Mervan BEKDAŞ, Sevil Bilir GÖKSUGÜR, Beyhan KÜÇÜKBAYRAK, Ayhan EKİCİ

The factors affecting morbidity and mortality in low birth-weight infants

Amaç: Hastanemizde doğan düşük doğum ağırlıklı bebeklerdeki kısa dönem morbidite ve mortalite sıklığını ve bunları etkileyen faktörleri incelemek. Yöntemler: 18 aylık dönem içinde hastanemizde doğan düşük doğum ağırlıklı 195 bebek ve aynı dönem içinde normal doğum ağırlıklı doğan 150 bebek kontrol grubu olarak seçildi. Bulgular: Söz konusu süre içinde hastanemizde doğan bebeklerin %4,4\'ü (n=168) düşük doğum ağırlıklı, %0,7\'si (n=27) çok düşük doğum ağırlıklı idi. Bu bebeklerde kontrol grubuna kıyasla çoğul gebelik ve asfiktik doğum anlamlı oranda yüksekti (sırasıyla p=0,029, p=0,011). Çok düşük doğum ağırlıklı bebeklerde asfiktik doğum (OR=14,2, 95% CI (6,6-30,7, p

Anahtar Kelimeler:

Düşük doğum ağırlığı, perinatal risk faktörleri, morbidite, mortalite

The factors affecting morbidity and mortality in low birth-weight infants

Objective: To investigate the frequency of short term morbidity and mortality and the factors affecting them for the infants born with low birth-weight at our hospital Methods: At our hospital, 195 infants born with low birth-weight within a period of 18 months were identified and 150 infants born with normal birth-weights were selected as the control group. Results: Within the mentioned period of time, 4.4% (n=168) of the infants born in our hospital had low birth-weight, 0.7% (n=27) had very low birth-weight (VLBW). Multiple pregnancies and asphyxiating birth rates were significantly high in these infants as compared to the control group. (p=0.029, p=0.011, respectively). For VLBW infants, the rates of asphyxiating birth (OR=14.2, 95% CI (6.6-30.7, p

Keywords:

Low birth weight, perinatal risk factors, morbidity, mortality,

PDF

___

Manning FA, Hohler C. Intrauterine growth retardation: di- agnosis, prognostication, and management based on ultra- sound methods, in Fleisher AÇ, Romero R, Manning FA, et al (eds): The principles and practices and ultrasonography, 4th. Ed. Norwalk, CT Appleton and Lange. 1991:331.
Joseph KS. Theory in obstetrics: an epidemiologic frame- work for justifying indicated early delivery. BMC Pregnan- cy Childbirth 2007;7:1-15.
Eichenwald EC. Care of the extremely low-birth-weight ınfant. In: Taeusch HW, Ballard RA, Gleason CA (eds). Av- ery’s Diseases of the Newborn. 8th ed. Philadelphia: Saun- ders, 2005:410-426.
Creasy RK, Iams JD. Preterm labor and delivery. In: Creasy RK, Resnik R (eds). Maternal-Fetal Medicine. 4th ed. Philedelphia: Saunders, 1999:498-531
Horbar J, Badger G, Carpanter J. Trends in mortality and morbidity for very low birth weight infants 1991-1999. Pe- diatrics 2002;110:143-151.
Gülcan H, Üzüm İ, Aslan S, et al. Outcome of very low birth weight infants in neonatal intensive care unit of İnönü Uni- versity Faculty of Medicine. J Inonu Fac Med 2004;11:19- 23.
Armangil D, Yiğit Ş, Tekinalp G, et al. The effect of antenatal corticosteroids on neonatal mortality and morbidity. Çocuk Sağlığı ve Hastalıkları Derg 2007;50:79-90.
Thornberg E, Thiringer K, Odeback A, et al. Birth asphyxia: Incidence, clinical course and outcome in a Swedish popu- lation. Acta Paediatr 1995;84:927–932.
Nobile CG, Raffaele G, Altomare C, et al. Influence of ma- ternal and social factors as predictors of low birth weight in Italy. BMC Public Health 2007;7:192-195.
Verrier M, Spears W, Ying J, et al. Patterns of birth weight in relation to gestational age, maternal age, parity, and prena- tal care in Texas’ triethnic population, 1984 through 1986. Tex Med 1993;89:51-56.
Kuo CP, Lee SH, Wu WY. Birth outcomes and risk factors in adolescent pregnancies: Results of a Taiwanese national survey. Pediatrics Intern 2010;52:447-452.
Gonik B. Creasy RK. Preterm labor: Its diagnosis and man- agement. Am J Obstet Gynaecol 1986;154:3-9.
Yogev Y, Melamed N, Tenenbaum-Gavish K, et al. Preg- nancy outcome at extremely advanced maternal age. Am J Obstet Gynecol 2010;203;1-7.
Turhan AH, Atıcı A, Özkan BA, et al. Outcomes of very low birth weight infants treated in neonatal intensive care unit of Mersin University. J Ist Faculty Med 2006;69:105-109.
Güvenal T, Çetin M, Mamik BA, et al. Evaluation of Perina- tal Outcome of Small for Gestational Age Babies. CÜ Tıp Fakültesi Dergisi 2001;23:189-193.
Onyiriuka AN. Trends in incidence of delivery of low birth weight infants in Benin City, Southern Nigeria. Nig Post- grad Med J 2006;13:189-194.
Kul M, Saldır M, Gülgün M. Retrospective evaluation of low birth weight newborns followed up with the diagnosis of respiratory distress syndrome in the newborn intensive care unit. Gulhane Med J 2005;47:290-293.
Onyiriuka AN. Incidence of delivery of low birth weight in- fants in twin gestations. Nig J Clin Pract 2010;13:365-370.
Coutinho PR, Cecatti JG, Fernanda GS, et al. Perinatal out- comes associated with low birth weight in a historical co- hort. Reproductive Health 2011;8:18-23.
Volpe JJ. Neurology of Newborn. 3th ed. WB Saunders Company, 1995;211-360.
Catlin EA, Carpenter MW, Brann BS, et al. The Apgar score revisited: influence of gestational age. J Pediatr 1986;109:865-868.
Wu YW, Backstrand KH, Zhao S, et al. Declining diagno- sis of birth asphyxia in California: 1991–2000. Pediatrics 2004:114:1584-1590.
Katar S, Devecioğlu C. Outcome of very low birth weight infants in neonatal care unit of Dicle University Faculty of Medicine. Dicle Med J 2006;33:248-251.
Bellad MB, Srividhya K, Ranjit K, et al. Factors associated with perinatal mortality: a descriptive observational study. JSAFOG 2010;2:49-51.
www.neonatology.org.tr/images/NeonBulten17.pdf
Doyle LW, Bowman E. Davis P, et al. Preterm infants 30-36 weeks’ gestation in Victoria, where should they be deliv- ered. Aust NZJ Obstet Gynecol 1998;38:298-300.
Siza JE. Risk factors associated with low birth weight of ne- onates among pregnant women attending a referral hospital in northern Tanzania. Tanzania J Health Res 2008;10:1-8.
Whitsett JA, Pryhuber GS, Rice WR. Acute respiratory dis- orders. In: Avery GB, MacDonald MG (eds). Neonatology: Pathophysiology and Management of the Newborn, 5th ed. Philadelphia: Lippincott Williams&Wilkins, 1999:505- 515.
Bülbül A, Okan F, Şahin S. Mortality and morbidity of very low birth weight preterm infants: short-term outcomes. Turk Arch Ped 2008;43:94-98.
Stark AR, Franta ID. Respiratory distress syndrome. Pediatr Clin North Am 1986;33:533-543.
Avery GB, Fletcher M, MacDonald M. Neonatology. 4 th edition. 1994 JB Lippincott Comp. Philadelphia. 1000- 1028.
Eicher DJ, Annibale DJ. Neonatal sepsis: evaluation and management. J S C Med Assoc 2002;98:106-112.
Erdem G, Erdoğan-Bakar E, Yiğit Ş, et al. Neurodevelop- mental outcome of premature babies treated in Hacettepe University Hospital Neonatal Intensive Care Unit. Çocuk Sağlığı ve Hastalıkları Dergisi 2006;49:185-192.
Çiçek N, Vitrinel A, Cömert S, et al. Follow up results of premature infants. Turk Arch Ped 2005;40:33-38.
Atasay B, Günlemez A, Ünal S, et al. Outcomes of very low birth weight infants in a newborn tertiary center in Turkey, 1997-2000.Turk J Pediatr 2003;45:283-289.