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Aim: According to delivery room guidelines, an optimal position is not specified for the stabilization of the baby. This study aimed to define the positions effects on postnatal adaptation parameters and cerebral oxygenation in non-resuscitated neonates. Materials and Methods: A total of 60 neonates delivered by cesarean section stabilized randomly in the supine, right-side, left-side, or prone positions were enrolled. Apgar scores, heart rates (HR), arterial oxygen saturations via pulse oximetry, and perfusion indexes (PI) at the 2nd, 5th and 10th minutes were recorded. Cerebral regional oxygen saturation (SpO2) of the patients was monitored by near-infrared spectroscopy. Results: In the prone position, the 1st minute Apgar score was significantly lower than other groups, but no difference was observed at the 5th minute Apgar scores (1st min Apgarprone, p=0.05). Although there was no statistically significant difference, the prone position had the lowest HR at the 2nd minute, while the supine posture had the greatest HR at the 5th and 10th minutes. While the groups’ SpO2 values were similar, the left-side group’s perfusion rates increased at the 5th and 10th minute marks (5th and 10th min PIleft-side, p=0.67, p=0.21, respectively). Regional cerebral oxygen saturation (rScO2) and cerebral fractional oxygen extraction did not differ significantly between groups at the 5th and 10th minute time intervals. Although right and left rScO2 were found to be higher in the first 5 minutes in the prone position, this elevation did not lead to a statistically significant difference, and right and left rScO2 values were found to be similar in all groups at the 10th minute. Conclusion: Adaptation parameters were not affected by position, except for lower 1st minute Apgar scores in the prone group and higher perfusion indices in the left lateral position. Cerebral perfusion was similar in all groups. The left-side position, which results in a higher PI, may be a good alternative. Studies with larger case series may provide further information.

INTRODUCTION: Prophylactic caffeine therapy, reduces the frequency of apnea in premature babies. Moreover, its effect has been well established in reducing the intermittent hypoxemia, and the need for additional ventilator support of infants with a birthweight of 1.250 g and respiratory distress. METHODS: Sixty-eight infants with birthweight of 1.250 to 2.000 g with respiratory distress and born at 32-34 GA and intubated with the indication of respiratory distress who also needed nasal ventilation for at least 48 hours were included in this prospective randomized controlled study, starting from birth one group received prophylactic caffeine citrate at loading dose of 20 mg/kg, and maintenance dose of 5 mg/kg in addition to respiratory support, long term neurological and developmental outcomes were recorded with Bayley-II. RESULTS: There was no difference in weight or gestational age at birth between the groups. Also, the groups were smilar in respiratory states. The caffeine group, was associated with a significant reduction in intubation requirement within the first 72 hr and shorter duration of mechanical and nasal ventilation, while there was no difference between the groups in total duration of oxygen therapy, and frequency of apneic episodes (respectively p=0.03, p=0.00, p=0.02, p>0.05). Any differences were not detected in terms of prematurity morbidities (p>0.05). Any significant intergroup differences were not detected as for PDA, NEC, IVC, laser-requiring ROP, and BPD (p>0.05). While the study was continuing regarding long-term neurodevelopmental outcomes Bayley neurodevelopmental tests were applied to 15 infants in the caffeine and 18 infants in the caffeine group at 12. and 18. months, and test results were csimilar in both groups (p>0.05). DISCUSSION AND CONCLUSION: The prophylactic use of caffeine in older preterm babies with respiratory distress, have short term benefits as lesser requirement for ntubation within the first 72 hours and decreased duration of ventilatory support without any advers side effects. Therefore if symptoms of respiratory distress are seen in preterm babies with a birthweight of >1.250 g, then initiation of prophylactic treatment may be considered. Larger scale randomized kontrollü studies are needed regarding this issue.

Aim:Neonatal bilirubin-induced neurologic dysfunction can present with a wide spectrum of symptoms from mild neurologic impairment to severe acute bilirubin encephalopathy. In this study, we aimed to determine the risk factors of unconjugated hyperbilirubinemia among hospitalized infants with serum total bilirubin levels ≥25 mg/dL and evaluate the effects of high serum bilirubin levels due to hemolysis on neurodevelopmental outcome at postnatal between 18 and 24 months.Materials and Methods:Thirty-six term infants were enrolled in the study. The patients were divided into two groups according to their condition of either hemolytic or nonhemolytic hyperbilirubinemia. Neurodevelopmental assessment with The Bayley scale of Infant Development-II at postnatal between 18 and 24 months was performed on all infants.Results:Fourteen infants (38.9%) were in the nonhemolytic group, while 22 (61.1%) were in the hemolytic group and there was no statistically significant difference between the groups in terms of the measured mean Mental Developmental index and Psychomotor Developmental index scores. All 4 patients who underwent exchange transfusion had subgroup incompatibility and their Psychomotor Developmental index scores were significantly lower (p

Introduction: Although drug poisoning rarely occurs during the neonatal period,morbidity and mortality are high when it occurs.Two cases who were admitted to the Emergency Department of our hospital due to digoxin and phenobarbital poisoning with a two-month interval were presented to draw attention to drug poisoning during neonatal period. Case1: A 3335gr girl was admitted to the Newborn Intensive Care Unit on the postnatal day 6 due to atrioventricular block and hyperpotasemia because of the administration of 1 teaspoon of digoxin by the family 72 hours after the diagnosis of ventricular septal defect.The patient was closely monitored by administering digoxin immun Fab once.On the 13th postnatal day,she was discharged with full recovery. Case2: A 3170gr girl was admitted to the emergency department due to respiratory depression and lethargy after 5mg/kg/day phenobarbital treatment was started at the external center with the diagnosis of prolonged jaundice on postnatal day 12 following an administration of 29mg/kg /day with wrong preparation of pharmacy.She was admitted to the Newborn Intensive Care Unit.The patient's phenobarbital blood level was 94.5μg /ml(N: 10-40μg /ml).Phenobarbital treatment was discontinued and the patient was monitored with nasal ventilation support for 3 days and discharged with full recovery on the 9th day of the follow-up. Discussion: Unnecessary drug initiation should be avoided in newborns,and the use of drugs whose therapeutic range is very narrow such as digoxin should be limited,except for congestive heart disease.Alternative treatments and drugs used by your mother and baby should be questioned comprehensively in every newborn case who applies with ambiguous complaints.

INTRODUCTION: The deficiency or absence of an enzyme or cofactor in the metabolic pathway leads to the formation or accumulation of a specific metabolite resulting in inborn errors of metabolism (IEM).The neonate who is, usually, born healthy at birth, will present symptoms such as a reduced activity, nutritional disorders, difficulty in breathing, changes in consciousness, or seizures within hours or days after birth.Since these symptoms are not specific to IEM, a high degree of clinical suspicion is essential in diagnosing and treating the disease and to prevent complications and death.The aim of this study was to evaluate the clinical and biochemical characteristics of neonates diagnosed with IEM. METHODS: Neonates who presented to the Neonatal Intensive Care Unit of X Hospital between 01.02.2015 and 01.02.2018 were included.Demographic and clinical features and laboratory findings of the neonates were retrieved from patients' records. RESULTS: Thirty-three patients with IEM were enrolled into the study.The median birth weight was 3000(interquartile range: 2865-3300) gr, the median gestational week was 39(interquartile range: 38 to 40). The most common presenting complaints were nutritional disorders and tachypnea with a rate of 45.5% which were followed by transaminase elevation(36.4%), hyperammonemia(36.4%), metabolic acidosis(33.3%) and hypoglycemia(27.3%).The most common diagnoses were galactosemia(21.2%), Zellweger syndrome(9.1%) and non-ketotic hyperglycinemia(9.1%).Overall, 64.7% of the patients were discharged with corrected laboratory values. DISCUSSION AND CONCLUSION: Nonspecific symptoms such as nutritional disorders, tachypnea, and jaundice, or nonspecific laboratory abnormalities such as metabolic acidosis or transaminase elevation should alert the physician for IEMs, particularly in countries where the prevalence of consanguineous marriages is high, such as Turkey.

Hemolysis and jaundice related to Rh incompatibility in the neonatal period has decreased substantially due to the widespread use of anti-D gammaglobulin in recent years. Nevertheless, the rate of subgroup mismatch in the etiology of hemolytic diseases of the newborn has increased significantly. In this article an 8-day-old newborn infant with “c” subgroup incompatibility and presenting with severe anemia, in whom hemolysis could be controlled with intravenous immunoglobulin infusion and subgroup appropriate blood transfusion, has been presented. Scientific studies have demonstrated that the hemolytic disease of patients who don’t have major blood group incompatibility but carry anti-C antibodies can be rather serious. Therefore, subgroup mismatch should always be kept in mind for newborns presenting with severe hemolytic anemia, and transfusion or if necessary exchange transfusion should be provided with subgroup matched blood products.

Background: Glucose transporter type 1 deficiency syndrome is the result of impaired glucose transport into the brain. Patients with glucose transporter type 1 syndrome may present with infantile seizures, developmental delay, acquired microcephaly, spasticity and ataxia. Case Report: Here, we report a rare case of glucose transporter type 1 deficiency syndrome caused by a different pathogenic variant in a 10-day-old neonate who presented with intractable seizures and respiratory arrest. Conclusion: This new pathogenic variant can be seen in glucose transporter type 1 deficiency syndrome

Abstract Background The effect of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) virus in the neonatal period on developing brain is still unknown. This study aims to investigate the long-term neurodevelopmental outcomes of newborns exposed to SARS-CoV-2 & Delta variant. Methods At a tertiary referral center, a prospective observational cohort research was carried out. All babies who were equal to or more than 34 gestational weeks gestation and were admitted to the NICU between January 2021 and January 2022 due to SARS-CoV-2 infection (Delta - or Delta +) were included in the study. Infants who were hospitalized for non-SARS-CoV-2 reasons at similar dates and who had no history of invasive mechanical ventilation were incorporated as a control group using a 2:1 gender and gestational age match. Thirty infants were assigned to the study group and sixty newborns to the control group based on the sample size calculation. These toddlers’ neurodevelopment was evaluated between the ages of 18 and 24 months using the Bayley-II scale. Results We enrolled 90 infants. SARS-CoV-2-positive infants had poorer psychomotor development index (PDI) scores and significantly greater mildly delayed performances (MDPs) at 18–24 months (PDI p = 0.05, MDPs p = 0.03, respectively). Delta variant showed statistically significant lower MDI and PDI scores (MDI p=0.03, PDI p=0.03, respectively). A smaller head circumference of SARS-CoV-2-positive toddlers was detected in the first year (p

(1) Background: This study aimed to determine whether standard-dose vitamin D supplementation could provide adequate levels in exclusively breastfed infants born with different cord 25(OH)D levels and to evaluate related neonatal morbidities. (2) Methods: A prospective cross-sectional study was designed in term infants. Three groups were formed based on cord 25(OH)D levels; Group1 Deficiency:25(OH)D < 12 ng/mL, Group2 Insufficiency:25(OH)D = 12–19 ng/mL, and Group3 Optimum:25(OH)D = 20–100 ng/mL. Cord and 1st month 25(OH)D levels, after receiving standard-dose vitamin D prophylaxis, neonatal outcomes and anthropometric measurements were compared. (3) Results: The study involved 86 infants. Group1 Deficiency had also significantly lower 25(OH)D levels at 1st month compared to the others (p < 0.001). There was a significant positive correlation between cord and 1st month 25(OH)D levels (r = 0.78, p < 0.001). Despite the fact that the mother’s age and clothing style were similar, Group1 Deficiency mothers had higher parity numbers and used less vitamin D during pregnancy (p = 0.03, p = 0.04). Neonatal outcomes analysis revealed that newborns in Group1 Deficiency experienced more respiratory distress, transient tachypnea, and early-onset sepsis, as well as more and longer hospital stays in the first-month of life (p < 0.05). (4) Conclusions: Infants with low cord 25(OH)D levels had also lower 25(OH)D values in the 1st month of life and experienced higher rates of neonatal morbidities. Given its numerous biological activities and impact on neonatal morbidities, determining an individualized dose of vitamin D supplementation may be more accurate than using the standard approach.

Objective: Today, the survival rate of low-birth-weight infants has increased thanks to supportive care. However, various permanent health problems, especially neurodevelopmental retardation, can be seen in these infants. This study investigates the risk factors associated with neurodevelopmental retardation, especially hypocarbia, in this patient group. Methods: All patients who were hospitalized in our neonatal ıntensive care unit between January 1 and December 31, 2016, with a gestational age of less than 32 weeks, without congenital anomalies, and who came for regular follow-up were included in this study. Demographic, clinical and laboratory data were obtained retrospectively from file records. The neurodevelopment of the patients was evaluated between 18 and 24 months with the Bayley Scales of Infants and Toddler Development, Second Edition (Bayley-II).The demographic, clinical and laboratory parameters of the patients with and without neurodevelopmental retardation were compared. Results: Neurodevelopmental retardation was observed in 9 (16.1%) of the 56 patients included in the study. No neurodevelopmental retardation was detected due to cerebral palsy, hearing impairment or visual impairment. When the patient groups with and without neurodevelopmental retardation were compared in terms of demographic, clinical and laboratory parameters, birth weight and first and fifth-minute Apgar scores were lower in patients with neurodevelopmental retardation, while mechanical ventilation requirement, reintubation, convulsion, patent ductus arteriosus treatment, hypotension, bronchopulmonary dysplasia, asphyxia, hyperglycemia and hypocarbia rate were higher (p