Özge SERÇE, Derya BENZER, Tuğba GÜRSOY, Fahri OVALI, GÜNER KARATEKİN

İstanbul’da Bir Referans Hastanesinin Üçüncü Basamak Yoğun Bakım Ünitesinde İzlenen Çok Düşük Doğum Ağırlıklı Yenidoğanların Klinik Seyri

Giriş: Gelişmekte olan ülkelerde bulunan değişik hastanelerin preterm yenidoğanlarla ilgili klinik sonuçları farklılık göstermektedir. Pratik hayatta yapılan uygulamaların etkinliğini monitorize etmek için her bir hastanenin kendisine ait güncel sürveyans çalışmalarını yapması gerekmektedir. Bu çalışmanın amacı İstanbul'da bulunan ana merkezlerden biri olan hastanemize yatırılmış çok düşük doğum ağırlıklı (ÇDDA) bebeklerin morbidite ve ölüm sonuçlarını değerlendirmek ve kötü seyirle ilişkili risk faktörlerini belirlemektir. Materyal ve Metod: Ocak 1, 2010-2011 tarihleri arasında Zeynep Kamil Kadın Doğum ve Çocuk Hastanesinde doğarak yenidoğan ünitesine yatırılan yenidoğanların (

Outcomes of very low birth weight infants in a reference hospital with a tertiary neonatal intensive care unit in Istanbul.

Background: TThe outcome of preterm neonates’ varies in different hospitals in developing countries. Due to monitoring the effectiveness of current practice, every hospital should evaluate their own surveillance of up-todate outcome of the infants. The aim of this study is to establish the morbidity and mortality of very low birth weight (VLBW) infants admitted to a referral hospital in Istanbul, Turkey and to analyze risk factors associated with poor outcome. Method: PThe files of the neonates (≤ 32 gestational weeks, ≤ 1500 g birth weight) who were born and hospitalized in Neonatology unit between January 1, 2010- 2011 at Zeynep Kamil Maternity and Childrens’Training and Research Hospital were investigated retrospectively. Risk factors were analyzed using logistic regression models. Results: Of all, 154/370 (41.6%) infants died. The main reasons of mortality were respiratory distress syndrome (RDS) (39.2%), congenital anomalies (14.4%), pulmonary hemorrhage (13.7%), and sepsis (12.4%). In the infants who survived the incidence of retinopathy of prematurity was 49.6%; of RDS, 44.7%; of bronchopulmonary dysplasia, 29.7%; of patent ductus arteriosus, 21.8%; of intraventricular hemorrhage, 18.6%; of necrotizing enterocolitis, 13%. Lower birth weight, resuscitation at delivery room, RDS, acute renal failure, and umbilical venous catheterization were negatively; cesarean delivery and physiological weight loss were positively correlated with mortality. Conclusions: Even with modern perinatal care, deaths of VLBW infants are still common in our hospital in which high risk pregnancies or without follow up pregnancies admitted. Lower birth weight was the significant risk factor for death and short-term disability.

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