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    Being small for gestational age affect neurodevelopmental outcomes in very preterm infants
    (Galenos Publishing House, 2022) Ceran, Burak; Büyüktiryaki, Mehmet; Okman, Esin; Kadıoğlu Şimşek, Gülsüm; Kanmaz Kutman, Hayriye Gözde; Üstünyurt Konuk, Zeynep; Canpolat, Fuat Emre
    Introduction: There is insufficient data on neurodevelopmental outcomes of infants small for gestational age (SGA) with ?30 weeks of gestation. The aim of our study was to compare the neurodevelopmental outcomes of preterm infants who are ?30 weeks, in terms of being SGA or appropriate for gestational age (AGA). Materials and Methods: The data of infants who were born at ?30 GW, were evaluated retrospectively. Neurological examinations and developmental assessment using Bayley Scales of Infant Development 2nd edition was performed at the corrected age of 18-24 months. Results: The data of 228 infants of whom 65 were SGA and 163 were AGA was evaluated in terms of neurodevelopment at the corrected age of 18-24 months. The mean gestational age (GA) was 28.4±1.1 in both groups (p=0.82) and the mean BW was 810±135 g in the SGA group and 1175±183 g in the AGA group (p<0.001). The SGA group had significantly lower Mental Development Index (p=0.01) and Psychomotor Development Index (p<0.001). In multivariate regression analysis, SGA was identified as an independent risk factor for neurodevelopmental delay (RR: 2.27; p=0.02). Conclusion: Being SGA is a risk factor for neurodevelopmental impairment of preterm infants (?30 GW).
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    Factors associated with neurodevelopmental impairment in preterm infants with bronchopulmonary dysplasia
    (Verduci Editore s.r.l, 2022) Yazıcı, A.; Büyüktiryaki, Mehmet; Şimşek, G. K.; Kanmaz Kutman, Hatice Gözde; Canpolat, Fuat Emre
    OBJECTIVE: Bronchopulmonary dysplasia (BPD) is a common and serious complication in preterm infants with very low birth weight and is known to lead to poor neurodevelopmental outcomes. This study aimed to identify factors associated with neurodevelopmental impairment (NDI) in patients with moderate to severe BPD. SUBJECTS AND METHODS: A total of 83 preterm infants born between 24- and 29-weeks' gestation who were admitted to the neonatal intensive care unit and developed moderate/severe BPD between 2013 and 2017 were retrospectively evaluated. Developmental assessment was performed at 18 to 24 months of corrected age using the Bayley Scales of Infant Development II (BSID-II). Patients with NDI (n=41) and without NDI (n=42) were compared. RESULTS: BSID-II Mental Development Index and Psychomotor Development Index scores were 87±11 and 83±8 in the non-NDI group and 57±12 and 52±8 in the NDI group, respectively (p<0.001). The NDI group had significantly lower birth weight (847±174 vs. 1012±192 g) and gestational age (26.1±1.3 and 27.6±1.6 weeks) compared to the non-NDI group (p<0.001). Intraventricular hemorrhage, periventricular leukomalacia, retinopathy of prematurity, exposure to steroids, duration of respiratory support, and length of hospital stay were significantly higher in the NDI group (p<0.001). CONCLUSIONS: Many of the conditions in this study were found to be associated with poor neurodevelopmental outcomes in patients with BPD, such as prolonged respiratory support, prolonged hospitalization, intraventricular hemorrhage, retinopathy, and steroid therapy, can be avoided or prevented with strict protocols and prevention strategies. Appropriate management of comorbid risk factors may help prevent poor neurodevelopmental outcomes.
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    Relationship between early respiratory support and neurodevelopment in extremely low birth weight infants
    (Galenos Publishing House, 2022) Beşer, Esra; Kadıoğlu Şimşek, Gülsüm; Küçükoğlu Keser, Merve; Büyüktiryaki, Mehmet; Kanmaz Kutman, Hayriye Gözde; Üstünyurt, Zeynep; Canpolat, Fuat Emre
    Objective: This study investigated relationship between early respiratory support and neurodevelopmental outcomes in extremely low birth weight infants. Methods: Our study included infants born before 32 weeks’ gestation at a birth weight of 750-1000 g that were admitted to the neonatal intensive care unit and underwent a neurodevelopmental evaluation at the corrected age of 24 months. Two hundred-twelve infants were divided into 3 groups by determining the predominant type of respiratory support required in the first 3 days of life. Infants who received supplemental oxygen therapy group 1, those who received nasal continuous positive airway pressure and/or nasal intermittent mandatory ventilation were in group 2, and intubated infants were included in group 3. Differences between the groups and relationships between neurodevelopment scores [mental development index (MDI); psychomotor development index (PDI)] were examined. Results: The patients mean birth weight was 887±73 g and mean gestational age was 27±1.9 weeks. MDI and PDI values were below 70 in the intubated patient group (68 and 66, respectively). Patients who received noninvasive ventilation or supplemental oxygen therapy for the first 3 days of life had significantly higher MDI and PDI values. In terms of morbidities of prematurity, intubated infants had higher rates of bronchopulmonary dysplasia, patent ductus arteriosus, intraventricular hemorrhage, and retinopathy of prematurity. Conclusion: Restrictive invasive ventilation policies can be applied to preterm infants and may improve neurodevelopmental outcomes. The results of this study suggest that every additional day of invasive mechanical ventilation should be avoided if possible.
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    Risk factors in addition to short and long-term outcomes with thin catheter surfactant administration failure in preterm infants: a retrospective analysis
    (2025) Kanmaz Kutman, Hayriye Gözde; Siyah Bilgin, Betül; Büyüktiryaki, Mehmet; Kadıoğlu Şimşek, Gülsüm; Üstünyurt, Zeynep; Canpolat, Fuat Emre
    Objective: To evaluate the incidence of thin catheter surfactant administration (TCA) failure and compare short and long-term neonatal outcomes who failed TCA or did not. Design: Single-center retrospective cohort study. Infants between 25 and 30 weeks of gestational age with respiratory distress syndrome and receiving 200 mg/kg poractant alfa via thin catheter administration were included. TCA failure was defined as the need for early mechanical ventilation (< 72 h). Infants were divided into two groups those who failed TCA or those who did not. Results: The TCA failure rate was 24.6%. Initial oxygen requirement (0.39% vs. 0.36%) and the number of small for gestational age infants were significantly higher in the TCA failure group (15% vs. 7.9%). Infants who failed TCA had a higher pneumothorax (6.7% vs. 1.1%, p = 0.03), BPD (15% vs.5.5%, p = 0.02), late-onset sepsis (36.7% vs. 18%, p = 0.04), retinopathy of prematurity rates (11.7% vs. 3.3%, p = 0.02) and an increased duration of respiratory support. However, Bayley Scales of Infant Development II scores were comparable between groups at 18 and 26 months of corrected age. Conclusion: Infants who fail TCA are at increased risk for short-term complications despite favourable long-term neurodevelopmental outcomes. Identifying infants at risk of TCA failure may help early prevention of morbidities and individualise their management.