Comparison of cord blood alarin levels of full-term infants according to birth weight.

OBJECTIVES: To compare the cord blood alarin levels of infants in different birth weight groups with those of infants born to mothers diagnosed with gestational diabetes mellitus (GDM) who were not subgrouped according to birth weight. METHODS: This prospective study was conducted between September 2023 and January 2024. Healthy term babies whose families agreed to participate in the study were divided into four groups according to their birth weight (small for gestational age (SGA), appropriate for gestational age (AGA) and large for gestational age (LGA)) and whether their mothers had GDM. RESULTS: There was a significant difference between the cord blood alarin levels of the AGA and SGA groups (p=0.014). There was also a significant difference between the cord blood alarin levels of the AGA and GDM groups (p=0.012). However, the cord blood alarin levels of the LGA group (whose mothers did not have GDM) were similar to those of the AGA group (p=0.394). CONCLUSIONS: We found evidence that alarin levels in umbilical cord blood are associated with low birth weight and GDM.

Are Congenital Urinary Tract Abnormalities Linked to Maternal Methylenetetrahydrofolate Reductase Polymorphisms in Fetuses of Intentionally Terminated Pregnancies with Oligo- or Anhydramnios ?

OBJECTIVE: We aimed to evaluate fetuses of terminated pregnancies with oligo-or anhydramnios (OAH) to further investigate the association between maternal methylenetetrahydrofolate reductase (MTHFR) polymorphisms and fetal urinary tract malformations. MATERIALS AND METHODS: This retrospective study included 16 pregnancies with OAH (with normal fetal karyotype) that were intentionally terminated before 22nd gestational week. Fetal autopsy was performed in all cases. We evaluated cases for presence of DNA methylation pathway-related gene polymorphisms. RESULTS: We demonstrated that renal abnormalities and disorders exist in 75% of the cases. Pulmonary system anomalies and single umbilical artery were the most frequently observed associated abnormalities. Polymorphisms with known reduced MTHFR activity were found in 81.8% (9/11) of the cases.Association between urinary system abnormalities and polymorphisms with known reduced MTHFR activity was observed in 88.8% (8/9) of the cases. CONCLUSION: Physicians should keep in mind that polymorphisms with known reduced MTHFR activity may be associated with urinary tract abnormalities and OAH.

Evaluation of neonatal outcomes according to the specific absorption rate values of phones used during pregnancy.

Objective: The aim was to compare neonatal outcomes according to cell phone specific absorption rate (SAR) levels and daily time spent on cell phones by pregnant women. Material and Methods: Women who gave birth at Konya City Hospital between September 2020 and February 2021 were included in this retrospective study. Gestational ages, birth weight, birth length, head circumference, sex, 5-minute APGAR scores, neonate postpartum resuscitation requirement, delivery type, the model of phone used by the pregnant women, and the average time spent on the phone during a day were recorded. To determine the relation between the SAR values of the phones used and delivering a small for gestational age (SGA) baby, receiver operating characteristic curve analysis was performed. Results: In total 1495 pregnant women were included. The rate of delivering a SGA fetus was significantly higher in women who used phones with higher SAR values (p=0.001). The cut-off value for the SAR level was 1.23 W/kg with 69.3% sensitivity and 73.0% specificity (area under the curve: 0.685; 95% confidence interval: 0.643-0.726). No correlation was found between time spent on the phone and SGA birth rate. Although both phone SAR values and time spent on the phone were higher in the symmetrical SGA group compared to the asymmetrical SGA group, the difference was not significant (p>0.05). Although the women who had preterm delivery had higher phone SAR values and had spent more time on the phone compared to those who had term deliveries, the difference was again not significant (p>0.05). Conclusion: As the SAR values of cell phones used during pregnancy increased, there was a trend towards delivering a SGA baby.

Malnutrition prevalence in hospitalized pediatric patients: A comparison of national and World Health Organization growth standards.

BACKGROUND: The aim of the study was to investigate the frequency of malnutrition in hospitalized children and compare national growth standards with World Health Organization (WHO) standards. METHODS: After obtaining height, weight, and mid-upper arm circumference values for 250 children aged 1 month to 5 years, nutrition status was assessed separately according to Neyzi and WHO standards. Weight-for-age z score (WAZ), weight-for-height z score (WHZ), height-for-age z score (HAZ), and mid-upper arm circumference z score (MUACz) were calculated based on age. Patients with WHZ < -2 were considered to have acute malnutrition, while those with HAZ < -2 were considered to have chronic malnutrition per WHO's definition. RESULTS: According to the WHO and Neyzi standards, the z scores were as follows: WAZ (-0.53 ± 1.54/-0.61 ± 1.52), HAZ (-0.42 ± 1.61/-0.45 ± 1.38), WHZ (-0.33 ± 1.26/none), MUACz (-0.58 ± 1.31/none). The difference between WAZ scores for the two standards was highly significant (P = 0.0001), whereas the difference between HAZ scores didn't reach statistical significance (P = 0.052). In our study when evaluated according to WHO standards, the prevalence of acute and chronic malnutrition was 9.6% and 13.6%, respectively. The prevalence of chronic malnutrition in those aged <2 years was higher than in the 2-5 years age group (16.8% and 4.5%, respectively; P = 0.012). CONCLUSION: There were highly significant differences in the assessment of malnutrition between the WHO and national Neyzi according to WAZ standards, contradicting the claim that WHO curves can be universally applicable. The high rates of acute and chronic malnutrition in our study indicate that malnutrition remains a significant nutrition problem in our country.

Comparison of urine bisphenol A levels in transient tachypnea of the newborn and healthy newborns.

BACKGROUND: To investigate the relationship between neonatal urine bisphenol A (BPA) levels and the prevalence and prognosis of transient tachypnea of the newborn (TTN). METHODS: This prospective study was conducted between January and April 2020 in the Neonatal Intensive Care Unit (NICU) of Gaziantep Cengiz Gökçek Obstetrics and Pediatric Hospital. The study group consisted of patients diagnosed with TTN and the control group was made up of healthy neonates housed together with their mothers. Urine samples were collected from the neonates within the first 6 hours postnatally. RESULTS: Urine BPA levels and urine BPA/creatinine levels were statistically higher in the TTN group (P < 0.005). The receiver operating characteristic (ROC) curve analysis determined the cut-off value of urine BPA for TTN to be 1.18 µg/L (95% confidence interval [CI]: 0.667-0.889, sensitivity: 78.1%, and specificity: 51.5%) and the cut-off value of urine BPA/creatinine to be 2.65 µg/g (95% CI: 0.727-0.930, sensitivity: 84.4%, and specificity: 66.7%). Furthermore, the ROC analysis indicated that the cut-off value of BPA for neonates requiring invasive respiratory support was 15.64 µg/L (95% CI: 0.568-1.000, sensitivity: 83.3%, and specificity: 96.2%) and the cut-off value for BPA/creatinine was 19.10 µg/g (95% CI: 0.777-1.000, sensitivity: 83.3%, and specificity: 84.6%) among the TTN patients. CONCLUSIONS: BPA and BPA/creatinine values were higher in the urine of newborns diagnosed with TTN which is a fairly common cause of NICU hospitalization, in samples collected within the first 6 hours after birth, which may be a reflection of intrauterine factors.

A new use of Lactobacillus rhamnosus GG administration in the NICU: colonized vancomycin-resistant enterococcus eradication in the gastrointestinal system.

INTRODUCTION: Enterococci are microbiota microorganisms that normally have low virulence; however, under some conditions they may cause community-acquired urinary tract and even hospital-acquired serious infections. Vancomycin-resistant enterococci (VRE) can cause aggressive infections in immunosuppressive patients; especially in newborns in intensive care units. Asymptomatic gastrointestinal system carriers are important sources of VRE. Asymptomatic patients colonized by VRE can infect both other patients and the environment. Prevention of gastrointestinal colonization of VRE is an important issue to prevent VRE infection, and for rational use of hospital source. METHOD: This study was carried out at Hacettepe University, Faculty of Medicine in Newborn Intensive Care Unit between November 2015 and March 2017. The newborn infants who were find as colonized by VRE during weekly surveillance VRE rectal stool culture screening were taken into the study. A single dose of one million colonies of Lactobacillus rhamnosus GG (LGG®) was given to the study group daily. The probiotic supplement continued until consecutive three negative cultures were detected or maximum 6 months. Control group received conventional treatment. RESULTS: In the study group, VRE eradication was successful in 21 patients out of 22 within 6 months and 1 patient was still VRE positive at 6 months. In the control group, VRE was eradicated in 12 patients out of 23 and 11 patients continued to be colonized by VRE at 6 months. There was a statistically significant difference between the groups (p <.05). CONCLUSION: Lactobacillus rhamnosus GG use is associated with early clearance of vancomycin-resistant enterococcus in newborn patients.

Neonatal outcomes of early- and late-onset preeclampsia.

BACKGROUND: The aim of the current study was to demonstrate the neonatal outcomes of infants born to mothers with early-onset preeclampsia (EP) and late-onset preeclampsia (LP), and compare the neonatal outcomes before and after 34 weeks of gestation in EP group. METHODS: In this retrospective study, we evaluated preeclamptic mother and child pairs who were followedup at Hacettepe University Hospital between the years 2010 and 2017. The pregnant women were classified as having EP if diagnosed before 34 weeks of gestation (n=91) and LP if diagnosed after 34 weeks of gestation (n=34). The women in the EP group were further divided into subgroups according to the gestational week at birth, including those who gave birth before 34 weeks of gestation (early birth; n=57) and after 34 weeks of gestation (late birth; n=34). Necessary clinical and demographic data were withdrawn from the electronic registry and patient files. RESULTS: Neonates in the EP/late birth subgroup had significantly lower gestational age and birthweight. Small for gestational age (SGA) frequency was higher in the early-onset subgroup born after 34 weeks` gestation compared to the late-onset preeclampsia group (p= 0,016). The incidence of neutropenia was significantly higher in the EP/late birth subgroup than in the LP group (p= 0.002). After correcting for gestational week and birth weight, neutrophil count was still significantly lower in the EP/late birth subgroup (p= 0.002). EP/late birth subgroup and LP group had comparable outcomes regardless of neutrophil count and SGA rate. CONCLUSIONS: Close follow up and postponing delivery in stable and appropriate pregnant women with preeclampsia would be beneficial for neonates.

Cord blood delta neutrophil index values of term neonates.

In this study, we aimed to demonstrate cord blood immature granulocyte (IG) count and delta neutrophil index (DNI) values for term neonates. This retrospective study consisted of 126 term newborns born between July 2017 and December 2017. Cord blood samples were collected during delivery and IG count together with DNI values were obtained. `Beckman Coulter DXH800 System Hematology Analyzer` was used for analysis and calculations. The median DNI value was found to be 1.0 (interquantile range(IQR) 0.5-1.8%) and the median gestational age at delivery was 38.4 (IQR 37.6-39.0) weeks. The median birth weight and IG count were 3250 (IQR 2955-3593) g and 66 (IQR 26.5-112.3)/mm3, respectively. In conclusion, we believe that determining the normal laboratory reference values of IG count or DNI, which are important potential diagnostic markers for neonatal sepsis, will contribute to future studies on the diagnosis of neonatal sepsis.

Congenital central nervous system anomalies: Ten-year single center experience on a challenging issue in perinatal medicine

Objective: Our goal was to highlight the prenatal diagnosis and management of central nervous system (CNS) anomalies through sharing our clinic's experience. Material and Methods: We evaluated prenatal findings and postnatal outcomes of neonates who had a CNS anomaly diagnosis in our clinic over a ten-year period. A total of 183 cases with various CNS anomalies were included in the study. Birth or termination preferences of mothers were recorded in all cases, and postnatal diagnosis concordance and prognosis after surgical procedures were evaluated in mothers who chose to continue the pregnancy. Results: The mean maternal age was 28.2±5.5 years, mean gravida was 2.2±1.3, and the mean gestational age at diagnosis was 30.5±5.5 weeks. Seventy-five out of 183 (41%) patients chose to terminate their pregnancy. Twenty babies (26.6%) in the termination of pregnancy group had additional anomalies. One hundred eight patients gave birth at our institution. The mean birth weight was 3060±647.5 g, the mean gestational week at delivery was 37.9±1.7 weeks, and mean APGAR score (5th minute) was 8.8±2.3. Four neonates died on the postpartum first day. The postnatal diagnosis of 60 of the 108 (55.5%) patients who gave birth was concordant with the prenatal diagnosis, and 32 of the 108 (29.6%) babies underwent surgical interventions. Conclusion: CNS anomalies have a broad spectrum and variable prognoses. This study highlights the limitations of prenatal diagnoses, and the need for parents to have this information in order to determine the course of their pregnancy and prepare themselves for the postnatal challenging treatment/rehabilitation process.

Normoblastemia multinuclear en un recién nacido secundaria a hipoxia. / Multinucleated normoblastemia in a newborn secondary to hipoxia.

Normoblasts may be seen in peripheral blood smear of newborns. The number of normoblasts per 100 white blood cells is generally in the range of 0-10.They can be seen more common than usual in hypoxic condition, because intrauterine hypoxia increases the production of red blood cells. However, multinucleated normoblasts in a newborn caused by hypoxia haven't been reported before. We present a newborn with multinucleated normoblasts secondary to intrauterine hypoxia. This case is important; because it is the first time multinucleated normoblasts in peripheral blood smear of a hypoxic newborn has been detected.

Es posible detectar normoblastos en los frotis de sangre periférica de los recién nacidos. En general, la cantidad de normoblastos por cada 100 leucocitos está en el intervalo de 0 a 10. Se observan con más frecuencia de lo usual ante una situación de hipoxia porque la hipoxia intrauterina aumenta la producción de eritrocitos. Sin embargo, no se había informado antes un caso de normoblastos multinucleados en un recién nacido a causa de la hipoxia. Presentamos el caso de un recién nacido con normoblastos multinucleados secundarios a hipoxia intrauterina. Este caso es importante porque es la primera vez que se han detectado normoblastos multinucleados en el frotis de sangre periférica de un recién nacido hipóxico.

Normoblastemia multinuclear en un recién nacido secundaria a hipoxia / Multinucleated normoblastemia in a newborn secondary to hypoxia

Es posible detectar normoblastos en los frotis de sangre periférica de los recién nacidos. En general, la cantidad de normoblastos por cada 100 leucocitos está en el intervalo de 0 a 10. Se observan con más frecuencia de lo usual ante una situación de hipoxia porque la hipoxia intrauterina aumenta la producción de eritrocitos. Sin embargo, no se había informado antes un caso de normoblastos multinucleados en un recién nacido a causa de la hipoxia. Presentamos el caso de un recién nacido con normoblastos multinucleados secundarios a hipoxia intrauterina. Este caso es importante porque es la primera vez que se han detectado normoblastos multinucleados en el frotis de sangre periférica de un recién nacido hipóxico.

Normoblasts may be seen in peripheral blood smear of newborns. The number of normoblasts per 100 white blood cells is generally in the range of 0-10.They can be seen more common than usual in hypoxic condition, because intrauterine hypoxia increases the production of red blood cells. However, multinucleated normoblasts in a newborn caused by hypoxia haven't been reported before. We present a newborn with multinucleated normoblasts secondary to intrauterine hypoxia. This case is important; because it is the first time multinucleated normoblasts in peripheral blood smear of a hypoxic newborn has been detected.