuncer aff041;  Beril Yasa aff042;  Betul Acunas aff043;  Sahin Takci aff044;  Zeynel Gokmen aff045;  Hilal Ozkan aff046;  Serdar Comert aff047;  Nuran Ustun aff048;  Mehmet Mutlu aff049;  Bilge Tanyeri Bayraktar aff050;  Leyla Bilgin aff051;  Funda Tuzun aff052;  Ozge Aydemir aff053;  Tugba Gursoy aff054;  Arzu Akdag aff055;  Asli Memisoglu aff056;  Emrah Can aff057;  Demet Terek aff058;  Serdar Beken aff059;  Ozden Turan aff060;  Nilufer Guzoglu aff061;  Rahmi Ors aff062;  Yusuf Kale aff063;  Berna Hekimoglu aff064;  Hakan Aylanc aff065;  Funda Eroglu aff066;  Suzan Sahin aff067;  Murat Konak aff068;  Dilek Sarici aff069;  Ilknur Kilic aff070;  Nilay Hakan aff071
Působiště autorů: Department of Neonatology, Gazi University Faculty of Medicine, Ankara,Turkey aff001;  Department of Neonatology, Yildirim Beyazit University Faculty of Medicine, Ankara, Turkey aff002;  Department of Neonatology, Etlik Zubeyde Hanim Women’s Health Teaching and Research Hospital, University of Health Sciences, Ankara, Turkey aff003;  Neonatology Division, Memorial Hospital, Istanbul, Turkey aff004;  Department of Neonatology Dr Zekai Tahir Burak Women’s Health Education and Research Hospital, University of Health Sciences, Ankara, Turkey aff005;  Department of Neonatology, Zeynep Kamil Maternity and Children’s Training and Research Hospital, University of Health Sciences, Istanbul, Turkey aff006;  Department of Neonatology, Inonu University, Faculty of Medicine, Malatya, Turkey aff007;  Department of Neonatology, Necmettin Erbakan University, Meram Faculty of Medicine, Konya, Turkey aff008;  Department of Neonatology, Kanuni Sultan Suleyman Training and Research Hospital, University of Health Sciences, Istanbul, Turkey aff009;  Department of Neonatology, Konya Education and Research Hospital, University of Health Sciences, Konya, Turkey aff010;  Neonatology Division, Medicalpark Hospital, Gaziantep, Turkey aff011;  Department of Neonatology, Dr Behcet Uz Children’s Hospital, University of Health Sciences, Izmir, Turkey aff012;  Department of Neonatology, Ataturk University, Faculty of Medicine, Erzurum, Turkey aff013;  Department of Neonatology, Medipol University, Faculty of Medicine, Istanbul, Turkey aff014;  Department of Neonatology, Cukurova University, Faculty of Medicine, Adana, Turkey aff015;  Neonatology Division, Mersin State Hospital, Mersin, Turkey aff016;  Department of Neonatology, Erciyes University, Faculty of Medicine, Kayseri, Turkey aff017;  Department of Neonatology, Baskent University, Faculty of Medicine, Adana, Turkey aff018;  Department of Neonatology, Erzurum Nenehatun Maternity Hospital, Erzurum, Turkey aff019;  Neonatology Division, Megapark Hospital, Kahramanmaras, Turkey aff020;  Neonatology Division, Denizli State Hospital, Denizli, Turkey aff021;  Department of Neonatology, Dr. Faruk Sukan Maternity and Children's Hospital, Konya, Turkey aff022;  Department of Neonatology, Yuksek Ihtisas University, Faculty of Medicine, Ankara, Turkey aff023;  Department of Neonatology, Ankara University Faculty of Medicine, Ankara, Turkey aff024;  Department of Neonatology, Kartal Lutfi Kirdar Education and Research Hospital, University of Health Sciences, Istanbul, Turkey aff025;  Neonatology Division, Doruk Private Hospital, Bursa, Turkey aff026;  Department of Neonatology, Numune Training and Education Hospital, University of Health Sciences, Adana, Turkey aff027;  Department of Neonatology, Sisli Hamidiye Etfal Education and Research Hospital, University of Health Sciences, Istanbul, Turkey aff028;  Neonatology Division, NCR International Hospital, Gaziantep, Turkey aff029;  Department of Neonatology, Tepecik Training and Research Hospital, University of Health Sciences, Izmir, Turkey aff030;  Department of Neonatology, Ondokuz Mayıs University, Faculty of Medicine, Samsun, Turkey aff031;  Department of Neonatology, Dicle University Faculty of Medicine, Diyarbakır, Turkey aff032;  Department of Neonatology, Bulent Ecevit University Faculty of Medicine, Zonguldak, Turkey aff033;  Department of Neonatology, Hacettepe University Faculty of Medicine, Ankara, Turkey aff034;  Neonatology Division, Denizli Saglik Hospital, Denizli, Turkey aff035;  Department of Neonatology, Mustafa Kemal University Faculty of Medicine, Hatay, Turkey aff036;  Department of Neonatology, Pamukkale University Faculty of Medicine, Denizli, Turkey aff037;  Department of Neonatology, Dr Sami Ulus Maternity and Children’s Hospital, University of Health Sciences, Ankara, Turkey aff038;  Department of Neonatology, Kahramanmaras Sutcu Imam University, Faculty of Medicine, Kahramanmaras, Turkey aff039;  Department of Neonatology, Fırat University, Faculty of Medicine, Elazig, Turkey aff040;  Department of Neonatology, Yuzuncu Yil University, Faculty of Medicine, Van, Turkey aff041;  Department of Neonatology, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey aff042;  Department of Neonatology, Trakya University Faculty of Medicine, Edirne, Turkey aff043;  Department of Neonatology, Gaziosmanpasa University, Faculty of Medicine, Tokat, Turkey aff044;  Department of Neonatology, Baskent University, Faculty of Medicine, Konya, Turkey aff045;  Department of Neonatology, Uludag University, Faculty of Medicine, Bursa, Turkey aff046;  Department of Neonatology, Suleymaniye Maternity, Research & Training Hospital, University of Health Sciences, Istanbul, Turkey aff047;  Department of Neonatology, Medeniyet University, Faculty of Medicine, Istanbul, Turkey aff048;  Department of Neonatology, Karadeniz Technical University, Faculty of Medicine, Trabzon, Turkey aff049;  Department of Neonatology, Bezmialem University, Faculty of Medicine, Istanbul, Turkey aff050;  Department of Neonatology, Umraniye Education and Research Hospital, University of Health Sciences, Istanbul, Turkey aff051;  Department of Neonatology, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey aff052;  Department of Neonatology, Osmangazi University Faculty of Medicine, Eskisehir, Turkey aff053;  Department of Neonatology, Koc University, Faculty of Medicine, Istanbul, Turkey aff054;  Department of Neonatology, Bursa Dortcelik Children's Hospital, Bursa, Turkey aff055;  Department of Neonatology, Marmara University, Faculty of Medicine, Istanbul, Turkey aff056;  Department of Neonatology, Bagcilar Education and Research Hospital, University of Health Sciences, Istanbul, Turkey aff057;  Department of Neonatology, Ege University, Faculty of Medicine, Izmir, Turkey aff058;  Department of Neonatology, Acıbadem University, Faculty of Medicine, Istanbul, Turkey aff059;  Department of Neonatology, Baskent University, Faculty of Medicine, Ankara, Turkey aff060;  Department of Neonatology, Kirikkale University, Faculty of Medicine, Kirikkale, Turkey aff061;  Neonatology Division, Medova Hospital, Konya, Turkey aff062;  Department of Neonatology, Cengiz Gokcek Maternity and Children's Hospital, Gaziantep, Turkey aff063;  Department of Neonatology, Trabzon Kanuni Education and Research Hospital, University of Health Sciences, Trabzon, Turkey aff064;  Department of Neonatology, Onsekizmart University, Faculty of Medicine, Canakkale, Turkey aff065;  Neonatology Division, Ankara Guven Hospital, Ankara, Turkey aff066;  Department of Neonatology, Adnan Menderes University, Faculty of Medicine, Aydin, Turkey aff067;  Department of Neonatology, Konya Selcuk University, Faculty of Medicine, Konya, Turkey aff068;  Department of Neonatology, Kecioren Education and Research Hospital, University of Health Sciences, Ankara, Turkey aff069;  Neonatology Division, Atasehir Kadikoy Sifa Hospital, Istanbul, Turkey aff070;  Department of Neonatology, Mugla Sıtkı Kocman University Faculty of Medicine, Mugla, Turkey aff071
Vyšlo v časopise: PLoS ONE 14(12)
Kategorie: Research Article
prolekare.web.journal.doi_sk: https://doi.org/10.1371/journal.pone.0226679

Souhrn

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.

Klíčová slova:

Neonates – Neonatal care – Steroids – Infants – Sepsis – Morbidity – Neonatal sepsis – Retinopathy of prematurity


Zdroje

1. Horbar JD, Wright EC, Onstad L. Decreasing mortality associated with the introduction of surfactant therapy: an observational study of neonates weighing 601 to 1300 grams at birth. The Members of the National Institute of Child Health and Human Development Neonatal Research Network. Pediatrics. 1993;92:191–6. 7710456

2. Iams JD, Romero R, Culhane JF, Goldenberg RL. Preterm birth: primary, secondary, and tertiary interventions to reduce the morbidity and mortality of preterm birth. Lancet. 2008;371:164–175. doi: 10.1016/S0140-6736(08)60108-7 18191687

3. Eichen wald EC, Stark AR. Management and outcomes of very low birth weight. N Engl J Med. 2008;358:1700–11. doi: 10.1056/NEJMra0707601 18420502

4. Singer LT, Salvator A, Guo S, Collin M, Lilien L, Baley J. Maternal psychological distress and parenting stress after the birth of a very low-birth-weight infant. JAMA. 1999 3;281:799–805.

5. Kultursay N. The status of women and of maternal and perinatal health in Turkey. The Turk J Pediatr. 2011; 53: 5–10. 21534333

6. Atasay B, Gunlemez A, Unal S, Arsan S. Outcomes of very low birth weight infants in a newborn tertiary center in Turkey, 1997–2000. Turk J Pediatr. 2003;45:283–9. 14768790

7. Gebesce A, Uslu H, Keles E, Demirdoven M, Tonbul A, Basturk B, et al. Evaluation of very low birth weight infants in the neonatal intensive care unit of a university hospital. Dicle Medical Journal. 2015; 42: 137–142.

8. Guran O, Bulbul A, Uslu S, Dursun M, Zubarioglu U, Nuhoglu A. The change of morbidity and mortality rates in very low birth weight infants over time. Turk Arch Ped 2013; 102–109.

9. Papile LA, Burstein J, Burstein R, Koffler H. Incidence and evolution of subepandymal and intraventricular hemorrhage: A study of infants with birth weight less than 1,500 gm. J Pediatr. 1978;92:529–34. doi: 10.1016/s0022-3476(78)80282-0 305471

10. Bell MJ, Temberg JL, Feigin RD, Keating J P, Marshall R, Barton L et al. Neonatal necrotizing enterocolitis. Therapeutic decisions based upon clinical staging. Ann Surg. 1978;187:1–7. doi: 10.1097/00000658-197801000-00001 413500

11. Dong Y, Speer CP. Late onset neonatal sepsis: recent developments. Arch Dis Child Fetal Neonatal Ed. 2015; 100: F257–63. doi: 10.1136/archdischild-2014-306213 25425653

12. WHO, March of Dimes, Partnership for Maternal, Newborn & Child Health, Save the Children. Born too soon: the global action report on preterm birth. (Accessed on May 04, 2012). Avaliable from:www.who.int/maternal_child_adolescent/documents/born_too_soon/en/

13. Adams M, Bassler D, Bucher HU, Roth-Kleiner M, Berger TM, Braun J, et al; Swiss Neonatal Network and the Vermont Oxford Network. Variability of Very Low Birth Weight Infant Outcome and Practice in Swiss and US Neonatal Units. Pediatrics. 2018;141. Pii: e20173436. doi: 10.1542/peds.2017-3436 29654158

14. Fanaroff AA, Stoll BJ, Wright LL, Carlo WA, Ehrenkranz RA, Stark AR, et al. Trends in neonatal morbidity and mortality for very low birthweight infants. Am J Obstet Gynecol. 2007;196:147.e1–8.

15. Ballot DE, Chirwa TF, Cooper PA. Determinants of survival in very low birth weight neonates in a public sector hospital in Johannesburg. BMC Pediatr. 2010;10:30. doi: 10.1186/1471-2431-10-30 20444296

16. VLBW Infant Survival in Hospitals of India (VISHI) Study Investigators, Murki S, Kumar N, Chawla D, Bansal A, Mehta A, Shah M, et al. Variability in survival of very low birth weight neonates in hospitals of India. Indian J Pediatr. 2015;82:565–7. doi: 10.1007/s12098-015-1714-6 25689961

17. Fernández R, D'Apremont I, Domínguez A, Tapia JL. Red Neonatal Neocosur. Survival and morbidity of very low birth weight infant in a South American neonatal network. Arch Argent Pediatr. 2014;112:405–12. doi: 10.1590/S0325-00752014000500004 25192520

18. Roberts D, Brown J, Medley N, Dalziel SR. Antenatal corticosteroids for accelerating fetal lung maturation for women at risk of preterm birth. Cochrane Database Syst Rev. 2017 21;3:CD004454.

19. Chee YY, Wong MS, Wong RM, Wong KY. Neonatal outcomes of preterm or very-low-birth-weight infants over a decade from Queen Mary Hospital, Hong Kong: comparison with the Vermont Oxford Network. Hong Kong Med J. 2017;23:381–6. doi: 10.12809/hkmj166064 28684649

20. Sweet DG, Carnielli V, Greisen G, Hallman M, Ozek E, Plavka R, et al. European Consensus Guidelines on the Management of Respiratory Distress Syndrome—2016 Update. Neonatology. 2017; 111:107–125. doi: 10.1159/000448985 27649091

21. Poindexter BB, Feng R, Schmidt B, Aschner JL, Ballard RA, Hamvas A, et al. Comparisons and Limitations of Current Definitions of Bronchopulmonary Dysplasia for the Prematurity and Respiratory Outcomes Program. Ann Am Thorac Soc. 2015;12:1822–30. doi: 10.1513/AnnalsATS.201504-218OC 26397992

22. Ellsbury DL, Acarregui MJ, McGuinness GA, Eastman DL, Klein JM.Controversy surrounding the use of home oxygen for premature infants with bronchopulmonary dysplasia. J Perinatol. 2004; 24:36–40. doi: 10.1038/sj.jp.7211012 14726936

23. Aly H. Is there a strategy for preventing bronchopulmonary dysplasia? Absence of evidence is not evidence of absence. Pediatrics 2007; 119:818–20. doi: 10.1542/peds.2006-3026 17403854

24. Askie LM, Darlow BA, Finer N, Schmidt B, Stenson B, Tarnow-Mordi W, et al. Association Between Oxygen Saturation Targeting and Death or Disability in Extremely Preterm Infants in the Neonatal Oxygenation Prospective Meta-analysis Collaboration. JAMA. 2018;319:2190–2201. doi: 10.1001/jama.2018.5725 29872859

25. Stoll BJ, Hansen NI, Adams-Chapman I, Fanaroff AA, Hintz SR, Vohr B, et al. Neurodevelopmental and growth impairment among extremely low-birth-weight infants with neonatal infection. JAMA. 2004;292:2357–65. doi: 10.1001/jama.292.19.2357 15547163

26. Stoll BJ, Hansen N, Fanaroff AA, Wright LL, Carlo WA, Ehrenkranz RA, et al. Late-onset sepsis in very low birth weight neonates: the experience of the NICHD Neonatal Research Network. Pediatrics. 2002;110:285–91. doi: 10.1542/peds.110.2.285 12165580

27. Horbar JD, Carpenter JH, Badger GJ, Kenny MJ, Soll RF, Morrow KA, et al. Mortality and neonatal morbidity among infants 501 to 1500 grams from 2000 to 2009. Pediatrics. 2012;129:1019–26. doi: 10.1542/peds.2011-3028 22614775

28. Turkish Neonatal Society, Nosocomial Infections Study Group. Nosocomial infections in neonatal units in Turkey: epidemiology, problems, unit policies and opinions of healthcare workers. The Turkish Journal of Pediatrics. 2010; 52: 50–57. 20402067

29. Battersby C, Santhalingam T, Costeloe K, Modi N. Incidence of neonatal necrotising enterocolitis in high-income countries: a systematic review. Arch Dis Child Fetal Neonatal Ed. 2018;103:F182–F189. doi: 10.1136/archdischild-2017-313880 29317459

30. Polin RA, Denson S, Brady MT; Committee on Fetus and Newborn; Committee on Infectious Diseases. Strategies for prevention of health care-associated infections in the NICU. Pediatrics. 2012;129:e1085–93. doi: 10.1542/peds.2012-0145 22451712

31. Gilbert C, Fielder A, Gordillo L, Quinn G, Semiglia R, Visintin P, et al. Characteristics of infants with severe retinopathy of prematurity in countries with low, moderate, and high levels of development: implications for screening programs. Pediatrics. 2005; 115:e518–25. doi: 10.1542/peds.2004-1180 15805336

32. Adams GGW, Bunce C, Xing W, Butler L, Long V, Reddy A, et al. Treatment trends for retinopathy of prematurity in the UK: active surveillance study of infants at risk. BMJ Open 2017; 7:e013366. doi: 10.1136/bmjopen-2016-013366 28325857


Článok vyšiel v časopise

PLOS One


2019 Číslo 12
Najčítanejšie tento týždeň
Najčítanejšie v tomto čísle
Kurzy

Zvýšte si kvalifikáciu online z pohodlia domova

Aktuální možnosti diagnostiky a léčby litiáz
nový kurz
Autori: MUDr. Tomáš Ürge, PhD.

Všetky kurzy
Prihlásenie
Zabudnuté heslo

Zadajte e-mailovú adresu, s ktorou ste vytvárali účet. Budú Vám na ňu zasielané informácie k nastaveniu nového hesla.

Prihlásenie

Nemáte účet?  Registrujte sa

#ADS_BOTTOM_SCRIPTS#