Selda Arslan

Neonatal Infection with Neisseria meningitidis: Analysis of a 97-Year Period Plus Case Study

ABSTRACT Neisseria meningitidis is one of the major causes of meningitis in children and adolescents, but it is rarely found during the neonatal period. Here, we describe a neonate with meningococcal sepsis who was admitted to the hospital on postnatal day 10, and we discuss the clinical features of neonatal infection with N. meningitidis in relation to the literature (analysis of a 97-year period).

A comparison of the effects of invasive mechanic ventilation/surfactant therapy and non-invasive nasal-continuous positive airway pressure in preterm newborns

Abstract Aims: This study compared the early-term outcomes of mechanical ventilation (MV)/surfactant treatment with nasal-continuous positive airway pressure (nCPAP) in preterm infants with respiratory distress syndrome (RDS). Materials and methods: Data from newborns born between ≥24 and ≤32 weeks of gestation, hospitalized at our newborn intensive care unit, and diagnosed with RDS between January 2009 and February 2012 were analyzed. Results: Of 193 newborns with RDS who were enrolled in the study, 113 were treated with nCPAP and 80 with MV at a level of 57.5% of nCPAP. Within the study group, 46.3% of the infants were female. The mean gestation of the continuous positive airway pressure (CPAP) group was 29.07 ± 1.99 weeks; that of the MV group was 28.61 ± 2.01 weeks. The birth weight was 1321.1 ± 325.4 g and 1240.3 ± 366.1 g; however, the difference between the two groups was not significant. MV was not required in 54.9% of the patients with nCPAP treatment. Bronchopulmonary dysplasia (BPD) developed in 20 (18.7%) patients in the nCPAP group and 18 (24.4%) patients in the MV group; the difference was not significant (p = .351). Between 2009 and 2012, nCPAP was used at a rate of 33.9, 70.8, 68.4, and 69%. The risk factors for developing BPD were low gestation week, duration of intubation, and proven sepsis (p = .0001, p = .004, and p = .011, respectively). Conclusions: Early nCPAP treatment in preterm infants (≤32 weeks of gestation) decreases both the need for MV and the use of surfactant, but without a significant effect on BPD development. (No. 2016/324)

Early Neonatal Outcomes of Very Low Birth Weight Infants of Preeclamptic Mothers

Objective: Our aim is to investigate the effect of preeclampsia on very low birth weight infants’ morbidity and mortality rates in early neonatal periods. Methods: Infants admitted to the Sisli Etfal Children Hospital Neonatal Intensive Care Unit between the years of 2007-2011 and birth weights under 1500 gr were examined retrospectively. Babies whose mothers with and without preeclampsia were compared in terms of demographic characteristics and neonatal morbidity and mortality results. The Chi-square test was used for qualitative data and an independent simple t-test was used for quantitative data. Results: The study included a total of 246 very low birth weight infants. 53 of them had preeclamptic mothers (Goup 1). The other groups consisted of 193 babies (Group 2). When the preeclamptic group was compared with the other group, mean gestational age, average birth weight and male gender ratios were similar (29.1±2.32 vs 28.8±3.12, 1086±254 g vs 1127±290 g, 49.1% vs 46.1%, respectively, for each p> 0.05). The rate of SGA infants in the preeclampsia group was elevated nonsignificantly (14% to 17%, p>0.05). There was no significant difference between groups according to antenatal factors that may affect prognosis (mean maternal age, regular pregnancy follow-up, application rates of antenatal steroids, placental abnormalities and oligohydramnios). Cesarean delivery in the preeclampsia group was significantly higher than in the other group (92.5% to 69.4%, p=0.0001). There were no significant differences between the groups in terms of respiratory distress syndrome (67.3% vs 72.6), stage 2-3 necrotizing enterocolitis (5.7% vs 3.6%), patent ductus arteriosus (9.1% vs 17.6%), grade 3-4 intraventricular hemorrhage (5.7% vs 6.7%) and retinopathy of prematurity (26.4% vs 21.2). Mortality (18.9% vs 26.9%, p:0.23), and red blood cell transfusion rates (42.6% vs 57.6%, p:0.065) were lower in infants of preeclamptic mothers although there was no statistically significant difference. Conclusion: Short-term morbidity and mortality rates were not changed in very low birth weight infants of mothers having preeclampsia. The gestational week of pregnancy and birth weight have been more influential in the prognosis of these babies. There is much debate regarding respiratory and other morbidities in preeclamptic premature babies in the literature. In future studies, evaluating the grade of preeclampcy will unravel these controversies. (JAREM 2012; 2: 64-7)