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    Early neonatal outcomes of very-low-birthweight infants in Turkey: A prospective multicenter study of the Turkish Neonatal Society
    (Public Library of Science, 2019) Koç, Esin; Demirel, Nihal; Baş, Ahmet Yağmur; Işık, Dilek Ulubaş; Hirfanoǧlu, İbrahim Murat; Tunç, Turan; Sari, Fatma Nur; Karatekin, Güner; Özdemir, Ramazan; Altunhan, Hüseyin; Çetinkaya, Merih; Özcan, Beyza; Özkiraz, Servet; Çalkavur, Şebnem; Tekgündüz, Kadir Şerafettin; Taştekin, Ayhan; Özlü, Ferda; Özyurt, Banu Mutlu; Özdemir, Ahmet; Çetinkaya, Bilin; Demirelli, Yaşar; Köklü, Esad; Çelik, Ülker; Tarakçı, Nuriye; Armangil, Didem; Okulu, Emel; Narter, Fatma Kaya; Mutlu, Birgül; Mert, Mustafa Kurthan; Bülbül, Ali; Asker, Hüseyin Selim; Uygur, Özgün; Uslu, İlker Sait; Ertuǧrul, Sabahattin; Aydemir, Cumhur; Çelik, Hasan Tolga; Küçüktaşçı, Kazım; Arslan, Selda; Ergin, Hacer; Zenciroğlu, Ayşegül; Yurttutan, Sadık; Orman, Ayşen; Tuncer, Oǧuz; Yaşa, Beril; Acunaş, Betül Ayşe; Takçı, Şahin; Gökmen, Zeynel; Özkan, Hilal; Cömert, Serdar; Üstün, Nuran Uzunalic; Mutlu, Mehmet; Bayraktar, Bilge Tanyeri; Bilgin, Leyla Karadeniz; Tüzün, Funda; Aydemir, Özge; Gürsoy, Tuǧba; Akdaǧ, Arzu; Memişoǧlu, Aslı Çınar; Can, Emrah; Terek, Demet Tümay; Turan, Özden; Güzoǧlu, Nilüfer; Örs, Rahmi; Kale, Yusuf; Hekimoğlu, Berna; Aylanç, Hakan; Eroglu, Funda; Şahin, Suzan; Konak, Murat; Sarıcı, Dilek; Kılıç, İlknur; Hakan, Nilay
    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: Bronchopulmonarydysplasia 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.
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    Vitamin D deficiency prevalence in late neonatal hypocalcemia: A multicenter study
    (Galenos Yayıncılık, 2021) Seymen-Karabulut, Gülcan; Günlemez, Ayla; Gökalp, Ayşe Sevim; Hatun, Şükrü; Narter, Fatma Kaya; Mutlu, Mehmet; Ertuğrul, Sabahattin
    Objective: Late neonatal hypocalcemia (LNH) is a common metabolic problem associated with hypoparathyroidism, high phosphate intake and vitamin D deficiency, often presenting with seizures. In this cross-sectional study, we aimed to evaluate the role of vitamin D deficiency in LNH in Turkey and to describe the characteristics of affected newborns. Methods: Conducted with a cross-sectional design and with the participation of 61 neonatal centers from December 2015 to December 2016, the study included term neonates with LNH (n=96) and their mothers (n=93). Data were registered on the FAVOR Web Registry System. Serum samples of newborns and mothers were analyzed for calcium, phosphate, magnesium, albumin, alkaline phosphatase, intact parathyroid hormone (iPTH) and 25 hydroxyvitamin D [25(OH)D] levels. Results: The median (range) onset time of hypocalcemia was 5.0 (4.0-8.0) days of age, with a male preponderance (60.4%). The median (range) serum 25(OH)D levels of the neonates and their mothers were 6.3 (4.1-9.05) and 5.2 (4.7-8.8) ng/mL, respectively. The prevalence of vitamin D deficiency (<12 ng/mL) was high in both the neonates (86.5%) and mothers (93%). Serum 25(OH)D levels of the infants and mothers showed a strong correlation (p<0.001). While the majority (93.7%) of the neonates had normal/high phosphorus levels, iPTH levels were low or inappropriately normal in 54.2% of the patients. Conclusion: Vitamin D deficiency prevalence was found to be high in LNH. Efforts to provide vitamin D supplementation during pregnancy should be encouraged. Evaluation of vitamin D status should be included in the workup of LNH.