Münevver Kaynak Türkmen, Ayşe Anık, Abdullah Barış Akcan, Deniz İlgün Güre, Gizem Ergin

Yenidoğan Yoğun Bakım Ünitesine Yatırılan Term Yenidoğan Bebeklerin Özellikleri: Tek Merkez Deneyimi

Amaç: Yenidoğan yoğun bakım ünitesine (YYBÜ) yatırılan preterm bebeklerin sorunları ile ilgili çok sayıda araştırma bulunmakta iken, literatürde term bebeklerin sorunlarını inceleyen kısıtlı sayıda çalışma bulunmaktadır. Bu çalışmada hastanemizin YYBÜ’de yatan term bebeklerin sorunları incelenmiştir. Gereç ve Yöntemler: 1 Ocak 2015 ile 31 Aralık 2020 tarihleri arasında YYBÜ’de yatan term bebeklerin ve annelerinin demografik ve klinik özellikleri tıbbi kayıtlardan geriye dönük olarak incelendi. Majör konjenital anomalisi olan, genetik sendrom tanısı alan ve herhangi bir nedenle başka bir hastaneye sevk edilen bebekler çalışma dışı bırakıldı. Kategorik değişkenler frekans (n) ve yüzde (%) olarak, nümerik değişkenler ise ortanca (25 persantil-75 persantil) olarak verildi. Bulgular: Çalışmaya 1,221 term bebek dahil edildi. Bu bebeklerin 349’u (%28,6) diğer bir sağlık merkezinden sevk ile yatırılmıştı. Çalışmaya alınan bebeklerin ortanca gebelik haftası 38 hafta (37-39), bebeklerin ortanca doğum ağırlığı 3,560 g (3.210-3.672) idi. Hastaneye yatış nedenleri değerlendirildiğinde, en sık nedenin solunum sıkıntısı (n=399, %32,7) olduğu görüldü. Bunu sırası ile yenidoğan sarılığı (n=370, %30,3), enfeksiyonlar (n=181, %14,8), hipoksik-iskemik ensefalopati (HİE) (n=98, %8), hipoglisemi (n=40, %3,3), düşük doğum ağırlığı (n=25, %2), beslenme sorunları (n=16, %1,3) ve diğer nedenler (n=92, %7,5) takip ediyordu. Ortanca hastanede yatış günü 5 (3-8) idi. Çalışma süresince yedi bebeğin yenidoğan enfeksiyonu olduğu, yedi bebeğin de HİE nedeni ile eksitus olduğu görüldü ve mortalite oranı %1,1 olarak belirlendi. Sonuç: Günümüzde YYBÜ’de yatan hastaların önemli bir kısmını term bebekler oluşturmaktadır. Yatış nedenleri göz önüne alındığında bazı antenatal uygulamaların ve ebeveyn eğitiminin bu bebeklerin yatış sıklığını azaltmada yardımcı olabileceği düşünülmüştür.

Characteristics of Term Neonates Admitted to the Neonatal Intensive Care Unit: A Single-center Experience

Objective: Considerable research has been reported about the problems of preterm neonates admitted to the neonatal intensive care unit (NICU); however, the number of studies examining the problems of term neonates is limited. Thus, this study examined the problems of term neonates admitted to the NICU. Materials and Methods: The demographic and clinical characteristics of mothers and term neonates admitted to the NICU between January 1, 2015, and December 31, 2020, were retrospectively examined from the medical records. Neonates with major congenital anomalies, diagnosed with genetic syndromes, or referred to another hospital for any reason were excluded from the study. Categorical variables are expressed as n and percentage (%) and numerical variables as median (25th-75th percentile) values. Results: In total, 1,221 term neonates were enrolled, of which 349 (28.6%) were referred from other centers. The mean gestational age of the infant was 38 weeks (37-39) and the median birth weight was 3.560 g (3,210-3,672). The most common reason for admission to hospital was respiratory distress (n=399, 32.7%), followed by neonatal jaundice (n=370, 30.3%), infections (n=181, 14.8%), hypoxic-ischemic encephalopathy (HIE) (n=98, 8%), hypoglycemia (n=40, 3.3%), small for gestational age (n=25, 2%), poor feeding (n=16, 1.3%), and others (n=92, 7.6%). The median length of hospital stay was 5 (3-8) days. The mortality rate was calculated as 1.1%. Mortality occurred in seven neonates due to infection during the study and in seven due to HIE. Conclusion: Term neonates represent a significant proportion of patients admitted to the NICU. In light of admission causes, various antenatal practices may help reduce the admission frequency of these neonates.

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