Doğum şekli ve anneye uygulanan anestezi tipinin postnatal erken dönemde yenidoğanlarda görülen tartı kaybına etkileri

Amaç: Bu çalışmada, doğum şekli ve anneye uygulanan anestezinin, yenidoğanlarda, erken postnatal dönemde görülen tartı kaybına etkisi olup olmadığını belirlemek amaçlandı.Materyal ve Metod: Retrospektif olarak gerçekleştirilen bu çalışmaya, Gazi Üniversitesi Tıp Fakültesi’nde doğan ve herhangi bir nedenle yenidoğan yoğun bakım ünitesine yatırılmayan, konjenital anomalisi olmayan, formula desteği almayan ve sadece anne sütü ile beslenen 1463 yenidoğan dahil edildi. Yenidoğanlar, doğum şekli ve anneye uygulanan anestezi tipine göre; normal spontan vajinal yolla doğup annesine anestezi uygulanmayan, annesine epidural anestezi uygulanan, sezaryenle doğup annesine genel anestezi veya epidural anestezi uygulanan olmak üzere 4 alt gruba ayrıldılar. Çalışmaya alınan tüm yenidoğanlar, postnatal 2., 3., 5. ve 7. günlerde tartıldı ve tartı alımı ve kayıpları (% olarak) kaydedildi.Bulgular: Yenidoğanlarda postnatal 2., 3., 5. ve 7. günlerdeki tartı kayıpları sırasıyla %5.3±2.7, %5.8±3.0, %4.6±3.2 and %2.2±2.4 olarak bulundu. Maksimum tartı kaybı postnatal 3. günde (%5.8) gerçekleşti. Sezaryen ile doğan yenidoğanlarda tartı kaybı, vajinal yolla doğanlara göre (p

Effects of birth route and type of maternal anesthesia on weight loss in newborns in early postnatal period

Aim: Our objective was to evaluate the effects of birth route and type of maternal anesthesia on weight loss in newborns in the early postnatal period.Material and Methods: All newborns who were born in Gazi University Medical Faculty in the study period without any congenital anomalies, completely breastfed and who were not hospitalized in neonatal intensive care unit were included in this retrospective study.Newborns were grouped according to mode of delivery (vaginal delivery or cesarean section) and type of maternal anesthesia (no anesthesia, epidural anesthesia, general anesthesia). All newborns who included in the study were evaluated for the postnatal weight loss (% of birth weight) at least once on the 2nd, 3rd, 5th and/or 7th day of life.Results: There were 1463 newborns who met the inclusion criteria. Average weight losses on the 2nd, 3rd, 5th and 7th days of life were 5.3±2.7%, 5.8±3.0%, 4.6±3.2% and 2.2±2.4%, respectively. Maximum weight loss (5.8%) occured on postnatal 3rd day. Newborns born by cesarean section lost more weight than those born vaginally (p

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  • 1. Abboud TK, Nagappala S, Murakawa K, David S, Haroutunian S, Zakarian M, Yanagi T, Sheikh-Ol-Eslam A. Comparison of the effects of general and regional anesthesia for cesarean section on neonatal neurologic and adaptive capacity scores. Anesth Analg 1985;64:996-1000.
  • 2. Lussos SA: Anesthesia for cesarean delivery. In: Datta S (ed): Common Problems in Obstetric Anesthesia. St Louis: CV Mosby,1995:203-227.
  • 3. Petropoulos G, Siristatidis C, Salamalekis E, Creatsas G. Spinal and epidural versus general anesthesia for elective cesarean section at term: effect on the acid-base status of the mother and newborn. J Matern Fetal Neonatal Med 2003;13:260-266.
  • 4. Rout CC, Rocke DA. Prevention of hypotension following spinal anesthesia for cesarian section. Int Anesthesiol Clin 1994;32:117-135.
  • 5. Riley ET, Cohen SE, Rubenstein AJ, Flanagan B. Prevention of hypotension after spinal anesthesia for cesarian section: six percent hetastarch versus lactated ringers solution. Anesth Analg 1995;81:838-842.
  • 6. Avoa A, Fischer P. The influence of perinatal instruction about breastfeeding on neonatal weight loss. Pediatrics 1990;86:313-315.
  • 7. Rodriguez G, Ventura P, Samper MP, Moreno L, Sarria A, Perez-Gonzalez JM. Changes in body composition during the initial hours of life in breast-fed healthy term newborns. Biol Neonate 2000;77:12-16.
  • 8. Marchini G, Stock S. Thirst and vasopressin secretion counteract dehydration in newborn infants. J Pediatr 1997;130:736-739.
  • 9. Bishop NJ, King FJ, Lucas A. Linear growth in the early neonatal period. Arch Dis Child 1990;65:707-708.
  • 10. Brace RA: Fluid distribution in the fetus and neonate. In: Polin RA, Fox WW (eds): Fetal and Neonatal Physiology. WB Saunders: Philadelphia, 1998:1703-1713.
  • 11. Lapillonne A, Braillon P, Claris O, Chatelain PG, Delmas PD, Salle BL. Body composition in appropriate and in small for gestational age infants. Acta Paediatr 1997;86:196-200.
  • 12. Bauer K, Bovermann G, Roithmaier A, Gotz M, Proiss A, Versmold HT. Body composition, nutrition, and fluid balance during the first two weeks of life in preterm neonates weighing less than 1500 grams. J Pediatr 1991;118:615-620.
  • 13. vd Wagen A, Okken A, Zweens J, Zijlstra WG. Composition of postnatal weight loss and subsequent weight gain in small for dates newborn infants. Acta Paediatr Scand 1985;74:57-61.
  • 14. Heimler R, Doumas BT, Jendrzejczak BM, Nemeth PB, Hoffman RG, Nelin LD. Relationship between nutrition, weight change, and fluid compartments in preterm infants during the first week of life. J Pediatr 1993;122:110-114.
  • 15. Offringa PJ, Boersma ER. Differences in early neonatal growth patterns between several developing countries and some industrialized societies. Hum Nutr Clin Nutr 1987;41:307-310.
  • 16. Bauer K, Versmold H. Postnatal weight loss in preterm neonates less than 1,500 g is due to isotonic dehydration of the extracellular volume. Acta Paediatr Scand Suppl 1989;360:37-42.
  • 17. Tulassay T. Role of atrial natriuretic peptide in the postnatal adaptation of term and preterm infants. Contrib Nephrol 1988;76:138-144.
  • 18. Enzunga A, Fischer PR. Neonatal weight loss in rural Zaire. Ann Trop Paediatr 1990;10:159-163.
  • 19. Martens PJ, Romphf L. Factors associated with newborn in-hospital weight loss: comparisons by feeding method, demographics, and birthing procedures. J Hum Lact 2007;23:233-241.
  • 20. Dollberg S, Lahav S, Mimouni FB. A comparison of intakes of breast-fed and bottle-fed infants during the first two days of life. J Am Coll Nutr 2001;20:209-211.
  • 21. Marchini G, Fried G, Ostlund E, Hagenas L. Plasma leptin in infants: relations to birth weight and weight loss. Pediatrics 1998;101:429-432.
  • 22. Modi N, Betremieux P, Midgley J, Hartnoll G. Postnatal weight loss and contraction of the extracellular compartment is triggered by atrial natriuretic peptide. Early hum Dev 2000;59:201-208.
  • 23. Menacker F, Declercq E, Macdorman MF. Cesarean Delivery: Background, Trends, and Epidemiology. Semin Perinatol 2006;30:235-241.
  • 24. Bailit JL, Love TE, Mercer B. Rising cesarean rates: Are patients sicker? Am J Obstet Gynecol 2004;191:800-803.
  • 25. Lubchenco LO, Hansman C, Boyd E. Intrauterine growth in length and head circumference as estimated from live births at gestational ages from 26 to 42 weeks. Pediatrics 1966;37:403-408.
  • 26. Tjon A Ten WE, Kusin JA, de With C. Early postnatal growth of Basotho infants in the Mantsonyane area, Lesotho. Ann Trop Paediatr 1986;6:195-198.
  • 27. Tulassay T, Seri I, Rascher W. Atrial natriuretic peptide and extracellular volume control after birth. Acta Paediatr Scand 1987;76:444-446.
  • 28. Bauer K, Cowett RM, Howard GM, vanEpp J, Oh W. Effect of intrauterine growth retardation on postnatal weight change in preterm infants. J Pediatr 1993;123:301-306.
  • 29. Hall RT, Mercer AM, Teasley SL, McPherson DM, Simon SD, Santos SR, Meyers BM, Hipsh NE. A breastfeeding assessment score to evaluate the risk for cessation of breast-feeding by 7 to 10 days of age. J Pediatr 2002;141:659-664.
  • 30. Sener EB, Guldogus F, Karakaya D, Baris S, Kocamanoglu S, Tur A. Comparison of neonatal effects of epidural and general anesthesia for cesarian section. Gynecol Obstet Invest 2003;55:41-45.
  • 31. Cody RJ, Atlas SA, Laragh JH, Kubo SH, Covit AB, Ryman KS, Shaknovich A, Pondolfino K, Clark M, Camargo MJ. Atrial natriuretic factor in normal subjects and heart failure patients. Plasma levels and renal, hormonal, and hemodynamic responses to peptide infusion. J Clin Invest 1986;78:1362-1374.
  • 32. Rascher W, Bald M, Kreis J, Tulassay T, Heinrich U, Scharer K. Atrial natriuretic peptide in infants and children. Hormone Res 1987;28:58-63.
  • 33. Laatikainen T, Hakkinen L, Nikkila L, Leppaluoto J, Vuolteenaho O. Atrial natriuretic peptide (ANP) and N-terminal peptide of proANP (NT-proANP) in maternal and umbilical cord plasma in spontaneous labor and at elective cesarean section. Eur J Obstet Gynecol Reprod Biol 1992;46:11-17.
  • 34. Gemelli M, Mami C, Manganaro R, Stelitano L, Bonaccorsi P, Martino F. Effects of the mode of delivery on ANP and renin-aldosterone system in the fetus and the neonate. Eur J Obstet Gynecol Reprod Biol 1992;43:181-184.