Yenidoğan yoğun bakım ünitesinde izlenen geç preterm bebeklerin maternal risk faktörlerine bağlı morbiditelerinin değerlendirilmesi

Abstract

Amaç: Bu çalışmada, geç preterm bebeklerde maternal risk faktörleri ve bu faktörlerin morbidite ve mortaliteye etkisinin belirlenmesi amaçlandı. Gereç ve Yöntemler: Bu çalışmaya, retrospektif olarak, 1 Ocak 2012 ile 30 Haziran 2015 tarihleri arasında Başkent Üniversitesi Tıp Fakültesi Hastanesi’nde doğan ve Yenidoğan Yoğun Bakım Ünitesi’ne yatırılan gebelik haftası 340/7-366/7 olan 242 geç preterm bebek alındı. Çoklu konjenital anomalisi, kromozom anomalisi olan ve dış merkezde doğup hastanemize yatırılan bebekler çalışma dışı bırakıldı. Her bebeğin doğum bilgileri ve maternal risk faktörleri hastanemiz veri tabanı kullanılarak neonatal veri toplama formlarına kaydedildi. Bulgular ve Sonuç: Tüm gebelik haftalarında en sık görülen morbiditeler; beslenme intoleransı (% 70.2), hiperbilirübinemi (% 43.0), yenidoğanın geçici takipnesi (% 40.0), hipoglisemi (% 16.9), respiratuvar distres sendromu (% 15.7) ve geç neonatal sepsis (% 13.7) olarak saptandı. Ablasyo plasentalı annelerin bebeklerinde respiratuvar distres sendromu (p=0.045), oligohidramniyozlu annelerin bebeklerinde yenidoğanın geçici takipnesi (p=0.04), gestasyonel diyabetes mellitusu olan annelerin bebeklerinde polisitemi (p=0.01) ve plasenta previası olan annelerin bebeklerinde hipoglisemi (p=0.04) anlamlı olarak fazla saptandı. Çalışmamızda 34.gestasyon haftasında doğan bebeklerde, geç preterm grubunun diğer gebelik haftalarına göre daha çok morbidite saptandı (p=0.01). Özellikle respiratuvar distres sendromu ve beslenme intoleransı 34.gestasyon haftasında doğan bebeklerde diğer gebelik haftasında doğan bebeklere göre istatistiksel olarak anlamlı şekilde daha fazla görüldü (p=0.002). Annede preeklampsi, plasenta previa, ablasyo plasenta, oligohidramniyoz ve gestasyonel diyabetes mellitus olmasının morbiditeyi artırdığı belirlendi. Geç preterm bebeklerde mortalite ve morbiditeyi etkileyen maternal risk faktörlerinin bilinmesi ortaya çıkabilecek problemlerin erken belirlenmesi ve önlenmesini sağlayacaktır.

Keywords

• geç preterm
• morbidite
• maternal hastalıklar

Evaluation of the morbidity of late preterm infants followed in the neonatal intensive care unit due to maternal risk factor

Abstract

Objective:.The aim of this study was to determine maternal risk factors and the effect of these factors on morbidity and mortalityin late preterm infants. Materials and method: In this retrospective study, the 242 late preterm babies who were born between 34 0/7 - 36 6/7weeks of gestation, between January 1, 2012 and June 30, 2015 at Başkent University Faculty of Medicine Hospital and hospitalized in the neonatal intensive care unit were included. Babies born at the outside center and hospitalized to our hospital with multiple congenital anomalies, chromosomal abnormalities were excluded from the study. Birth data and maternal risk factors for each neonate were recorded in neonatal data collection forms using the database of our hospital. Results and conclusion: The most common morbidity were identified as feding intolerance (70.2 %), hyperbilirubinemia (43.0 %), transient tachypnea of the newborn (40.0 %), hypoglycemia (16.9 %), respiratory distress syndrome (15.7 %) and late neonatal sepsis (13.7 %). Respiratory distress syndrome in infants of mothers with ablation placenta (p=0.045), transient tachypnea of the newborn in infants of mothers with oligohydramniosis (p=0.04), hypoglycemia in infants of mothers with gestational diabetes mellitus (p=0.01) and hypoglycemia in mothers with placenta previa (p=0.04) were seen significantly higher. In our study, morbidity was found in infants born at 34 weeks of gestation compared to other gestational weeks of late preterm group (p=0.01). Especially respiratory distress syndrome and feeding intolerance were statistically significantly higher in babies born at the 34 gestational week compared to babies born at the other week of gestation (p=0.002). It was determined that preeclampsia, placenta previa, ablation placenta, oligohydramniosis and gestational diabetes mellitus in mother increased to morbidity. Knowing the maternal risk factors affecting mortality and morbidity in late preterm infants will enable early detection and prevention of possible problems

Keywords

• late preterm
• morbidity
• maternal diseases

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