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1.
BMC Public Health ; 24(1): 441, 2024 Feb 12.
Artigo em Inglês | MEDLINE | ID: mdl-38347475

RESUMO

BACKGROUND: The aim of this study was to examine the characteristics of infant mortality associated with critical congenital heart disease (CCHD). METHODS: In a cross-sectional study, data for the study were obtained through Death Notification System, Birth Notification System and Turkish Statistical Institute birth statistics. RESULTS: Of all infant deaths, 9.8% (4083) were associated with CCHD, and the infant mortality rate specific to CCHD was 8.8 per 10,000 live births. CCHD-related infant deaths accounted for 8.0% of all neonatal deaths, while the CCHD specific neonatal death rate was 4.6 per 10,000 live births. Of the deaths 21.7% occurred in the early neonatal, 30.3% in the late neonatal and 48.0% in the post neonatal period. Group 1 diseases accounted for 59.1% (n = 2415) of CCHD related infant deaths, 40.5% (n = 1652) were in Group 2 and 0.4% (n = 16) were in the unspecified group. Hypoplastic left heart syndrome was the most common CCHD among infant deaths (n = 1012; 24.8%). The highest CCHD related mortality rate was found in infants with preterm birth and low birth-weight while multiparity, maternal age ≥ 35 years, twin/triplet pregnancy, male gender, maternal education in secondary school and below, and cesarean delivery were also associated with higher CCHD related infant mortality rate. There was at least one non-cardiac congenital anomaly/genetic disorder in 26.1% of all cases. CONCLUSION: CCHD holds a significant role in neonatal and infant mortality in Türkiye. To mitigate CCHD-related mortality rates, it is crucial to enhance prenatal diagnosis rates and promote widespread screening for neonatal CCHD.


Assuntos
Cardiopatias Congênitas , Nascimento Prematuro , Lactente , Gravidez , Feminino , Recém-Nascido , Humanos , Masculino , Adulto , Cardiopatias Congênitas/diagnóstico , Estudos Transversais , Turquia , Mortalidade Infantil , Morte do Lactente
2.
BMC Pregnancy Childbirth ; 23(1): 871, 2023 Dec 16.
Artigo em Inglês | MEDLINE | ID: mdl-38104075

RESUMO

BACKGROUND: The aim of this study is to examine the features of critical congenital heart disease (CCHD). METHODS: The study was planned as a retrospective cohort study. Data for the study were obtained through national data collection systems and 2018-2020 CCHD cohort was established. In this study, we divided the patients into two groups: Group 1 included seven primary target diseases of the newborn CCHD screening program and Group 2 included secondary target diseases. RESULTS: There were 9884 CCHD cases, with a prevalence of 27.8 per 10,000 live births. Of the cases 44.4% were in Group 1 (12.3 per 10,000) and 54.8% were in Group 2 (15.2 per 10,000). Of all cases 55.5% were male and the female/male ratio was 1/1.2. While 21.8% of the cases were premature, 23.0% were babies with low birth weight (LBW), 4.8% were born from multiple pregnancies. The highest prevalence of CCHD was found in LBW (84.8 per 10,000), premature infants (57.8 per 10,000) (p < 0.001). The fatality rate in the cohort was 16.6% in the neonatal period, 31.6% in the first year of life respectively. The mean estimated survival time in the birth cohort was 40.0 months (95% CI: 39.5-40.6). The mean survival time for Group 1 diseases was 33.4 months (95% CI: 32.5-34.2), while it was 45.4 months (95% CI: 44.7-46.0) for Group 2 diseases (p < 0.001). Preterm birth, LBW, maternal age and region were evaluated as factors associated with mortality risk. CONCLUSION: This study showed that CCHDs are common in Turkey and mortality rates are high. There are regional differences in CCHD both prevalence and survival. Improving prenatal diagnosis rates and expanding neonatal CCHD screening are of key importance.


Assuntos
Cardiopatias Congênitas , Nascimento Prematuro , Lactente , Gravidez , Humanos , Recém-Nascido , Masculino , Feminino , Cardiopatias Congênitas/epidemiologia , Cardiopatias Congênitas/diagnóstico , Estudos Retrospectivos , Turquia/epidemiologia , Triagem Neonatal
3.
BMC Pregnancy Childbirth ; 22(1): 340, 2022 Apr 19.
Artigo em Inglês | MEDLINE | ID: mdl-35439969

RESUMO

OBJECTIVE: The aim of this study is to determine the frequency of neural tube defects (NTDs) and to examine the epidemiological characteristics of NTD related deaths in Turkey. METHODS: This nationwide descriptive study was included NTD related infant deaths, termination of pregnancy for fetal anomaly (ToPFA) and stillbirth cases registered in Death Notification System between 2014 and 2019, and patients diagnosed with NTD in the 2018 birth cohort. FINDINGS: In the 2018 birth cohort, there were 3475 cases of NTD at birth (27.5 per 10,000). The fatality rates for live-born babies with NTD in this cohort were 13.5% at first year, and 15.6% at the end of March, 2022. NTDs were associated with 11.7% of ToPFA cases, 2.5% of stillbirths and 2.8% of infant deaths in 2014-2019. NTD related stillbirth rate was 1.74 per 10,000 births, while NTD related ToPFA rate and infant mortality rate were 0.61 and 2.70 per 10,000 live births respectively. NTD-related stillbirth and infant mortality rate were highest in the Eastern region (3.64 per 10,000 births; 4.65 per 10,000 live births respectively), while ToPFA rate was highest in the North and West regions (1.17 and 0.79 per 10,000 live births respectively) (p < 0.05). Prematurity and low birth weight were the variables with the highest NTD related rates for stillbirths (11.26 and 16.80 per 10,000 birth), ToPFA (9.25 and 12.74) per 10,000 live birth), and infant deaths (13.91 and 20.11 per 10,000 live birth) (p < 0.05). CONCLUSION: NTDs are common and have an important place among the mortality causes in Turkey. Primary prevention through mandatory folic acid fortification should be considered both to reduce the frequency of NTD and related mortality rates.


Assuntos
Defeitos do Tubo Neural , Natimorto , Feminino , Ácido Fólico , Humanos , Lactente , Morte do Lactente , Recém-Nascido , Defeitos do Tubo Neural/epidemiologia , Defeitos do Tubo Neural/prevenção & controle , Gravidez , Prevalência , Natimorto/epidemiologia , Turquia/epidemiologia
4.
Andrologia ; 54(6): e14415, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35263457

RESUMO

The purpose of this study is to evaluate the impact of a microfluidic approach for spermatozoon selection in male infertility patients undergoing intracytoplasmic sperm injection (ICSI). This research enrolled 128 individuals who had ICSI for male-factor infertility. The patients were separated into two groups according to the method used to pick the spermatozoa: group I (n = 64), which used traditional swim-up procedures, and group II (n = 64), which used the Fertile Chip for spermatozoon selection during ICSI therapy. Fertilization rates and embryo quality were the major outcomes. The rates of pregnancy, clinical pregnancy and live birth were used as secondary outcomes. As a result, there was no statistically significant difference between the two groups in terms of fertilization rate, total grade 1 and 2 embryos. Implantation rate was significantly higher in the Fertile Chip group than in the control group (50% vs. 31%, p = 0.02). The Fertile Chip group had considerably greater pregnancy rates, clinical pregnancy rates (CPR) and live birth rates than the control group (62.5% vs. 45.3%, p = 0.038; 59.4% vs. 35.9%, p = 0.006 and 46.8% vs. 25%, p = 0.009). Fertile Chip had no effect on fertilization rates or embryo quality in male-factor infertility couples. However, the Fertile Chip group had a statistically higher pregnancy rate, CPR and live birth rate.


Assuntos
Infertilidade Masculina , Microfluídica , Feminino , Fertilização in vitro , Humanos , Infertilidade Masculina/terapia , Masculino , Gravidez , Taxa de Gravidez , Estudos Prospectivos , Estudos Retrospectivos , Injeções de Esperma Intracitoplásmicas/métodos , Espermatozoides
5.
Turk J Pediatr ; 63(1): 37-47, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33686825

RESUMO

BACKGROUND: Injury is the most common cause of preventable morbidity and mortality among children. The aim of this study was to determine the epidemiological characteristics and trends of injury-related mortality in children under five and to provide evidence for future preventive strategies. METHODS: Our study was designed as a descriptive cross-sectional study. National under-five mortality data from the Death Notification System database, entered between January 1st, 2014, and December 31th, 2017, was included in the study. RESULTS: Among all under-five deaths registered in the system, 2,560 injury-related death cases were included in the study. Overall, deaths related to injuries accounted for 4.1% of all deaths in children under five years old. Of all injury deaths, 59.9% of cases were male, 52.7% occurred at home or its close vicinity, and 80.3% were children aged 12-59 months. Injury-related under-five deaths were mainly attributed to traffic injuries (36.5%), falls (12.0%), and suffocation (10.2%). Traffic injuries were the most common cause of injury-related deaths both in infants 0-11 months and children 12-59 months old. The second and third most common causes of injury-related deaths among infants 0-11 months were suffocation and falls, while these were falls and drowning in children aged 12-59 months, respectively. The injury-related under-five mortality rate dropped from 11.3 per hundred thousand in 2014 to 9.1 in 2017. Causes of all unintentional injury-related deaths were associated with season except for other unintentional injuries and exposure to mechanical forces (p < 0.001). CONCLUSIONS: The injury-related mortality rate among children under five years declined from 2014 to 2017, however it is still high. To prevent injuries in children under five, it is important to raise awareness and increase the supervision of children by their caregivers. At the national level, multisectorial cooperation with a holistic approach will be of key importance.


Assuntos
Afogamento , Ferimentos e Lesões , Cuidadores , Causas de Morte , Criança , Pré-Escolar , Estudos Transversais , Humanos , Lactente , Masculino , Turquia/epidemiologia
6.
J Clin Res Pediatr Endocrinol ; 8(2): 187-91, 2016 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-27086874

RESUMO

OBJECTIVE: Thyroid-stimulating hormone (TSH) level in neonates is recommended as an indicator for presence of iodine deficiency (ID) at a population level and as a monitoring tool in programs of iodine supplementation. The purpose of this study, based on data from the National Newborn Screening Program (NNSP) for congenital hypothyroidism (CH) in 2014, was to analyze neonatal TSH levels to predict the current status of iodine nutrition in Turkey. METHODS: According to screening methodology, heel-prick blood samples of newborns were collected on filter paper cards usually on day 3-5 after birth (or shortly before discharge). Results of samples collected >48 h after birth were analyzed. The degree of severity of ID was assessed by using the epidemiologic criteria of the World Health Organization (WHO). Elevated TSH levels (>5 mIU/L) were processed and classified according to province, region, birth season, and sampling time. RESULTS: A total of 1,298531 newborns were registered in the NNSP for the CH database. Of those, 1,270311 newborns had screening results collected >48 h after birth and were included in the statistical analyses. The national prevalence of elevated TSH was 7.2%. While the Gaziantep sub-region had the highest TSH elevation rate (15.9%), the Tekirdag sub-region had the lowest rate (4.0%; p<0.001). Seasonal variations were also significant, and the elevated TSH prevalence rate was highest in winter (7.4%; p<0.001). CONCLUSION: National CH screening results suggest that Turkey may still be mildly iodine deficient. Nationwide studies should be performed for direct assessment and monitoring of iodine status in vulnerable populations to confirm accuracy of our results.


Assuntos
Iodo/deficiência , Triagem Neonatal/métodos , Doenças da Glândula Tireoide/epidemiologia , Doenças da Glândula Tireoide/prevenção & controle , Tireotropina/sangue , Feminino , Humanos , Recém-Nascido , Masculino , Prevalência , Turquia/epidemiologia
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