İSTANBUL'DA BİR REFERANS HASTANESİNİN ÜÇÜNCÜ BASAMAK YOĞUN BAKIM ÜNİTESİNDE İZLENEN ÇOK DÜŞÜK DOĞUM AĞIRLIKLI YENİDOĞANLARIN KLİNİK SEYRİ

Autor: Güner Karatekin, Derya Benzer, Fahri Ovali, Tugba Gursoy, Ozge Serce
Rok vydání: 2014
Předmět:
Zdroj: Zeynep Kamil Tıp Bülteni. 45:30
ISSN: 2148-4864
1300-7971
2010-2011
DOI: 10.16948/zktb.84910
Popis: Giris: Gelismekte olan ulkelerde bulunan degisik hastanelerin preterm yenidoganlarla ilgili klinik sonuclari farklilik gostermektedir. Pratik hayatta yapilan uygulamalarin etkinligini monitorize etmek icin her bir hastanenin kendisine ait guncel surveyans calismalarini yapmasi gerekmektedir. Bu calismanin amaci Istanbul’da bulunan ana merkezlerden biri olan hastanemize yatirilmis cok dusuk dogum agirlikli (CDDA) bebeklerin morbidite ve olum sonuclarini degerlendirmek ve kotu seyirle iliskili risk faktorlerini belirlemektir. Materyal-Metod: Ocak 1, 2010-2011 tarihleri arasinda Zeynep Kamil Kadin Dogum ve Cocuk Hastanesinde dogarak yenidogan unitesine yatirilan yenidoganlarin (≤1500 gram, dogum agirligi ≤32 gebelik haftasi) dosyalari geriye donuk tarandi. Risk faktorleri lojistik regresyon modelleri ile arastirildi. Sonuclar: Tum vakalar icinde 154/370 (%41.6) yenidogan olmustu. Olumun ana nedenleri respiratuar distress sendromu (RDS) (%39.2), konjenital anomali (%14.4), pulmoner kanama (%13.7) ve sepsisti (%12.4). Yasayan yenidoganlarda premature retinopatisi %49.6; RDS %44.7; bronkopulmoner displazi %29.7; patent duktus arteriyozus %21.8; ventrikul ici kanama %18.6; nekrotizan enterokolit %13 siklikta gorulmekteydi. Dusuk dogum agirligi, dogum odasinda canlandirma uygulanmasi, RDS, akut bobrek yetmezligi, gobek ven kateteri takilmasi arttirici; sezeryan ile dogum ve fizyolojik tarti kaybinin olmasi azaltici yonde olum ile iliskiliydi. Tartisma: Takipsiz veya yuksek riskli gebeliklerin kabul edildigi hastanemizde uygulanan modern perinatal bakima ragmen, CDDA’li bebeklerin olum oranlari halen sikti. Olum ve kisa donem morbiditeler acisindan dusuk dogum agirligina sahip olmanin en onemli risk faktoru oldugu gorulmekteydi. Anahtar Kelimeler: Dusuk dogum agirligi, morbidite, olum, risk faktoru [Outcomes of very low birth weight infants in a reference hospital with a tertiary neonatal intensive care unit in Istanbul] Abstract Background: The outcome of preterm neonates’ varies in different hospitals in developing countries. Due to monitoring the effectiveness of current practice, every hospital should evaluate their own surveillance of up-to-date outcome of the infants. The aim of this study is to establish the morbidity and mortality of very low birth weight (VLBW) infants admitted to a referral hospital in Istanbul, Turkey and to analyze risk factors associated with poor outcome. Methods: The files of the neonates (≤ 32 gestational weeks, ≤ 1500 g birth weight) who were born and hospitalized in Neonatology unit between January 1, 2010-2011 at Zeynep Kamil Maternity and Childrens’ Training and Research Hospital were investigated retrospectively. Risk factors were analyzed using logistic regression models. Results: Of all, 154/370 (41.6%) infants died. The main reasons of mortality were respiratory distress syndrome (RDS) (39.2%), congenital anomalies (14.4%), pulmonary hemorrhage (13.7%), and sepsis (12.4%). In the infants who survived the incidence of retinopathy of prematurity was 49.6%; of RDS, 44.7%; of bronchopulmonary dysplasia, 29.7%; of patent ductus arteriosus, 21.8%; of intraventricular hemorrhage, 18.6%; of necrotizing enterocolitis, 13%. Lower birth weight, resuscitation at delivery room, RDS, acute renal failure, and umbilical venous catheterization were negatively; cesarean delivery and physiological weight loss were positively correlated with mortality. Conclusions: Even with modern perinatal care, deaths of VLBW infants are still common in our hospital in which high risk pregnancies or without follow up pregnancies admitted. Lower birth weight was the significant risk factor for death and short-term disability. Key words: Low birth weight; morbidity; mortality, risk factor
Databáze: OpenAIRE
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