Background/Objectives: There are other benefits of vitamin D than those for bone health. To determine the association of serum 25-hydroxy vitamin D (25(OH)D) concentrations in newborns with acute lower respiratory infection (ALRI) and without clinical signs of rickets, and their mothers. The design comprises a hospital-based case-control study. Subjects/Methods: The study group consisted of 25 newborns with ALRI who were admitted to neonatal intensive care unit and their mothers. Controls were 15 healthy newborns of the same age as the study group and their mothers. A commercial radioimmunoassay was used to measure 25(OH)D concentrations in serum for assessing vitamin D status. Results: The two groups were similar in gestational week, birth weight, birth height, head circumference, age and gender. The mean serum 25(OH)D concentrations in the study group newborns were lower than those of the control group (9.12±8.88 ng/ml and 16.33 ± 13.42 ng/ml, respectively) (P ¼ 0.011). Also, mean serum 25(OH)D concentrations in the mothers of the study group were lower than those in the mothers of the control group (13.38±16.81 ng/ml and 22.79±16.93 ng/ml respectively) (P ¼ 0.012). In 87.5% of all newborns and 67.5% of all mothers, serum 25(OH)D concentrations were lower than 20 ng/ml. The 25(OH)D concentrations of newborns were highly correlated with mothers' serum 25(OH)D concentrations. Conclusions: Our findings suggest that newborns with subclinical vitamin D deficiency may have an increased risk of suffering from ALRI. The strong positive correlation between newborns' and mothers' 25(OH)D concentrations shows that adequate vitamin D supplementation of mothers should be emphasized during pregnancy especially in winter months.
Approved by the following research ethics committee: Zeynep Kamil Maternity and Children's Disease Training and Research Hospital.
ABSTRACTPurpose: To evaluate 2-year outcomes following intravitreal bevacizumab (IVB) as monotherapy for aggressive posterior retinopathy of prematurity (APROP). Methods: Medical records of 40 infants were retrospectively reviewed. Group I included infants who had received IVB injections for APROP. Group II included infants who underwent laser treatment for APROP. Anatomic and refractive outcomes and the presence of anisometropia and strabismus were assessed at follow-up examinations. Results: Group I included 48 eyes of 25 infants (11 males) with a mean gestational age (GA) of 26.40 ± 1.82 weeks and a mean birth weight (BW) of 901.40 ± 304.60 g. Group II included 30 eyes of 15 infants (6 males) with a mean GA of 27.30 ± 1.82 weeks and a mean BW of 941.00 ± 282.48 g. GA, BW, and gender distributions were similar between groups (P=0.187, P=0.685, and P=1.000, respectively). Refractive errors were significantly less myopic in group I (0.42 ± 3.42 D) than in group II (-6.66 ± 4.96 D) at 2 years (P=0.001). Significantly higher rates of anisometropia and strabismus were observed in group II than in group I (P=0.009 and P=0.036, respectively).
Conclusions:The study demonstrated that IVB monotherapy can be useful in the treatment of APROP. The decreased incidence of early unfavorable refractive and functional outcomes in the IVB group compared with the laser group showed a potential benefit for patients treated with IVB, and this needs to be better evaluated in future prospective studies.
Presepsin can be used as a reliable biomarker for LOS and treatment response in preterm infants. However, we could not demonstrate the efficacy of presepsin for the detection of disease severity or prognosis.
Objective This study aimed to determine the accuracy of neonatal lung ultrasound (LUS) in predicting the need for surfactant therapy compared with chest X-ray (CXR) in preterm infants.
Study Design A prospective double-blind study was conducted in infants with a gestational age <34 weeks with respiratory distress syndrome (RDS) by evaluation with LUS and CXR on admission.
Results Among 45 preterm infants, the median (interquartile range [IQR]) LUS score was 4 (2–8) in the mild RDS group, whereas it was 10 (IQR: 9–12) in the severe RDS group (p < 0.01). The LUS score showed a significant correlation with the need for total surfactant doses (ρ = 0.855; 95% confidence interval [CI]: 0.801–0.902; p < 0.001). A cut-off LUS score of four predicted the need for surfactant with 96% sensitivity and 100% specificity (area under the curve [AUC]: 1.00; 95% CI: 0.97–1.00; p < 0.01). LUS scores predicted continuous positive airway pressure (CPAP) failure accurately (AUC: 0.804; 95% CI: 0.673–0.935; p = 0.001). A significant correlation was observed between LUS scores and positive end-expiratory pressure levels (ρ = 0.782; p < 0.001). During the study period, the CXR number per infant with RDS decreased significantly when compared with preceding months (p < 0.001). The LUS score in the first day of life did not predict the development of bronchopulmonary dysplasia (AUC: 0.274; 95% CI: 0.053–0.495; p = 0.065).
Conclusion The LUS score in preterm infants accurately predicts the severity of RDS, the need for surfactant and CPAP failure. The routine use of LUS can decrease the frequency of CXRs in the neonatal intensive care units.
Key Points
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