Sepsis is an important cause of morbidity and mortality among newborn infants. Blood culture is the gold standard. Early and definitive diagnosis of neonatal sepsis is difficult because its sings and symptoms are nonspecific. New leukocyte parameters such as neutrophil volume (MNV), conductivity (MNC), scattering (MNS) and volume distribution width (NDW) were introduced in the diagnosis of sepsis recently. We aimed to investigate these parameters in newborn sepsis and compare their efficacy with serum CRP, Procalcitonin (PCT), IL-6 levels.
Methods
This study was conducted in Hacettepe University Neonatology Unit, between July 2010 and February 2012. Total 227 newborns, 116 sepsis (40 proven, 76 clinical sepsis) and 111 control included in the study.
Results
Results are summarized in the Table 1.
Conclusions
In conclusion new CBC parameters can be helpful in differential diagnosis of newborn sepsis in addition to other screening parameters. MNV seems the most useful parameter with the highest spesifity.
Newborn infants with maternal-fetal ABO incompatibility are at a greater risk for developing subsequent significant hyperbilirubinemia, and therefore, prediction of probable risk factors, such as the degree of hemolysis, gains importance. In this study, we aimed to evaluate the effect of fetal-neonatal blood group on the severity of hemolysis and jaundice due to maternal-fetal ABO incompatibility. In a retrospective analysis of 166 cases with ABO hemolytic disease of the newborn, risk factors for the severity of jaundice were compared in infants with blood group A or B. Both groups had similar demographic parameters such as birth weight, gender and day of admission. Similarly, there were no statistically significant differences in hematological parameters, such as initial hemoglobin levels, initial and final indirect bilirubin levels, frequency of positive direct Coombs test and hemolytic findings on peripheral blood smear, duration of phototherapy, number of exchange transfusions, and intravenous immunoglobulin (IVIG) therapy (p>0.05). We conclude that blood type has no effect on the severity of the hemolytic jaundice in ABO incompatibility.
This study was performed to assess the neurological status of high-risk infants by "general movements" (GMs) method and to compare it with the findings of standard clinical neurological examination and neuroimaging findings during the early rehabilitation period. Neurodevelopmental examination was performed by a neonatologist at the corrected ages of 40 weeks, and 3, 6 and 12 months. Assessment of the physiotherapist included video recording of "Prechtl Analysis of GMs" from the first week of life to the corrected age of 5 months. All infants underwent an early physiotherapy program, and follow-up examinations continued until 12 months. A percentage of agreement of 0.86 was found between cranial ultrasound imaging results and GMs and of 0.78 between neurological examination and GMs. Prechtl analysis was found to be important for detecting neurological dysfunction and differentiating normal neurological development in high-risk infants during the early intervention period. This analysis can be used complementary to other diagnostic and imaging techniques in the follow-up of preterm infants.
Neonates born to mothers with immune thrombocytopenic purpura (ITP) have an increased risk of having thrombocytopenia and bleeding. The aim of our study was to determine maternal and fetal factors that can predict bleeding risk in neonates born to mothers with ITP, and effective treatment strategies by retrospective analysis of our single-center data. We performed a retrospective data review of neonates that were recorded as 'neonates born to mothers with ITP' in the Neonatal ICU of Hacettepe University, Ihsan Dogramacı Children's Hospital, Ankara, Turkey. Medical records of 36 neonates born from 35 mothers were analyzed. Among the 36 neonates born to mothers with ITP, thrombocytopenia (platelet count of less than 150 × 10/l) was detected in 20 (56.0%) neonates on the first day of life. Twelve of the 20 neonates with thrombocytopenia (60.0%) required treatment to increase the platelet counts. Clinical findings related to thrombocytopenia occurred in three (15.0%) neonates, but none of them presented with severe bleeding. There was no statistically significant association between neonatal lowest platelet count and maternal lowest platelet count, maternal platelet count at the time of delivery, and duration of thrombocytopenia, respectively. Neonates born to mothers with ITP have an increased tendency to develop thrombocytopenia, but severe bleeding is very rare in these neonates. Clinicians should pay special attention to follow these neonates. According to our results, both intravenous immunoglobulin and methyl prednisolone were found to be in equivalent efficacy for the treatment of neonatal thrombocytopenia due to maternal ITP.
This study aims to determine whether fetal growth is related to insulin-like growth factor-1 in dichorionic and monochorionic twins and also aims to investigate the correlation of insulin-like growth factor-1 to birthweight discordance in twins. We studied 100 women with twin pregnancies. The correlation tests of 36 discordant twins (15 monochorionic, 21 dichorionic) showed correlation between insulin-like growth factor-1 difference and birthweight discordance (insulin-like growth factor-1 vs. birthweight of first twin, r = +0.915, at 0.01 level, IGF-1 vs birthweight of second twin r = +0.790, at 0.01 level). In 49 monochorionic twins, independent of discordance, there was a correlation between birthweight discordance and insulin-like growth factor-1 difference ( r = .538, at the 0.01 level). This correlation was not significant in dichorionic twins, r = .144, p = .01. These data suggest that growth discordances of twins exposed to the same maternal environment may be due to variations in IGF-1, depending upon the genetic similarity.
This study aimed to investigate the prohepcidin levels in premature newborns with oxygen radical diseases such as bronchopulmonary dysplasia, retinopathy of prematurity and necrotizing enterocolitis and to compare these levels with those of healthy premature newborns. Eighty premature infants (25-34 weeks gestational age) were enrolled. The patient group was composed of 38 premature babies with oxygen radical diseases, and the control group consisted of 42 healthy premature newborns. Complete blood count, serum iron and ferritin concentrations, iron-binding capacity (IBC), transferrin and prohepcidin levels were measured. The mean ferritin and prohepcidin levels were higher in the patient group than in the control group (p = 0.038 and p = 0.022, respectively). No significant correlations were found between serum prohepcidin levels and iron parameters. We believe that this finding will contribute to a greater understanding of the etiopathogenesis of oxygen radical diseases. There is a need for future studies to explore the link between underlying inflammatory mechanisms and hepcidin in oxygen radical diseases.
Enteral and parenteral glutamine supplementation in preterm infants has been shown to have some beneficial effects on neonatal morbidity and mortality, although the results are controversial. In this study, we aimed to determine if long-term glutamine-supplemented enteral nutrition affects growth parameters in very-low-birth-weight (VLBW) preterm infants. Preterm infants with a birth weight of < or = 1500 g were assigned to receive enteral glutamine supplementation (300 mg/kg/day) or placebo between 8-120 days (4 months) of life. At the end of each month, growth parameters [weight, length, head circumference, left upper mid-arm circumference (MAC) and left mid-thigh circumference (MTC)] were determined and enteral glutamine dose was adjusted according to the current weight. In VLBW infants (n = 69), the glutamine-supplemented group (n = 36) had significantly higher mean weight, length, head circumference, MAC and MTC than the control group (n=33) at the end of the fourth month. These findings suggest that long-term enteral glutamine supplementation may lead to significant improvements in growth in all body measures in VLBW infants, possibly in a time-dependent pattern.
