PREMATÜRE KIRIKLARI VE İLİŞKİLİ FAKTÖRLERİN İNCELENMESİ: BİR VAKA-KONTROL ÇALIŞMASI

Year 2025, Volume: 26 Issue: 4, 317 - 325, 13.10.2025

Sinem Yalnızoğlu Çaka , Sümeyra Topal , Selin Aytemiz , Sadık Yurttutan

https://doi.org/10.18229/kocatepetip.1600431

Abstract

AMAÇ: Preterm yenidoğanların doğumda ve doğumdan sonra yaşadıkları süreçler iskelet büyümesini ve kemik mineralizasyonunu etkileyebilir. Bu çalışmada Yenidoğan Yoğun Bakım Ünitesi'ne kabul edilen prematüre bebeklerde meydana gelen kırıkların değerlendirilmesi ve bazı özelliklerle ilişkisinin araştırılması amaçlanmıştır.
GEREÇ VE YÖNTEM: Bu retrospektif çalışma, 2012 - 2022 yılları arasında Yenidoğan Yoğun Bakım Ünitesine kabul edilen ≤ 36+6 gebelik haftasında doğan pretermlerde gerçekleştirilen bir vaka-kontrol çalışmasıdır. Örneklem 78 preterm doğumdan (39 vaka ve 39 kontrol) oluşmaktadır. Doğum kayıtları ve kırıkla ilişkili olabilecek doğum sonrası taburculuk sürecine kadar olan klinik takipleri (laboratuvar sonuçları, konjenital hastalıklar, parenteral beslenme, solunum desteği vb.) analiz edildi.
BULGULAR: Çalışma sonucunda prematürelerde kırık prevalansı %0,94 olarak saptanmıştır. Katılımcıların %26,9’unun (n=21) kırık bölgesi humerus ve kırık gerçekleşme zamanı ortalaması 21,18±23,68 gündür. Bu çalışmada vaka grubundaki pretermlerin kontrol grubuna kıyasla APGAR skorlarının daha düşük, total parenteral beslenme, mekanik ventilasyon ve yatış sürelerinin daha uzun ve aradaki farkın istatistiksel olarak anlamlı olduğu bulunmuştur (p<0,05). Ayrıca pretermlerin bazı laboratuvar sonuç (Fosfor, Parathormon vb) düzeyleri gruplar arasında anlamlı farklılıklar göstermektedir (p<0,05).
SONUÇ: Kırık açısından risk faktörlerinin belirlenmesi ve fark edilmesi, devamında ise uygun tedavi ve bakımın sağlanması prematüre bebeklerde kırık oranlarını azaltacaktır.

Keywords

Kemik hastalıkları , kırık , hemşirelik bakımı , prematüre

Project Number

Yoktur

FRACTURES OF PREMATURITY AND ASSOCIATED FACTORS: A CASE-CONTROL STUDY

Abstract

OBJECTIVE: The processes experienced by preterm neonates at birth and after birth may affect skeletal growth and bone mineralization. This study aims to evaluate the fractures occurring in premature infants admitted to the Neonatal Intensive Care Unit and to investigate the relationship with some characteristics.
MATERIAL AND METHODS: This retrospective study is a case-control study conducted in preterms born at ≤ 36+6 weeks gestational age admitted to the Neonatal Intensive Care Unit between 2012 and 2022. The sample comprised 78 preterm births (39 cases and 39 controls). Birth records and clinical follow-ups (laboratory results, congenital diseases, parenteral nutrition, respiratory support, etc.) until the postnatal discharge process that may be related to fracture were analyzed.
RESULTS: The prevalence of fractures in premature infants was found to be 0.94%. The fracture site of 26.9% (n=21) of the participants was the humerus and the mean time to fracture was 21.18±23.68 days. It was found that preterms in the case group had lower APGAR scores and longer total parenteral nutrition, mechanical ventilation and hospitalization times compared to the control group and the difference was statistically significant (p<0.05). In addition, some laboratory results (Phosphorus, Parathormone, etc.) levels of preterms showed significant differences between the groups (p<0.05). Genetic congenital anomaly, cholestasis and sepsis increased the case status 32.764, 21.782 and 0.051 times, respectively (p<0.05). It appears that the incidence of fractures in premature infants who are breastfed is 0.108 times less than in those who are not breastfed. Total parenteral nutrition duration variable decreases the effect of the presence of breast milk.
CONCLUSIONS: Identifying and recognizing the risk factors for fractures and providing appropriate treatment and care will reduce fracture rates in premature infants.

Keywords

Bone diseases , fracture , nursing care , premature.

Project Number

Yoktur

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