Anemi ile doğan prematüre bebeklerdeki mortalite ve morbiditelerin değerlendirilmesi

Yıl 2024, , 12 - 15, 30.04.2024

Cüneyt Tayman , Ufuk Çakır

https://doi.org/10.20492/aeahtd.1366267

Öz

AMAÇ: Prematüre bebeklerde anemi ile doğmak ciddi klinik sorunlara yol açabilir. Ancak özellikle ülkemizde bu konu üzerine yapılmış yeterince çalışma mevcut değildir. Çalışmamızda doğum sonrası anemi tespit edilen çok düşük doğum ağırlıklı (ÇDDA; <1500 g) prematüre bebeklerde klinik sonuçların değerlendirilmesi amaçlanmıştır.
GEREÇ VE YÖNTEM: Çalışmamızda ünitemizde <1500 g doğan prematüre bebekler dahil edildi ve veriler retrospektif olarak kayıt edildi. Umbilikal kordondan bakılan hemoglobin (Hb) düzeyi <13 g/dL olanlar anemi grubuna ve HB düzeyi ≥13 g/dL olanlar anemi olmayan gruba dahil edildi. Anemi olan ve olmayan hastalar demografik ve klinik özellikleri açısından karşılaştırıldı.
BULGULAR: Umbilikal kord Hb düzeyine göre 22 preterm bebek anemi, 162 preterm bebek anemi olmayan gruba dahil edilerek toplam 184 bebek çalışmaya alındı. Sonuçlarımızda ÇDDA bebeklerde doğumda anemi sıklığı %11,95 (22/184) olarak bulundu. Anemi olan grupta ilk eritrosit transfüzyon zamanı (12,91±5,22 gün) anemi olmayan gruba göre (17,68±9,34 gün) anlamlı olarak daha kısa bulundu (p=0,032). Anemi olan grupta ciddi İVK (%13,63) ile NEK oranları (%18,18) anemi olmayan gruba göre (sırasıyla, %4,32 ile %2,46) istatistiksel olarak anlamlı yüksek bulundu (sırasıyla, p=0,045, p=0,033)
SONUÇ: Doğumda anemi açısından özellikle riskli olan preterm bebeklerin doğumda anemik olması durumunda bazı morbiditelerin artacağı unutulmamalıdır.

Anahtar Kelimeler

Anemi, morbidite, mortalite, prematüre

Etik Beyan

Bu çalışma için Zekai Tahir Burak Kadın Sağlığı Eğitim ve Araştırma Hastanesi Klinik Araştırmalar Etik Kurulu'ndan 19.03.2019 tarih ve 33/2019 sayılı kararla etik onay alındı.

Destekleyen Kurum

Yok

Proje Numarası

Yok

Teşekkür

Yok

Evaluation of morbidity and mortality in preterm newborns with anemia

Öz

AIM: Anemia may cause negative clinical results to preterm newborns. But there are no enough studies to evaluate this problem. In this study, we aimed to evaluate the clinical results of very low birth weight (VLBW: <1500 g) preterm newborns with anemia.
MATERIAL AND METHODS: In our study, preterm infants with <1500 g in our unit were included and the data were recorded retrospectively. Preterms who had cord hemoglobin (Hb) of <13 g/dL were enrolled into anemia group and preterms who had Hb of ≥13 g/dL were enrolled into the control group. Patients with and without anemia were compared in terms of demographic and clinical characteristics.
RESULTS: According to umbilical cord Hb level, 22 preterm infants were included in the anemia group and 162 preterm infants were included in the group without anemia. A total of 184 infants were included in the study. In our results, the incidence of anemia at birth in VLBW infants were 11.95% (22/184). The first erythrocyte transfusion time (12.91±5.22 days) in the anemia group was significantly shorter than the group without anemia (17.68±9.34 days) (p=0.032). Severe intracranial hemorrhage (13.63%) and necrotizing enterocolitis (18.18%) among anemia group were found to be significantly higher than without anemia group (4.32%, 2.46%, respectively) (p=0.045, p=0.033, respectively).
CONCLUSION: It should not be forgotten that some morbidities will increase if preterm infants, who are especially at risk for anemia at birth.

Anahtar Kelimeler

Anemia, morbidity, mortality, premature

Etik Beyan

For this study, ethical approval was obtained from the Clinical Research Ethics Committee of Zekai Tahir Burak Women’s Health Training and Research Hospital with a decision dated 19.03.2019 and numbered 33/2019.

Destekleyen Kurum

None

Proje Numarası

Yok

Teşekkür

None

Kaynakça

• 1. Tiruneh T, Shiferaw E, Enawgaw B. Prevalence and associated factors of anemia among full-term newborn babies at University of Gondar comprehensive specialized hospital, Northwest Ethiopia: a cross-sectional study. Ital J Pediatr. 2020;46(1):1.
• 2. Zhang Y, Jin L, Liu JM, Ye R, Ren A. Maternal hemoglobin concentration during gestation and risk of anemia in ınfancy: Secondary analysis of a randomized controlled trial. J Pediatr. 2016;175(8):106- 110.e2.
• 3. Çetinkaya M, Atasay B, Perk Y. Turkish Neonatal Society guideline on the transfusion principles in newborns. Turk Pediatri Ars. 2018;53(Suppl 1):S101-S108.
• 4. Whyte R, Kirpalani H. Low versus high haemoglobin concentration threshold for blood transfusion for preventing morbidity and mortality in very low birth weight infants. Cochrane Database Syst Rev. 2011;(11):CD000512.
• 5. Alan S, Arsan S, Okulu E, et al. Effects of umbilical cord milking on the need for packed red blood cell transfusions and early neonatal hemodynamic adaptation in preterm infants born ≤1500 g: a prospective, randomized, controlled trial. J Pediatr Hematol Oncol. 2014;36(8):e493-8.
• 6. Banerjee J, Asamoah FK, Singhvi D, Kwan AW, Morris JK, Aladangady N. Haemoglobin level at birth is associated with short term outcomes and mortality in preterm infants. BMC Med. 2015;13(1):16.
• 7. Fenton TR. A new growth chart for preterm babies: Babson and Benda’s chart updated with recent data and a new format. BMC Pediatr. 2003;3(12):13.
• 8. Özkan H, Erdeve Ö, Kutman HGK. Turkish Neonatal Society guideline on the management of respiratory distress syndrome and surfactant treatment. Turk Pediatri Ars. 2018;53(Suppl 1):S45-S54.
• 9. Cakir U, Tayman C. A mystery of patent ductus arteriosus and serum osmolality in preterm infants. Am J Perinatol. 2019;36(6):641- 646.
• 10. Volpe JJ. Impaired neurodevelopmental outcome after mild germinal matrix-intraventricular hemorrhage. Pediatrics. 2015;136(6):1185-1187.
• 11. Chiang MF, Quinn GE, Fielder AR, et al. International classification of retinopathy of prematurity, third edition. Ophthalmology. 2021;128(10):e51-e68.
• 12. Cakir U, Tayman C, Yarci E, et al. Novel useful markers for follow- up of necrotizing enterocolitis: endocan and interleukin-33. J Matern Fetal Neonatal Med. 2020;33(14):2333-2341.
• 13. Hosono S, Mugishima H, Kitamura T, et al. Effect of hemoglobin on transfusion and neonatal adaptation in extremely low-birthweight infants. Pediatr Int. 2008;50(3):306-311.
• 14. Rocha G, Pereira S, Antunes-Sarmento J, Flôr-de-Lima F, Soares H, Guimarães H. Early anemia and neonatal morbidity in extremely low birth-weight preterm infants. J Matern Fetal Neonatal Med. 2021;34(22):3697-3703.
• 15. Meng Q. Effect of anemia on mortality in very low birth weight premature infants. Chin J Pract Nurs 2020;(36):1732-1735.
• 16. Tayman C, Tonbul A, Uras N, Kahveci H, Köseoglu B, Tatlı MM. Preterm bebeklerde nekrotizan enterokolit için risk faktörlerinin değerlendirilmesi. J Curr Pediatr. 2011;9(2):7-13.
• 17. Ergenekon E, Tayman C, Özkan H. Turkish neonatal society necrotizing enterocolitis diagnosis, treatment, and prevention guidelines. Turk Arch Pediatr. 2021;56:513-524