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OBJECTIVE: We aimed to evaluate surfactant frequency and surfactant indications, as well as lung problems in late preterm infants. STUDY DESIGN: This retrospective and cross-sectional study was carried out by HSU Izmir Dr. Behcet Uz Pediatric Diseases and Surgery Research and Training Hospital. Infants who were born late preterm between January 2016 and January 2022 were hospitalized in the NICU due to respiratory distress in the first 24 hours. Lung problems and surfactant administration of these infants were evaluated. The frequency of surfactant dosages, their indications, and their effects were examined. As the control group, patients who were admitted to the NICU in the same period due to respiratory distress with similar indications but did not receive surfactant were considered. RESULTS: It was observed that surfactant was not administered to 105 infants and surfactant was administered to 106 infants. The median gestational week of the infants included in the study was 35 (34/36) weeks and the birth weight was 2185 (1780/2590) grams. A significant difference was observed in birth weight between the groups (p<0.001). Invasive ventilation was required in 52.1% of all cases and noninvasive ventilation was required in 33.6%. In the delivery room, the need for resuscitation and intubation was higher in the group requiring surfactant (p=0.001). The most common lung pathology in the surfactant group was RDS. CONCLUSION: It must not be forgotten that infants who are born late preterm infants are preterm infants and the evaluation of antenatal steroid administration must not be ignored. [ABSTRACT FROM AUTHOR]

Copyright of Fenerbahce University Journal of Health Sciences (FBU-JOSH) / Fenerbahçe Üniversitesi Sağlık Bilimleri Dergisi is the property of Fenerbahce University Journal of Health Sciences (FBU-JOSH) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Staffing levels, fatigue, and intervention timing may vary based on working hours and potentially influence the clinical outcomes of newborns. It remains unclear how the birth time of premature infants throughout the day affects their clinical outcome. This study aimed to compare the clinical outcomes of premature infants born during and after work hours. In this single-center retrospective cohort study, infants born at <32 weeks of age were categorized into two groups based on birth time. The first group included infants born during daytime working hours on weekdays, whereas the second group included infants born during nighttime working hours on weekdays, weekends, and public holidays. Both groups were compared in terms of clinical outcomes. Data from 572 patients born at <32 weeks of age were analyzed, with 137 (24%) infants in the on-hours group and 435 (76%) in the off-hours group. No significant differences were observed between the groups in terms of gestational age (GA) (27.4 ± 2.8 weeks vs. 27.7 ± 2.7 weeks), birth weight (BW) (1132 ± 459 g vs. 1064 ± 450 g), and gender distribution (53.2% vs. 55.4% male) (P > .05). There were no significant differences in other clinical outcomes, morbidities, or mortality rates between the groups (P > .05). Despite potential fluctuations in neonatal intensive care unit (NICU) staffing levels during on- and off-duty hours, the morbidity and mortality of premature infants aged <32 weeks were not affected in our unit. Each NICU should assess whether delivery time influences clinical outcomes, based on unique care conditions. The change in clinical outcomes depending on the time of birth may be particularly important in low- and middle-income countries (LMIC). Negative results may be an indication that the staff is under excessive workload. In addition, by providing a solution to the cause of the detected problem, both clinical outcomes may be improved and patient care costs due to morbidity may be reduced. Our results may be particularly important for studies to be conducted on this subject in LMIC., (© The Author(s) [2024]. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Copyright of Turkish Journal of Health & Sport is the property of Turkish Journal of Health & Sport and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: Understanding the etiologies of infant deaths and predicting risk begins with defining cases correctly. The collection and analysis of reliable statistical data are an essential part of comprehensive investigations on local and national levels. Material and Methods: This was a descriptive study. Diagnosis as a cause of infant death and other factors were examined. Data were analyzed using the SPSS 17.0 program. Frequencies and means were computed. Results: According to the data of 35 227 live births and 288 infant deaths during the year, the infant mortality rate of Adana province was 8.2 per thousand. We found that the most common cause of infant death was sepsis (26.0%). Other causes of infant death included prematurity and problems related to prematurity (12.6%), congenital heart disease and complications (12.6%), respiratory problems (11.9%), congenital anomaly (9.8%), immaturity (<750 g birth weight or 24 gestational weeks) (8.4%), and sudden death (6.0%). Conclusion: In our descriptive study, we presented the causes of infant mortality to minimize infant mortality due to preventable causes. Efforts to reduce infant mortality should be supported and improved by health management. Emphasis on prenatal care is one of the important things to reduce premature births. [ABSTRACT FROM AUTHOR]

Aim: Neonatal mortality rate is a good indicator to show the developmental status of a country. The aim was to assess mortality rate and causes of death in a tertiary level neonatal intensive care unit (NICU) at Sanliurfa Training and Research Hospital. Material and Methods: All infant deaths occurred in one year period between 2017 and 2018 at Sanliurfa Training and Research Hospital NICU were retrospectively reviewed and causes of death and mortality rate were examined. A total of 189 (9.4%) infants died in the study period. Most common cause of death was prematurity and associated conditions (49.2%) followed by perinatal asphyxia (16.4%) and congenital anomalies (12.7%). In term infants perinatal asphyxia (36.9%), congenital anomalies (16.9%) and acute bilirubin encephalopathy (12.3%) were the three leading causes of death. The median age of death was 3 (1-240) days. Most of the deaths (73%) occurred in the early neonatal period. Conclusion: Prematurity, perinatal asphyxia, congenital anomalies and severe hyperbilirubinemia are the leading causes of neonatal mortality in Sanliurfa. Measures for antenatal follow-up, diagnosis of antenatal risk factors, early neonatal follow-up and certification of health staff in delivery room would contribute for reduction of neonatal mortality in southeast region of Turkey. [ABSTRACT FROM AUTHOR]

Purpose: To reveal refractive errors, the relationship between refractive errors and optical parameters, and the effect of prematurity and retinopathy of prematurity (ROP) on ocular development in school children with a history of prematurity., Methods: Premature children aged 8-12 years were divided into 3 groups as those without ROP (Group 1), with ROP that did not require treatment (Group 2), and with laser-treated ROP (Group 3). Age-matched full-term healthy children were included in the control group. Demographic features were recorded. A detailed ophthalmologic examination was performed. Anterior chamber depth (ACD), trabecular-iris angle (TIA), iris thickness (IT), lens thickness (LT), vitreous body length (VBL), axial length (AL) were measured by ultrasound biomicroscopy (UBM). The results were compared between groups., Results: Group 3 had the lowest best corrected visual acuity (0.81 ± 0.31 SL), the highest rates of myopia (55.9%) and astigmatism (50.0%). In the premature groups, ACD (p < 0.001), TIA (p < 0.001), IT (p = 0.016), VBL (p < 0.001) and AL (p < 0.001) were lower; LT (p < 0.001) was higher than in the control group. As birth weight (BW) and gestational age (GA) increased, ACD, TIA, VBL and AL increased, and LT decreased (p < 0.001). In the group 3, 35.2% anisometropia, 17.6% of esotropia and 5.9% of exotropia were detected., Conclusions: The frequency of myopia, astigmatism, hyperopia and anisometropia is increasing in premature children, especially in cases with laser-treated ROP. Premature cases are characterized by thicker lens, shallower ACD, narrower TIA and shorter AL. Refractive errors, anisometropia, amblyopia and strabismus are important causes of visual impairment in children with laser-treated ROP., (© 2023. The Author(s), under exclusive licence to Springer Nature B.V.)

INTRODUCTION: The frequency of transfusion is high in infants admitted to neonatal intensive care unit (NICU). There is a higher risk of transfusion complications compared to other age groups, and there are many special considerations for transfusion in neonates. The aim of this study was to investigate the records of infants who had blood product transfusions in NICU, to investigate which patient groups were transfused, the characteristics of the blood products used and the current transfusion practices. MATERIALS and METHODS: Between November 2013 and May 2018, the records of 968 newborn infants admitted to the Istanbul Hospital NICU of Başkent University School of Medicine were retrospectively analyzed. RESULTS: Of the babies, 43.8% were female, median birth weight was 2598 (1478 - 3228) grams, median birth week was 36.5 (30 - 39) weeks and median hospitalization days were 32 (15 - 67.5) days. The most commonly used blood group was A Rh (+), the least used blood group AB Rh (-). 39.9% of the transfusions were fresh frozen plasma, 36.2% erythrocyte and 23.5% platelet suspension. In addition to prematurity and related diseases, diseases requiring surgery of central nervous system, congenital heart or gastrointestinal system diseases were the most common transfused group. According to term babies, the rate of use of thrombocyte suspension was higher in preterm infants, however the rate of use of other products was similar. CONCLUSIONS: Knowledge of the selection, preparation of blood products to be used in transfusion and the specific methods for reducing the risks of transfusion will reduce the potential risks and increase the safety of transfusion. [ABSTRACT FROM AUTHOR]

Objective: Infant mortality rates are one of the principal parameters reflecting countries' general and mother-baby health levels. Evaluating and lowering these rates is therefore highly important. This descriptive study examined the infant mortality rate in 2014-2015, its causes and the factors affecting it, and assessed preventable causes of infant death. Methods: Our work was carried out in Erzurum, a province of northeast Anatolia. Erzurum Public Health Directorate Infant Mortality Commission reports and Provincial Infant Mortality Investigation Committee study forms concerning infant deaths were examined retrospectively. Causes listed in the Perinatal and Infant Mortality Information Form prepared by the Ministry of Health were used to classify causes of infant death as underlying, intermediate or immediate. Results: The infant mortality rate in the province of Erzurum increased from 9.4 infant deaths per 1,000 live births in 2015 to 10.0 in 2015. Additionally, 27.3% of infant deaths in 2014 and 34.0% in 2015 occurred in the early neonatal period. The most common underlying cause of death was congenital anomaly in 2014 and sepsis in 2015. The most common intermediate cause of death in both years was prematurity. Conclusions: Approximately 50% of mothers of deceased infants received insufficient prenatal care sessions, and infant mortalities largely derive from congenital anomaly, sepsis and prematurity. [ABSTRACT FROM AUTHOR]

Background: Developments in the field of perinatal and neonatal care have allowed a greater number of premature or risky infants to survive. Especially premature babies, because of the long length of stay in hospital Neonatal Intensive Care Unit (NICU) 's are increasing their occupancy rates. Neonatal intensive care diseases, in terms of costs constitute the largest group of hospitalization. In this study, we aimed to determine the cost of the patients in NICU, to determine the factors that affect the cost and to set new targets for what can be done to reduce the cost. Material and Methods: The data of 738 patients who were admitted to the NICU between January 1st, 2009 and December 31st, 2009 and were followed up and treated were evaluated retrospectively. The cost analysis of all obtained data was performed. Results: 398 (53.9%) of the 738 patients were male and 340 (46.1%) were female. In terms of cost, the average daily cost of care for a baby with a birth weight between 750-999 grams was 799.16 TL, 650.76 TL for babies 1000-1250 g, 448.30 TL for babies 1250-1499 g, 361.64 TL for babies 1500-2499 g, 312.55 TL for babies 2500-4000 g and 308.12 TL for those >4000 g. When the cost according to gestational week is evaluated; a baby with less than 28 weeks were found to be 805.89 TL, 28 to 31 weeks 534.17 TL, 32 to 36 weeks 400.23 TL, 35 to 37 weeks 385.97 TL and 38 weeks' or longer 302.28 TL. As birth weight and gestational week increased, hospitalization time and total daily average costs decreased (p <0.05). Total daily average cost of patients with respiratory distress syndrome (RDS), cyanotic congenital heart diseases (CCHDs), acyanotic congenital heart diseases (CHDs), early neonatal sepsis, congenital pneumonia, transient tachypnea of the newborn (TTN), meconium aspiration syndrome (MAS), perinatal asphyxia and fetal distress was found to be high (p <0.05). In our study, the survival rate of infants under <1500 g was 81.4% and <1000 g was 36.3%. According to gestational week, the survival rate of less than 28 weeks infants was 39.5%. Conclusion: We found that gestational week, birth weight, RDS, fetal distress, asphyxia, CCHDs, acyanotic CHDs, TTN, early neonatal sepsis, congenital pneumonia and MAS were the strongest determinants of hospital stay and cost. It was observed that the duration of hospital stay and cost increased and the survival rates of the patients decreased especially as the gestational week and birth weights of the patients hospitalized in the NICU decreased. As a result, the most effective way to reduce the cost of the NICU was to prevent premature birth. [ABSTRACT FROM AUTHOR]

Background: Mothers of premature infants are in the risk group for having psychological symptoms and attachment-interaction difficulties. Preventing these maternal risks is essential for providing optimal care and health opportunities for infants, consequently improving developmental outcomes., Methods: In this study, we aimed to understand how mothers experienced prematurity within four processes retrospectively: (a) the mother's hospitalization after birth, (b) the infant's hospitalization in the Neonatal Intensive Care Unit (NICU), (c) after discharge, and (d) in early childhood. We adopted Max van Manen's phenomenology of practice and interviewed nine mothers whose children were born premature and reached early childhood., Findings: The themes were as follows: (a) incomplete mother; (b) facing prematurity, uncertainty, natural touch barrier, facing reductive social response, and NICU friendship; (c) being on the alert, a period of complete closure, and fighting with the reductive social response; (d) association to prematurity and (cannot) overcome the difficulties. We expressed the mothers' overall experiences through the metaphor "living with a birthmark." This metaphor represents the longitudinal effects of prematurity. As much as it is apparent and painful at first, it fades over time, and the pain lessens, but the effects of the birthmark remain in early childhood. The birthmark becomes a part of the mother-baby relationship., Conclusions and Practice Implications: Our study contributes to premature infant care and health literature by highlighting the longitudinal experiences of mothers on prematurity., Competing Interests: Declaration of Competing Interest The author(s) declared no potential conflicts of interest concerning the research, authorship, and/or publication of this article., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Objective This study aims to develop a scoring system for the prediction of broncho-pulmonary dysplasia (BPD). Methods Medical records of 652 infants whose gestational age and birth weight were below 32 weeks and 1,500 g, respectively, and who survived beyond 28th postnatal day were reviewed retrospectively. Logistic regression methods were used to determine the clinical and demographic risk factors within the first 72 hours of life associated with BPD, as well as the weights of these factors on developing BPD. Predictive accuracy of the scoring system was tested prospectively at the same unit. Results Birth weight, gestational age, gender, presence of respiratory distress syndrome, patent ductus arteriosus, intraventricular hemorrhage, hypotension were the most important risk factors for BPD. Therefore, a scoring system (BPD-TM score) ranging from 0 to 13 and grouped in four tiers (0-3: low, 4-6: low intermediate, 7-9: high intermediate, and 10-13: high risk) was developed based on these factors. Below the score of 4, 4.1 % of infants (18/436), above the score of 9, 100% (29/29) of the infants developed BPD. The score was validated successfully in 172 infants. Conclusion With this easy to use scoring system, one can predict the neonate at risk for BPD at 72 hours of life and direct preventive measures toward these infants. [ABSTRACT FROM AUTHOR]

Background The aim of this study was to investigate the relationship between plasma chitotriosidase activity, an inflammatory protein secreted mainly from macrophages, and neonatal morbidity and mortality in premature infants. Methods Cord blood chitotriosidase activity was studied in healthy control infants (53 term, group 1; 26 late preterm [33-37 gestational weeks], group 2) and 35 preterm infants (≤32 weeks; group 3). In group 3, consecutive samples at 3 h, 24 h, 72 h, 7 days, 14 days, and 36 weeks after conception were also analyzed. Group 3 was also evaluated for mortality, respiratory treatment and bronchopulmonary dysplasia ( BPD), patent ductus arteriosus ( PDA), intraventricular hemorrhage ( IVH) and retinopathy of prematurity ( ROP) and necrotizing enterocolitis ( NEC). Results Cord blood chitotriosidase activity was positively correlated with gestational age and birthweight. SNAPPE- II score was correlated with chitotriosidase activity at 24 h. Consecutive chitotriosidase activity for group 3 was non-significantly higher in infants who died in the early neonatal period. Higher chitotriosidase activity was observed in mechanically ventilated infants than infants treated with non-invasive assisted ventilation. BPD, PDA, IVH and ROP, but not NEC, were related to higher chitotriosidase activity, being significant at some of the time points. Conclusion Neonatal stress such as invasive ventilation may create a risk for the development of BPD, PDA, IVH, and ROP by increasing macrophage activation in preterm infants as reflected in the higher chitotriosidase activity. High chitotriosidase activity may also be associated with disease severity and mortality. [ABSTRACT FROM AUTHOR]

Objective: The object of the study is to determine the frequency and associated factors in development of ROP at very low birth weight infants born in our hospital and hospitalized in neonatal intensive care unit. Material and Method: 246 babies born and followed up in our hospital between January 2007 and December 2011 and had birth weight < 1500 g were evaluated retrospectively. Effective factors on development of retinopaty of prematurity were evaluated. Results: Of these patients, 55 (22.4%) were diagnosed with ROP. The mean gestational age in babies diagnosed as ROP was 28.3±2.3 weeks and we found that with decreasing gestational age risk of development of ROP increased (p: 0.011). Of 55 patients with diagnosis of ROP; 29 (%52.7) were followed up with stage 1,17 (%30.9) were at stage 2,8 (%14.6) were at stage 3 and 1 patient was (%1.8) at stage 5. We detected statistically significant correlation between development of ROP and PDA, advanced stage of NEC (stage 2-3), sepsis, presence of BPD (p values respectively; p=.0001, p=0.004, p=0.003, p=0.0001 and p=0.002). There was no relationship with mechanical ventilation, CPAP application and surfactant application. Factors such as maternal hypertension, diabetes, preeclampsia, smoking, age and mode of delivery were not associated with development of ROP. From the 55 cases detected retinopathy of prematurity, 9 (%16.3) had ≥ stage 3 ROP and treated with laser photocoagulation, and 1 (%1.8) of these cases developed permanent visual loss. Conclusion: Development of ROP which is the second cause of acquired visual loss in the world has multifactorial etiology and for reducing the incidence low birth weight babies should be examined with taking into account these factors [ABSTRACT FROM AUTHOR]

Our aim was to assess trends in neonatal mortality in 2009, evaluate advances in health policy, determine new goals to preserve a higher quality health service, and to prevent neonatal deaths. Data were gathered from the system of the General Directorate of Mother and Child and Family Planning. Maternal age, birth weight, gestational week, delivery at a health center, delivery by trained assistant, antenatal visits, and cause of death were evaluated. The neonatal mortality rate was 10/1,000 in Turkey in 2009, significantly better than rates of 26 in 1998, 17 in 2003, and 13 in 2008. The percentage of pregnant women making a minimum of four antenatal visits was around 80 %. Most deaths were attributable to prematurity and its complications, including 47.2 % of early neonatal mortality (ENM) and 36.1 % of late neonatal mortality (LNM). In ENM, the next-most common causes of death were congenital anomalies other than heart and genetic disorders (17.5 %), infections (6.5 %), asphyxia (6.1 %), and congenital heart disease (4.0 %), whereas in LNM, they were infections (19.9 %), congenital anomalies other than heart and genetic disorders (13.1 %), congenital heart disease (7.7 %), and asphyxia (3.8 %). Neonatal mortality in Turkey has declined within 8 years to level similar to that reached by Organisation for Economic Co-operation and Development countries over 30 years. Our findings show that each of the major causes of the neonatal death can be prevented by available interventions. Interventions to prevent prematurity, early diagnosis of congenital anomalies, and the prevention of infections would contribute to further reductions in neonatal mortality in Turkey. [ABSTRACT FROM AUTHOR]

Objective: To evaluate early aggressive vs. conservative nutrition and its effect on Retinopathy of Prematurity (ROP) in <32 weeks of gestation neonates. Methods: A prospective, randomized, clinical study was conducted in NICU with a total of 75 preterm infants. In the intervention group, infants received early aggressive nutrition immediately after birth, in the control group infants were started on conventional parenteral nutrition (PN). Blood samples were obtained for Insulin-like growth factor 1 (IGF-1) and insulin-like growth factor binding protein 3 (IGFBP3) levels before commencement of PN on the first postnatal day, and from week 1 to 6 every week. All the infants were examined for ROP. Findings: Infants in the early aggressive group had a reduction in the risk of ROP of 5% (2 from 40); the number of infants needed treatment averaged 3.7 (2.7 to 5.2). A total of 11 neonates in the conventional group were detected having ROP (P<0.05). Overall, IGF-I levels were higher in the aggressive PN (APN) vs the conventional PN (CPN). ROP development was higher in the CPN compared to the APN. IGF-1levels were lower in ROP developers compared with non-ROP in the APN group. There was no difference in IGF-I levels in ROP developers versus non-ROP in the CPN group. IGF-1 levels were lower in the CPN group compared with the APN group in the third week in ROP developers. There was a correlation between ROP and IGF-1 levels. Through ROC analysis, IGF-1 was demonstrated as being a sensitive marker for ROP. Conclusion: IGF-1 levels were higher in the APN group versus the CPN group. This may indicate that IGF-1 levels simply being higher is not enough; rather, that being higher above a cutoff value may prevent ROP. [ABSTRACT FROM AUTHOR]

Aim: To report outcomes of diode laser photocoagulation for zone 1 retinopathy of prematurity (ROP) in a tertiary university clinic. Material and Method: The records of 452 eyes of 257 preterm infants who were seen in retina division of Department of Ophthalmology, Cerrahpasa Faculty of Medicine between June 2007 and December 2010 and subsequently were diagnosed as zone 1 prethreshold ROP based on early treatment (The Early Treatment for Retinopathy of Prematurity Study = ETROP) criteria and treated with diode laser photocoagulation in accordance with ETROP criteria for ROP were reviewed retrospectively. Anatomic and structural success (regression of ROP and attached macula) were evaluated separately for zone 1 posterior (group A) and anterior (group B). Results: In group A the mean birth weight was 1120.2 g (range 490-2500 g) and the mean gestational age was 28.2 weeks (range 22-35 wks). In group B, the mean birth weight was 1128.9 g (560-1930 g) and the mean gestational age was 28.4 weeks (24-34). A success rate of 98.15% and 98.65% was achieved for group A and B, respectively. Conclusions: Zone 1 ROP group includes patients with a high risk. Diode laser photocoagulation in prethreshold stage is effective and safe for the treatment of zone 1 ROP. Updating perinatal care could provide a decrease in the incidence of ROP in premature newborns with a higher birth weight. [ABSTRACT FROM AUTHOR]

Purpose: We aimed to determine applicable guidelines for screening of retinopathy of prematurity (ROP), and evaluate the contribution of risk factors for severe ROP. Methods: A prospective cohort study of neonates with a gestational age (GA) < 34 weeks or birth weight < 2000g who were admitted to the Neonatal Intensive Care Unit (NICU) of a tertiary level hospital was conducted. The study group was classified into three groups according to eye examination findings as no ROP, mild ROP and severe ROP. Results: Of the 700 neonates screened, the frequencies of ROP for any stage and severe ROP were 32.7% and 3.1%, respectively. Laser photocoagulation was needed in 9.6% of neonates with ROP. None of the neonates with a GA ≥ 31 weeks required treatment. Any ROP was detected in 199 (53.6%) of the babies < 32 weeks ( n == 371), 22 (5.9%) of whom were treated with laser photocoagulation. Independent risk factors for severe ROP in babies < 32 weeks GA were birth weight, duration of mechanical ventilation and patent ductus arteriosus (PDA). Conclusion: This is the largest prospective cohort study including infants younger than 34 weeks GA from Turkey. Our data which belongs to the last 1-year period shows lower incidence of severe ROP when compared to previous reports from Turkey. According to our data, screening babies smaller than 32 weeks GA or 1500g birth weight seems reasonable. In the presence of long duration of mechanical ventilation and PDA, screening should be intensified. [ABSTRACT FROM AUTHOR]

Background: The thyroid gland and hormonal regulation are among the most important systems to be investigated in pre-term infants. This study sought to investigate thyroid hormone levels of healthy and unhealthy pre-term infants., Methods: The prospective study included 53 consecutive premature infants admitted to the neonatal intensive care unit within a duration of one year. Of these preterm babies, 20 were healthy, while 33 had problems such as asphyxia or RDS. Venous blood samples were collected at baseline 0-24 hours, 7 and 14 days and FT3, FT4, and TSH levels were determined. Other data recorded included demographic characteristics of the patients and clinical variables., Results: The most frequent health problems were RDS (87.9%), sepsis (30.3%), and retinopathy of prematurity (24.2%). The mean TSH levels showed a consistent decline at three consequent measurements in both groups, which were always significantly lower in unhealthy pre-terms. In both groups, TSH levels showed significant decreases on Day 7 and Day 14 compared to the baseline levels (p<005). The levels of FT3 and FT4 consistently showed significant correlations with gestational week and birth weight at each of the three measurements., Conclusion: Pre-term infants, especially those having problems, have significant hypothyroxinemia that may require thyroid hormone replacement therapy.

Background: Chorioamnionitis is closely related to premature birth and has negative effects on neonatal morbidity and mortality., Methods: In this prospective study, 43 mothers who delivered earlier than 35 gestational weeks and their 57 infants were evaluated clinically and with laboratory findings. Placentas and umbilical cords were investigated histopathologically for chorioamnionitis and funisitis., Results: The overall frequency of clinical and histological chorioamnionitis (HCA) was 8.3% and 23.2%, respectively. The frequency of HCA was 47.3% and 83.3% in mothers delivered <32 weeks and <30 weeks, respectively. Maternal demographic and clinical findings and also leukocyte and C-reactive protein values were not indicative of HCA. Infants of mothers with HCA had significantly lower Apgar scores together with higher SNAP-PE-II and CRIB scores. These infants had increased mechanical ventilator and surfactant requirements, higher incidences of patent ductus arteriosus, early sepsis, and bronchopulmonary dysplasia, and higher mortality rates. The effect of HCA on neonatal morbidity and mortality was more prominent than the effect of low birthweight and lower gestational age., Conclusion: Chorioamnionitis not only causes premature deliveries, but is also associated with neonatal complications and increased mortality. Clinical findings and infectious markers in mother or infant do not predict the diagnosis of histological chorioamnionitis. Therefore, placental histopathology may have a role in predicting neonatal outcome in premature deliveries, especially those below 30 weeks., (Copyright © 2013. Published by Elsevier B.V.)