Yenidoğan Yoğun Bakım Ünitesinde İzlenen Çok Düşük Doğum Ağırlıklı Bebeklerde Morbidite Ve Mortalite Sonuçları: 15 Yıl Arayla İki Beş Yıllık Dönemin Karşılaştırılması

Yıl 2023, Cilt: 37 Sayı: 2, 123 - 131, 06.09.2023

Yağmur Damla Akçura , Coşkun Armağan , Can Akyıldız , Burak Deliloğlu , Nuray Duman , Funda Tuzun , Hasan Özkan

https://doi.org/10.18614/deutip.1243733

Öz

Giriş ve yöntemler:
Perinatal ve neonatal bakımdaki gelişmeler sayesinde prematüre bebeklerin yaşama oranları artmıştır. Ülkelerin ve birimlerin gelişmişlik düzeyine bağlı olarak bazı morbidite oranları artabilir, bazılarında ise azalabilir. Bu retrospektif kesitsel çalışmada; çok düşük doğum ağırlıklı (ÇDDA) bebeklerin morbidite ve mortalite sonuçları önceki çalışmamızdaki bebeklerin sonuçları ile gelişmiş ülke verileri karşılaştırılarak değerlendirildi.
Bulgular:
Son gruba 203 bebek dahil edildi. Bu bebeklerin ortalama doğum ağırlıkları 976±308 gr ve ortalama gebelik haftaları 27,8±2,5 hafta idi. Gebelik yaşı 28 hafta ve üzerinde olan bebeklerin oranı, 173 bebek içeren ilk gruba göre anlamlı derecede düşüktü. Majör morbiditelerle ilgili olarak, bronkopulmoner displazi (orta ila şiddetli) ve nekrotizan enterokolit (>evre 2) oranları son grupta anlamlı olarak daha yüksekti; prematüre retinopatisi (>derece 2), intraventriküler kanama (>derece 2) ve periventriküler lökomalazi oranları da iki grup arasında benzerdi. Sağkalım oranları benzer bulunurken, majör morbidite olmaksızın sağkalım oranı son grupta anlamlı olarak daha düşüktü.
Çözüm:
Mortalite ve morbidite verileri gelişmiş ülkelerle karşılaştırıldığında son dönemde doğum ağırlığı ve gebelik yaşı açısından daha küçük bebeklerin görülmesine rağmen sağkalım oranları değişmedi. Çalışma, özellikle küçük gebelik haftalarında ölüm oranlarında iyileşmeye ihtiyaç olduğunu gösterirken, majör morbidite oranları genellikle cesaret vericiydi.

Anahtar Kelimeler

morbidite, mortalite, çok düşük doğum ağırlığı, yenidoğan

Destekleyen Kurum

yok

Proje Numarası

yok

Morbidity And Mortality In Very Low Birth Weight Infants: A Comparison Of Two Five-Year Periods With A 15-Year Interval

Öz

Introduction and methods:
Thanks to developments in perinatal and neonatal care, the survival rate of premature babies has increased. Depending on the development level of countries and units, some of the morbidity rates may increase, while others may decrease. In this retrospective cross-sectional study; the morbidity and mortality results of very low birth weight (VLBW) infants were evaluated by comparing the results of the infants in our previous study and the data of developed countries.
Results:
203 infants were included in the last group. The mean birth weight of these babies was 976±308 g and the mean gestational age was 27.8±2.5 weeks. The rate of babies with a gestational age of 28 weeks and above were significantly lower than the first group containing 173 infants. Regarding major morbidities, the rates of bronchopulmonary dysplasia (moderate to severe) and necrotizing enterocolitis (>stage 2) were significantly higher in the last group; while the rates of retinopathy of prematurity (>grade 2), intraventricular hemorrhage (>grade 2) and periventricular leukomalacia were also similar among the two groups. While survival rates were found to be similar, the survival rate without major morbidity was significantly lower in the last group.
Conclusion:
While the survival rates remained unchanged despite the observation of smaller babies in terms of birth weight and gestational age in the last period when mortality and morbidity data were compared with developed countries, the study demonstrated a need for improvement in mortality rates especially in small gestational weeks, while major morbidity rates were generally encouraging.

Anahtar Kelimeler

morbidity, mortality, very low birth weight, newborn

Proje Numarası

yok

Kaynakça

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