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    Early neonatal outcomes of very-low-birthweight infants in Turkey: A prospective multicenter study of the Turkish Neonatal Society
    (Public Library of Science, 2019) Koc E.; Demirel N.; Bas A.Y.; Isik D.U.; Hirfanoglu I.M.; Tunc T.; Cetinkaya M.
    Objective To investigate the early neonatal outcomes of very-low-birth-weight (VLBW) infants discharged home from neonatal intensive care units (NICUs) in Turkey. Material and methods A prospective cohort study was performed between April 1, 2016 and April 30, 2017. The study included VLBW infants admitted to level III NICUs. Perinatal and neonatal data of all infants born with a birth weight of ?1500 g were collected for infants who survived. Results Data from 69 NICUs were obtained. The mean birth weight and gestational age were 1137 ±245 g and 29±2.4 weeks, respectively. During the study period, 78% of VLBW infants survived to discharge and 48% of survived infants had no major neonatal morbidity. VLBW infants who survived were evaluated in terms of major morbidities: Bronchopulmonarydysplasia was detected in 23.7% of infants, necrotizing enterocolitis in 9.1%, blood culture proven late-onset sepsis (LOS) in 21.1%, blood culture negative LOS in 21.3%, severe intraventricular hemorrhage in 5.4% and severe retinopathy of prematurity in 11.1%. Hemodynamically significant patent ductus arteriosus was diagnosed in 24.8% of infants. Antenatal steroids were administered to 42.9% of mothers. Conclusion The present investigation is the first multicenter study to include epidemiological information on VLBW infants in Turkey. Morbidity rate in VLBW infants is a serious concern and higher than those in developed countries. Implementation of oxygen therapy with appropriate monitoring, better antenatal and neonatal care and control of sepsis may reduce the prevalence of neonatal morbidities. Therefore, monitoring standards of neonatal care and implementing quality improvement projects across the country are essential for improving neonatal outcomes in Turkish NICUs. © 2019 Koc et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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    Incidence and severity of retinopathy of prematurity in Turkey
    (BMJ Publishing Group, 2015) Bas A.Y.; Koc E.; Dilmen U.; Oguz S.S.; Ovali F.; Demirel N.; Zenciroglu A.; Tekin N.; Caner I.; Arslanoglu S.; Celik Y.; Öztürk A.; Cömert S.; Bulbul A.; Kultursay N.; Koklu E.; Duman N.; Koksal N.; Salihoglu O.; Coban A.; Demirel G.; Bolat F.; Gökalp A.; Satar M.; Ipek M.S.; Bas E.K.; Narli N.; Mutlu M.; Cetinkaya M.; Akman I.; Yigit S.; Narter F.; Sivasli E.; Ahrabi A.F.; Atalay Y.; Tanyeri B.; Arsan S.; Perk Y.; Ors R.; Tuncer O.; Ecevit A.; Oygur N.; Ozdemir O.M.; Hakan N.; Aliefendioglu D.; Acunas B.; Cetin H.; Ozek E.; Tunc T.; Turkmen M.; Aydemir C.; Takci S.
    Background: The purpose of this study was to estimate the current incidence of retinopathy of prematurity (ROP) and the need for treatment in preterm infants in Turkey. Methods: The study included preterm infants who had been screened for ROP between 2011 and 2013 in 49 neonatal intensive care units. Infants with birth weight (BW) ?1500 g or ?32 weeks' gestational age and those with BW >1500 g or >32 weeks' GA with an unstable clinical course were included. The incidence of any ROP or severe ROP and treatment modalities were determined. Results: The study population included 15 745 preterm infants: 11 803 (75%) with GA ?32 weeks, and 3942 (25%) with GA >32 weeks. Overall, 30% were found to have any stage of ROP, and 5% had severe ROP. Severe ROP was diagnosed in 8.2% of infants with BW ?1500 g and 0.6% of infants with BW >1500 g. Of all infants diagnosed with ROP, 16.5% needed laser photocoagulation, and 20 patients born at >32 weeks' GA required this treatment modality. Vitroretinal surgery was performed in 28 infants with severe ROP: 23 with GA ?28 weeks and 5 with GA 29-32 weeks. Conclusions: The findings of our study have the important implication that more mature babies are at risk of severe ROP requiring treatment. An effective programme for detecting and treating ROP should be established in Turkey.