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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.
  • [ X ]
    Öğe
    Incidence, risk factors and severity of retinopathy of prematurity in Turkey (TR-ROP study): a prospective, multicentre study in 69 neonatal intensive care units
    (Bmj Publishing Group, 2018) Bas, Ahmet Yagmur; Demirel, Nihal; Koc, Esin; Isik, Dilek Ulubas; Hirfanoglu, Ibrahim Murat; Tunc, Turan; Sari, Fatma Nur
    Background To evaluate the prevalence, risk factors and treatment of retinopathy of prematurity (ROP) in Turkey and to establish screening criteria for this condition. Methods A prospective cohort study (TR-ROP) was performed between 1 April 2016 and 30 April 2017 in 69 neonatal intensive care units (NICUs). Infants with a birth weight (BW)=1500 g or gestational age (GA)<= 32 weeks and those with a BW> 1500 g or GA> 32 weeks with an unstable clinical course were included in the study. Predictors for the development of ROP were determined by logistic regression analyses. Results The TR-ROP study included 6115 infants: 4964 (81%) with a GA <= 32 weeks and 1151 (19%) with a GA>32 weeks. Overall, 27% had any stage of ROP and 6.7% had severe ROP. A lower BW, smaller GA, total days on oxygen, late-onset sepsis, frequency of red blood cell transfusions and relative weight gain were identified as independent risk factors for severe ROP in infants with a BW=1500 g. Of all infants, 414 needed treatment and 395 (95.4%) of the treated infants had a BW <= 1500 g. Sixty-six (16%) of the treated infants did not fulfil the Early Treatment for Retinopathy of Prematurity requirements for treatment. Conclusions Screening of infants with a GA <= 34 weeks or a BW<1700 g appears to be appropriate in Turkey. Monitoring standards of neonatal care and conducting quality improvement projects across the country are recommended to improve neonatal outcomes in Turkish NICUs.