İleri derece preterm ve geç preterm yenidoğanlarda farklı büyüme eğrileri ile intrauterin ve ekstrauterin büyüme geriliğinin değerlendirilmesi
Küçük Resim Yok
Tarih
2023
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Trakya Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
İleri derece preterm ve geç preterm yenidoğanlarda büyümenin nasıl izlenmesi gerektiği ve bebeklerde ideal büyüme modelini neyin oluşturduğu konusunun araştırılması amacıyla Ocak 2016 ve Aralık 2022 tarihleri arasında TÜTF Çocuk Sağlığı ve Hastalıkları Anabilim Dalı Yenidoğan Yoğun Bakım Ünitesinde takip ve tedavi edilmiş olan 215 ileri derece preterm ve 86 geç preterm Fenton ve "Intergrowth 21" büyüme eğrileri ile değerlendirilmek için çalışmaya alındı. Olgular doğum, postnatal 1. hafta, postnatal 2. hafta ve taburculuktaki ağırlık, boy, baş çevresi ölçümlerine göre büyüme eğrilerinde incelendi ve antenatal özellikler ile neonatal morbiditeler açısından karşılaştırıldı. İleri derecede pretermlerde; doğum ağırlık ile boy persantil ve z skoru değerlerine göre "Intergrowth 21" büyüme eğrisinde, doğum baş çevresine göre ise Fenton büyüme eğrisinde SGA oranı istatiksel anlamlı olarak daha fazla bulundu. Çalışılan diğer zaman dilimlerindeki; ağırlık ile boy persantil ve z skoru değerlerine göre Fenton büyüme eğrisinde, baş çevresine göre ise "Intergrowth 21" büyüme eğrisinde SGA/EUBG oranı istatiksel anlamlı olarak daha fazla saptandı. Çalışmamızda; postnatal 2. hafta ağırlık z skorlarında Fenton büyüme eğrisine göre SGA olan olgularda kanıtlanmış sepsis dışında bütün çalışılan morbiditelerin görülme oranı "Intergrowth 21" büyüme eğrisinin aksine anlamlı yüksek saptandı. Öte yandan taburculuk haftasındaki ağırlık persantil ve z skoru çoklu lojistik regresyon analizlerinde "Intergrowth 21" büyüme eğrisinde çalışılan daha fazla neonatal morbiditenin varlığının EUBG'yi artırdığı gösterildi. Geç pretermlerde; neonatal morbiditeler açısından büyüme eğrilerinin karşılaştırılmalarında kesin sonuçlara ulaşılamadı. Sonuç olarak, hangi büyüme eğrisi ile büyümenin izlenmesi gerektiği sorusuna yanıt verebilmek için bu iki büyüme eğrisini geniş serilerde karşılaştıran prospektif çalışmalara ihtiyaç duyulmaktadır. Anahtar kelimeler: Büyüme eğrileri, büyüme geriliği, preterm, postnatal büyüme, morbidite
The study was conducted to investigate how growth should be monitored in very preterm and late preterm neonates and to determine the ideal growth model in infants. Between January 2016 and December 2022, a total of 215 very preterm and 86 late preterm infants who were followed and treated in the Neonatal Intensive Care Unit of TUMF Department of Pediatrics, were included in the study to be evaluated using Fenton and "Intergrowth 21" growth charts. The cases were examined on the growth charts based on weight, length, and head circumference measurements at birth, postnatal week 1, postnatal week 2, and discharge, and compared in terms of antenatal characteristics and neonatal morbidities. In very preterm infants, the rate of SGA according to the "Intergrowth 21" growth chart was statistically significantly higher based on weight and length percentiles and z-scores at birth, while it was higher based on Fenton growth chart according to head circumference. In the other time periods examined, the SGA/EUGR rate was statistically significantly higher based on Fenton growth chart for weight and length percentiles and z-scores, while it was higher based on "Intergrowth 21" growth chart for head circumference. In our study, the incidence of all studied morbidities, except proven sepsis, was significantly higher based on Fenton growth chart compared to "Intergrowth 21" growth chart in infants with SGA according to weight z-scores at postnatal week 2. On the other hand, logistic regression analyses revealed that a higher rate of EUGR according to weight percentiles and z-scores at discharge was observed in cases where there were more neonatal morbidities as indicated by the "Intergrowth 21" growth chart. In late preterm infants, no definitive conclusions could be drawn regarding the comparison of growth charts in terms of neonatal morbidities. In conclusion, prospective studies comparing these two growth charts in large series are needed to answer the question of which growth chart should be used for monitoring growth. Keywords: Growth curves, growth retardation, preterm, postnatal growth, morbidity
The study was conducted to investigate how growth should be monitored in very preterm and late preterm neonates and to determine the ideal growth model in infants. Between January 2016 and December 2022, a total of 215 very preterm and 86 late preterm infants who were followed and treated in the Neonatal Intensive Care Unit of TUMF Department of Pediatrics, were included in the study to be evaluated using Fenton and "Intergrowth 21" growth charts. The cases were examined on the growth charts based on weight, length, and head circumference measurements at birth, postnatal week 1, postnatal week 2, and discharge, and compared in terms of antenatal characteristics and neonatal morbidities. In very preterm infants, the rate of SGA according to the "Intergrowth 21" growth chart was statistically significantly higher based on weight and length percentiles and z-scores at birth, while it was higher based on Fenton growth chart according to head circumference. In the other time periods examined, the SGA/EUGR rate was statistically significantly higher based on Fenton growth chart for weight and length percentiles and z-scores, while it was higher based on "Intergrowth 21" growth chart for head circumference. In our study, the incidence of all studied morbidities, except proven sepsis, was significantly higher based on Fenton growth chart compared to "Intergrowth 21" growth chart in infants with SGA according to weight z-scores at postnatal week 2. On the other hand, logistic regression analyses revealed that a higher rate of EUGR according to weight percentiles and z-scores at discharge was observed in cases where there were more neonatal morbidities as indicated by the "Intergrowth 21" growth chart. In late preterm infants, no definitive conclusions could be drawn regarding the comparison of growth charts in terms of neonatal morbidities. In conclusion, prospective studies comparing these two growth charts in large series are needed to answer the question of which growth chart should be used for monitoring growth. Keywords: Growth curves, growth retardation, preterm, postnatal growth, morbidity
Açıklama
Tıpta Uzmanlık
Anahtar Kelimeler
Çocuk Sağlığı ve Hastalıkları, Child Health and Diseases
