The utility and reliability of the PreViAs questionnaire forthe assessment of vision in Turkish neonates and infants. / Utilidad y confiabilidad del cuestionario PreViAs para la evaluación de la visión en neonatos y lactantes turcos.

Introduction: Evaluating the visual functions of children with an easy-to-use and evidence-based method during the preverbal period will enable early diagnosis and intervention of visual impairments. The aim of this study is to determine the utility and reliability of the Turkish version of the Preverbal Visual Assessment (PreViAs) questionnaire, which was developed to evaluate the visual functioning of preverbal infants. Population and Methods: The PreViAs questionnaire was administered to primary caregivers of term infants under 24 months of age, and their responses were recorded. Results: Data from the 278 participating infants were analyzed to assess the internal consistency of the PreViAs questionnaire. Results showed a high level of consistency with Cronbach's alpha value of 0.958 for the total score, suggesting strong internal coherence. In addition, the Cronbach's alpha values for each domain were 0.890, 0.913, 0.951, and 0.922 for visual attention, visual communication, visual processing, and visual-motor coordination, respectively, indicating good internal consistency for each subdomain. Conclusion: The Turkish version of the PreViAs questionnaire is useful and reliable for assessing functional vision during the preverbal period.

Introducción. La evaluación de la visión en los niños durante el periodo preverbal, con un método fácil de usar y basado en la evidencia, permitiría el diagnóstico temprano y la intervención en los trastornos visuales. El objetivo del estudio fue determinar la utilidad y confiabilidad de la versión en idioma turco del cuestionario Preverbal Visual Assessment (PreViAs), desarrollado para evaluar la visión en niños preverbales. Población y métodos. El cuestionario PreViAs se administró a los cuidadores primarios de niños nacidos de término, antes de los 24 meses de edad. Se registraron sus respuestas. Resultados. Se analizaron los datos de 278 participantes para evaluar la consistencia interna del cuestionario PreViAs. Se encontró un alto nivel de consistencia con un alfa de Cronbach de 0,958 para el puntaje total, lo que sugiere una fuerte coherencia interna. Los valores del alfa de Cronbach para cada dominio fueron: 0,890 ­ 0,913 ­ 0,951 y 0,922 para la atención visual, la comunicación visual, el procesamiento visual y la coordinación visomotora respectivamente; esto indica una buena consistencia interna para cada subdominio. Conclusión. La versión en idioma turco del cuestionario PreViAs es útil y confiable para evaluar la visión durante el periodo preverbal.

Phototherapy-induced hypocalcemia and hypoparathyroidism in icteric term newborns.

OBJECTIVES: Phototherapy is demonstrated to cause hypocalcemia by decreasing melatonin levels and increasing cortisol levels. However, the relationship between parathyroid hormone (PTH) level and calcium has not been previously evaluated in patients receiving phototherapy. Our study aimed to evaluate the effect of phototherapy on ionized calcium (iCa), total calcium (tCa), corrected calcium (cCa), magnesium (Mg), phosphorus (P), 25-hydroxyvitamin D (25(OH)D), and PTH levels. METHODS: Infants who were born at term and received inpatient phototherapy for indirect hyperbilirubinemia were included in our study. The patients' gestational age, birth weight, and phototherapy durations were recorded. Total bilirubin, albumin, iCa, tCa, cCa, Mg, 25(OH)D, and PTH levels before and after phototherapy were compared. Laboratory results were also compared between patients who received phototherapy for ≤24 h, 25-47 h, and ≥48 h. RESULTS: A total of 166 term infants were included in the study. The mean duration of phototherapy was 31.9 ± 9.2 h. Albumin levels before and after phototherapy were similar (p=0.246). However, there were significant decreases in iCa, tCa, cCa, Mg, 25(OH)D, and PTH levels after phototherapy (p<0.001), while P level was significantly increased after phototherapy (p<0.001). In addition, P levels increased with >24 h of phototherapy, while iCa, tCa, cCa, Mg, 25(OH)D, and PTH levels decreased significantly with ≥48 h of phototherapy (p=0.002, p=0.008, p=0.001, p=0.012, and p<0.001, respectively). CONCLUSIONS: This study demonstrates that PTH suppression is one of the causes of phototherapy-induced hypocalcemia.

The Relationship of Adolescent Motherhood to the Macronutrient Content of Breast Milk.

Objective: Breast milk is the best nutrient for newborns due to its rich dietary content, immunological factors, ease of accessibility, and affordability. Given the fact that adolescent birth rate in Turkey is high, this study examines the effects of adolescent motherhood with regard to macronutrient contents in breast milk. Study Design: We collected colostrum samples from mothers staying at our hospital. Gestational ages were ≥37 weeks. Demographic characteristics of the patients were registered. The MIRIS (Mid-Infrared Human Milk Analyzer) device was operated to analyze breast milk, adopting a spectroscopy method for measurements. Protein, fat, carbohydrate, and energy levels of the hindmilk samples were measured; thus, study groups were compared. Results: The study included 224 mothers, of whom 49 were adolescents and 125 were adults. Maternal weight and maternal body mass index, weight gain during pregnancy, mode of delivery and gestational age, as well as birth weight and gender of the infants were similar. As breast milk contents were compared, we found out that fat content levels in the colostrum of adolescent mothers were significantly higher, with respect to the other group. Protein and carbohydrate levels were lower in adolescents, even if they were not statistically significant. There was no difference between the groups in terms of energy levels. Conclusion: Adolescent motherhood may have negative influences on infant welfare. However, in terms of breast milk content quality, adult mothers are not superior to adolescents.

Evaluation of Breast Milk Macronutrient Content in Preeclamptic Mothers.

Background: Preeclampsia remains among the leading causes of maternal and perinatal morbidity and mortality worldwide. This study aimed to evaluate the macronutrient content of colostrum in mothers with preeclampsia. Materials and Methods: Women who delivered by cesarean section at ≤37 weeks of gestation were included in the study. Fresh colostrum samples were collected by manual expression on postpartum days 2 and 4 and were analyzed using a mid-infrared human milk analyzer. Demographic characteristics of the patients were recorded. The protein, fat, carbohydrate, and energy composition of the milk samples were compared between mothers with and without preeclampsia. Results: A total of 58 colostrum samples (25 preeclampsia, 33 nonpreeclampsia) were analyzed. The median gestational age of the infants was similar in both groups (32 versus 33 weeks; p > 0.05). There were also no differences between the groups in terms of maternal age, maternal body mass index, maternal weight gain during pregnancy, and infant gender. Median protein, fat, and carbohydrate levels in the colostrum of the preeclamptic mothers were 2.2, 2.1, and 6.3 g/dL, respectively, compared with 1.8, 2.4, and 6.2 g/dL in the nonpreeclamptic mothers, respectively. Although the colostrum of preeclamptic mothers had higher protein content and lower fat content, the difference was not statistically significant. Carbohydrate and energy contents were similar in both groups. Conclusions: The presence of preeclampsia does not cause a significant change in the macronutrient composition of mother's milk. Analyses of micronutrients at different lactation stages in larger samples are needed.

Comparison of the Macronutrient Content of Colostrum: Locals with Refugees.

Background: Breast milk (BM) is considered the ideal and natural way of feeding for all infants. Although previous studies evaluated the factors influencing the content of BM, data concerning the effect of being a refugee on macronutrient contents of BM are rather inadequate. Therefore, we aimed to compare the macronutrient content of colostrum samples of Turkish and Syrian mothers. Materials and Methods: BM from lactating mothers who delivered term newborns was collected within the first 48 hours of lactation. Milk protein, fat, carbohydrate, and energy levels were measured by using a mid-infrared human milk analyzer. Demographic characteristics of the mothers and the infants were recorded. Results: Colostrum samples of 180 lactating mothers (Turkish: 96, Syrian: 84) were obtained. There were no significant differences between the groups in terms of body mass index of the mothers, mode of delivery, and infant gender. However, Syrian mothers gained less weight during pregnancy compared with Turkish mothers (p = 0.029). The median protein, fat, and energy levels of colostrum samples were found to be significantly higher in Turkish mothers than in Syrian mothers (p = 0.001, p = 0.017, p < 0.001, respectively). Cesarean delivery and being a Syrian refugee were independently associated with lower protein content of colostrum in logistic regression analysis. Conclusion: Lactating mothers who delivered their babies through vaginal route were found to be advantageous in terms of colostral protein content. Also, an association between being a refugee and lower protein content of colostrum was remarkable.