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Objective:To determine exposure to endocrine-disrupting phthalates in preterm infants in neonatal intensive care units (NICU).Methods:Urine samples (n=151) from 36 preterm infants (<32 weeks of gestation and/or <1500 g of birth weight) were collected on the first 3 days of admission to the NICU and biweekly thereafter. Diethylhexyl phthalate contents of indwelling medical devices used in various procedures and the concentrations of phthalate metabolites in the urine samples were analyzed. The relationships between urinary excretion, exposure intensity, postnatal age and birth weight were examined.Results:The mean gestational age and mean birth weight of the study infants were 28.9±1.5 weeks and 1024±262 g, respectively. Diethylhexyl phthalate was detected in umbilical catheters, endotracheal tubes, nasogastric tubes, and nasal cannula. Monoethylhydroxyhexyl phthalate (MEHHP) was the most frequently detected metabolite (81.4%); its concentration increased during the first 4 weeks and then started to decrease but never disappeared. Patients who did not need indwelling catheters (except nasogastric tubes) after 2 weeks were classified as group 1 and those who continued to have indwelling catheters as group 2. Although not of statistical significance, MEHHP levels decreased in group 1 but continued to stay high in group 2 (in the 4th week, group 1: 65.9 ng/mL and group 2: 255.3 ng/mL). Levels of MEHHP in the first urinary samples were significantly higher in infants with a birth weight <1000 g (<1000 g: 63.2±93.8 ng/mL, ≥1000 g: 10.9±22.9 ng/mL, p=0.001).Conclusion:Phthalate metabolites were detected even in the first urine samples of very low birth weight newborns. Phthalate levels were higher in the first weeks of intensive invasive procedures and in preterm infants with a birth weight less than 1000 g. MEHHP was the most frequently detected metabolite and could be a suitable biomarker for the detection of phthalate exposure in preterm infants.

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The aim of this study was to evaluate diagnostic value of 25-hydroxyvitamin D level, Upar, IL-33 and ST2 in comparison with C-reactive protein, TNF-a and Interleukin-6 in neonatal sepsis. A total of 106 term babies were included 20 of whom were the control group. We used only data of high probable sepsis with blood culture positive infants, therefore 46 infants were excluded. Blood was collected from infants from the first day of sepsis (l.value) and 48-72 hours later (2.value). There were significant differences between the controls and sepsis (l.value) for 25-hydroxyvitamin D levels (35±19ng/ml and 69±7.5ng/ml, p=O.Ol), for IL-33 levels (90±34 ng/ml and 412±170 ng/ml, p=O.Ol), for sST21eveis (453±44 ng/ml and 4120±2720ng/ml, p=O.Ol), for sUpar levels (2.1±1.3 ng/ml and 11.4 ± 5.2 ng/ml, p=O.Ol), respectively. There were significant differences between sepsis (l.value) and sepsis (2.value.) with reference to 25-hydroxyvitamin D, IL-33, sST2, and suPAR levels, respectively. In