Sema ARAYICI, Gülsüm KADIOĞLU ŞİMŞEK, Fuat Emre CANPOLAT, Birgül SAY, Nurdan URAŞ, Evrim ALYAMAÇ DİZDAR, Şerife Suna OĞUZ

Geç Preterm Yenidoğanlar ve Yoğun Bakım Ünitelerine Yatış Nedenleri

Amaç: Yenidoğan yoğun bakım ünitemizde (YYBÜ) takip edilen geç preterm (GP) bebeklerin klinik ve demografik özelliklerini belirlemek, YYBÜ’ne yatış gereksinimlerinin nedenlerini değerlendirmek.Gereç ve Yöntemler: Bu retrospektif çalışmaya Ocak 2012- Aralık 2012 tarihleri arasında doğan ve YYBÜ’de takip edilen, gestasyon haftası 340/7-366/7 olan yenidoğan bebekler dahil edildi. Bebekler yatış nedenleri, klinik ve demografik özellikleri açısından değerlendirilerek YYBÜ’de takip edilen term yenidoğanlarla karşılaştırıldı.Bulgular: Çalışma süresi boyunca hastanemizde toplam doğum sayısı 17690, YYBÜ’ne yatan toplam hasta sayısı ise 2844’dü. Bu doğumların 13975’i (%79) term doğum, 1981’i (%11.2) GP doğumdu. YYBÜ’ye yatış oranı GP’ lerde %21.5 (n=426), termlerde ise %5.5 (n=765)’di. GP ve term bebeklerin ortalama gestasyon haftası sırasıyla 35.1±0.8 ve 38.5±1.2 hafta, ortalama doğum ağırlığı ise sırasıyla 2384±502 ve 3185±593 gramdı. Her iki grupta da en sık yatış nedeni solunum sıkıntısıydı (GP bebeklerde %55.2, n=235, term bebeklerde %52.3, n=400). Hastanede yatış süresi GP bebeklerde ortalama 8.2±5.5 gün, term bebeklerde 6.9±5.2 gündü. Term bebeklerle karşılaştırıldığında GP bebeklerde hipoglisemi (p=0.014), polisitemi (p=0.046) ve beslenme güçlüğü (p=0.009) anlamlı olarak yüksek saptandı.Sonuç: Term bebeklere göre fizyolojik ve metabolik açıdan matürasyonunu tamamlamamış olan GP bebekler hipoglisemi, polisitemi ve beslenme güçlüğü gibi komplikasyonlar açısından risk altındadırlar. Bu nedenle gelişebilecek komplikasyonlar daha yakın takip edilmelidirler.

Anahtar Kelimeler:

Beslenme güçlüğü, Geç preterm bebekler, Hipoglisemi, Morbidite

Late Preterm Neonates and Causes of Admission to the Neonatal Intensive Care Unit

Objective: To evaluate the clinical and demographic characteristics and the causes of admission of late preterm (LP) neonates admitted to our neonatal intensive care unit (NICU).Material and Methods: This retrospective study was conducted at our NICU, between January 2012 and December 2012. Neonates born at 340/7-366/7 weeks of gestation and admitted to the NICU were included in the study. Neonates were evaluated in terms of the reasons for hospitalization and the clinical and demographic characteristics and then compared with term ones.Results: During the study period there were 17690 births in our hospital; these included 13975 (79%) term births, 1981 (11.2%) LP births. The number of neonates admitted to the NICU was 2844. The NICU admission rates for LP infants and term infants were 21.5% (n=426) and 5.5% (n=765), respectively. The mean gestational age of the LP and term neonates was 35.1±0.8 and 38.5±1.2 weeks, and the mean birth weight was 2384±502 and 3185±593g, respectively. The most common reason for hospitalization was respiratory distress in both groups (55.2%, n=235 in the LP neonates, 52.3%, n=400 in the term neonates). The mean duration of hospitalization was 8.2 ± 5.5 days in LP infants and 6.9 ± 5.2 days in term infants. Compared with term infants, LP infants had signifi cantly higher rates of hypoglycemia (p=0.014), polycythemia (p=0.046), and feeding diffi culty (p=0.009). Conclusion: LP infants who have not completed the physiological and metabolic aspects of maturation than term infants are at risk for many complications such as hypoglycemia, polycythemia and feeding diffi culty. They should therefore be monitored more closely for development of complications

Keywords:

Feeding diffi culty, Late preterm infants, Hypoglycemia, Morbidity,

PDF

___

Machado Jşnior LC, Passini Jşnior R, Rodrigues Machado Rosa I. Late prematurity: A systematic review. J Pediatr (Rio J) 2014;90:221-31.
Brown HK, Speechley KN, Macnab J, Natale R, Campbell MK. Neonatal morbidity associated with late preterm and early term birth: The roles of gestational age and biological determinants of preterm birth. Int J Epidemiol 2014;43:802-14.
Davidoff MJ, Dias T, Damus K, Russell R, Bettegowda VR, Dolan S, et al. Changes in the gestational age distribution among U.S. singleton births: Impact on rates of late preterm birth, 1992 to 2002. Semin Perinatol 2006;30:8–15.
Boyle JD, Boyle EM. Born just a few weeks early: Does it matter? Arch Dis Child Fetal Neonatal Ed 2013;98:F85-8.
Khashu M, Narayanan M, Bhargava S, Osiovich H. Perinatal out- comes associated with preterm birth at 33 to 36 weeks’ gestation: A population-based cohort study. Pediatrics 2009;123:109-13.
Kalyoncu O, Aygun C, Cetinoglu E, Kucukoduk S. Neonatal morbidity and mortality of late-preterm babies. J Matern Fetal Neonatal Med 2010;23:607-12.
Bhutani VK, Johnson L. Kernicterus in late preterm infants cared for as term healthy infants. Semin Perinatol 2006;30:89-97.
Cohen-Wolkowiez M, Moran C, Benjamin DK, Cotten CM, Clark RH, Benjamin DK Jr, et al. Early and late onset sepsis in late preterm infants. Pediatr Infect Dis J 2009;28:1052-6.
Adamkin DH. Feeding problems in the late preterm infant. Clin Perinatol 2006;33:831-7.
hastanede yatış süresi 8.1 ± 5.5 gün olarak bulunmuştur. 426 (21.5) 235 (11.8) 26 (1.3) 31 (1.5) 25 (1.3) 11 (0.6) 32 (1.6) 6 (0.3) 8 (0.4) 765 (5.5) 400 (2.9) 23 (0.1) 34 (0.2) 69 (0.5) 29 (0.2) 29 (0.2) 13 (0.09) 18 (0.1) p 0.02 0.028 0.12 0.11 0.028 0.23 0.32 Mortalite (n, %)