Melinda Matyas

P342 Multiple causes of respiratory distress in an extreme premature newborn with chromosome 6q deletion

Introduction Chromosome 6q deletion is a rare chromosomal anomaly, associating different phenotypes, depending on the quantity of genetic material that is lost. Most cases exhibit growth restriction, low birth weight, facial dysmorphism, limb and cardiac anomalies, respiratory distress, neuromotor delay. There are 41 cases reported, with variable involvement of the long arm of chromosome 6. Material and method We present a premature male newborn, 29 weeks gestation age, 950g birth weigh, Apgar scores 2/4/6, with history of prolonged rupture of membranes (21 days). Clinical findings: severe respiratory distress, facial dysmorphism, low set years, short thorax, congenital stridor, clubfoot. He needed nCPAP respiratory support, then SIMV for persisting respiratory distress, because of laryngotracheomalacia (confirmed by ORL exam). Supraglosoplasty was performed. Eventually he needed tracheostomy. Karyotype showed 6q deletion. Discussions and conclusions There are 20 reported cases of interstitial 6q deletion; respiratory distress is due to thorax anomalies, diaphragmatic hernia, tracheoesophageal fistulas or cardiac malformations. The association of respiratory distress syndrome through surfactant deficiency and possibly congenital pneumonia and congenital laryngotracheomalacia in a premature newborn having interstitial 6q deletion, warranted prolonged respiratory support and hospitalisation.

OC-74 The metabolic consequences of feeding types of preterm neonates

Background and aim High risk newborns are often much smaller than healthy infants when are discharged from hospital. Different types of feeding: breastmilk, formula or mixed can influence growth rates and improve development. The aims of the study were to evaluate the growth rates; catch–up rate and some biological parameters of the nutritional status such as: hemoglobine, iron, calcium, phosphor, magnesium, the level of plasmatic protein, nitrogen balance at differents ages : 1-2-4-6 months in three different types of nutrition – breastmilk, special formula for premature, breastmilk with premature formula or started formula. Material and methods A retrospective study was performed in a tertiary neonatal care unit between 2011–2013 in the County Hospital of Cluj, Romania on 383 infants presented to periodical examination in the follow-up program: 465 records. We divided into 3 categories : group I-VG≤32 weeks, group II-VG between 32–36 weeks and group III-VG≥36 weeks of gestation. The evaluation consultations were performed at 1-2-3-4-5-6 months. Each evaluation consisted of determining: weight, CBC, calcium, iron, magnesium, protein, Blood Urea Nitrogen (BUN) levels. Informed consent was obtained Statistical analysis was made with Microsoft Excel 2016 and IBM SPSS v.23. Results Growth rate up to 6 months wasn ‘t significantly influenced by the type of feeding (p=0.319). Hemoglobine at 2 months highlighted statistically higher values in formula fed group: 11.77±2.07g compare with premature formula fed group:10.848±1,7556g(p=0.008). The values of iron at 2 months hasn’t presented any significant differences according to the types of feeding (p=0.475). There is a significant decrease of iron levels that occurs gradually with age in the breastfed ones, r=−0.89. Different calcium levels were registered according to types of feeding (p=0.003) until 6 months. Magnesemia were not influenced by feeding type at any groups. BUN in group I was significantly smaller in breastfed compared with premature formula fed infants(p=0.000) at 2 months. Up to 6 months the value is significantly lowered in cases of breastfed, p=0.001. The values of the protein in≤32 weeks is directly influenced by the type of feeding p=0.024. Protein levels is significantly influenced in group II(p=0.026). Phosphatemia is significantly influenced by the type of feeding in group II(p=0.043). ConclutionS Increase in bodyweight of newborns under 32 SS isn’t influenced significantly by the type of feeding up to 6 months. Calcium registered significantly different values under the different types of feeding in the prematures≤32 weeks of gestation in the first 6 months of life. Phosphoremia is significantly influenced by the type of feeding in the second group. Iron drops significantly with age in breastfedgroup. The level of protein in group I is directly influenced by the type of feeding. At 2 months of age BUN is significantly influenced by the type of feeding in the first group.

OC-37 Study of oxidativ stress in preterm neonates

Aim Preterm neonates associate a more pronounced oxidative stress than term healthy newborns.Several neonatal condition like respiratory distress (RDS),asphyxia, intraventricular hemorhage, bronchopulmonary dysplasia, retinopathy and necrotizing enterocolitis will increase the oxidative stress. The aim of the study was to evaluate the oxidative stress trough the lipid peroxidation at preterm newborns with different pathological conditions associated to preterm birth. Material and methods We conducted a prospective, non –randomised study.The study group was represented by sixty preterm newborns with RDS. The control was represented by 20 healthy term newborns. For all patients family’s consent was obtained. The study of the oxidative stress was performed by measurement of malonildyaldehide (MDA) with Satoh’s method. For each newborn we determined the MDA on the first and third day of life. For the control was carried out one determination on the first day of life.The statistical analysis was done using the statistica programm. Results In the study group the RDS was present in different forms:mild – 35% newborns, medium −42% and severe – 23%. Seven newborns presented neonatal septicemia. Cerebral haemorrhage was present at 12 newborns of the study group. Asphyxia at birth was present at 11 preterm neonates. MDA was higher at the neonates with the above circumstances. On the first day of life the MDA value was higher than on third day at the control. Study group MDA was significantly higher than at control. Conclusion Different conditions associated to preterm delievry will increase the oxidative stress. The oxidative stress is more severe at this category than at healthy control neonates.

PO-0577 “old” And “new” Markers In Early Neonatal Sepsis – Diagnosis Value

Background and aim To evaluate the diagnosis value of TLR-2 (Toll-like Receptors), TLR-4, IL-6 (interleukine -6), TNF-α (tumour necrosis factor – α) and CRP(C reactive protein) in the diagnosis of early neonatal sepsis at the premature babies with premature rupture of the membranes. Material and methods Diagnosis of sepsis was done according with International Sepsis Definitions Criteria. Study group involved newborns with signs and symptoms suggestive for systemic infection, requiring full sepsis evaluation and antibiotic treatment and control group is represented by healthy newborns. We determined in the I-st day TLR-2, TLR-4, IL-6, TNF-α and CRP and in the III-th day the same without TLR. We used latex agglutination test for CRP, Elisa technique for TNF-α and IL-6 and flow cytometry for TLR. Statistical analysis was done with “Statistica VI”. Results Sepsis group presented in the I-st day: TNF-α (pg/ml)= 14,7[5,0–24,3]; IL6 (pg/ml)=153,7[82,3–225,1]; CRP (mg%)= 0,83[0,54–1,12]; and the expression (%) of TLR2 = 42,5 [29,5–55,4]; and TLR4 = 2,2[1,26–3,15]. TNF- α correlates significantly and negative with TLR2. TLR2 correlates significantly and positive with TLR4. In the 3-rd day: TNF-α (pg/ml)= 10,1[5,1–15,1]; IL6(pg/ml)=46,5[16,3–76,7]; CRP (mg%)= 1,2[0,6–1,81]. Control group presented: TLR2(%) = 5,69 (p = 0,00006) and TLR4(%) = 0,67(p = 0,037). In the first day TNF-α and IL6 were higher in study group vs. control group but no statistical differences. Conclusions TLR-2 and TLR-4 could confirm like markers the neonatal sepsis. IL-6 and TNF-α consider to be markers of early neonatal sepsis. CRP could not be consider like marker for early neonatal sepsis.

PO-0747 The Study Of Oxidative Stress At Preterm Newborns With Respiratory Distress Syndrome

Aim The diseases of newborns which involve oxidative stress are: respiratory distress (RDS), bronchopulmonary dysplasia, retinopathy and necrotizing enterocolitis. The aim of the study was to evaluate the oxidative stress trough the lipid peroxidation at preterm newborns with RDS. Material and methods We conducted a prospective, non –randomised study. The study group was represented by sixty preterm newborns with RDS. The control was represented by 20 healthy late preterm newborns. For all patients family’s consent was obtained. The study of the oxidative stress was performed by the measurement of malonildyaldehide (MDA) by Satoh’s method. For each newborn we determined the MDA on the first and third day of life. For the control was carried out one determination on the first day of life. The statistical analysis was done using the SPSS program. Results The RDS was present in mild form at 35% newborns, medium form at 42% and severe form at 23%. Seven newborns presented neonatal septicemia. Cerebral haemorrhage was present at 12 newborns of the study group. At 13 preterm the RDS was treated with mechanical ventilation. The MDA was higher at the neonates with the above circumstances. On the first day of life the MDA value was higher than on third day at the control. Also the MDA was significantly higher on the study group than at the control. Conclusion The RDS at preterm is a significant risk factor for oxidative stress. The association of other diseases to RDS will increase the oxidative stress.