منیژه مصطفی قره باغی

Prematurity is one of the major health problems and common causes of neonatal mortality. One of the complications of premature infants is hyponatremia. The effect of hyponatremia on the prognosis of preterm infants has not been well studied. This study aimed to evaluate infants with late hyponatremia, its risk factors, and prognosis.

This descriptive analytical study reviewed preterm infants (<34 weeks) admitted to Al-Zahra or Children’s Hospital in Tabriz for one year (2019). Neonates diagnosed with hyponatremia after the second week were identified and evaluated for risk factors and short-term outcome.

A total of 186 neonates were studied. The mean gestational age of the neonates was 30 weeks (first and third quarters = 29-32 weeks). 101 (54.3%) infants were male. The route of delivery was the cesarean section in 60.7% of cases. Late hyponatremia was present in 50 (26.8 %) infants. Gestational age and birth weight were significantly lower in infants with hyponatremia than in the control group. Multivariate analysis showed that low birth weight, the use of prenatal steroids, and inappropriate weight for gestational age status independently predict the incidence of late hyponatremia. There was a significant relationship between the presence of prolonged late hyponatremia (over 7 days) and bronchopulmonary dysplasia and osteopenia of prematurity. However, no significant association was found between the presence of prolonged late hyponatremia in preterm infants with the length of hospital stay and in-hospital mortality.

Based on the findings of this study, low birth weight, prenatal steroid use, and lack of appropriate weight for gestational age were risk factors for late hyponatremia in preterm infants. Prolonged hyponatremia is associated with bronchopulmonary dysplasia and osteopenia of prematurity

Patent Ductus Arteriosus (PDA) is considered one of the most prevalent types of congenital heart disease. The closure of the ductus arteriosus physiologically occurs at the first 48-72 hours after the birth in healthy term infants. Different causes can result in the pathological opening of ductus arteriosus. This study aims to investigate the effect of oral acetaminophen on the closure of PDA in preterm neonates.

The present study is a trial without control. Forty-five preterm neonates with a gestational age of <32 weeks were studied. Acetaminophen was orally administered with a dose of 10mg/kg every 6 hours for three days. Closure of ductus arteriosus was considered as the success of treatment. Data were analyzed using SPSS 15. Data were reported as )frequency-percent) and mean ± SD. To evaluate the normal distribution of data, we used a Kolmogorov-Smirnov test. Statistical significance was defined as P<0.05.

The study population consisted of 20 male and 25 female infants with the mean gestational age of 28.95 ± 1.66 weeks. Cesarean-born infants and vaginal-born infants consisted 17.8% and 82.2% of the study population, respectively. The proportion of PDA closure after administration of oral acetaminophen was 82.3%.

The current study indicates that oral acetaminophen is highly effective in closing PDA. Considering its trivial side effects, it has the potency to be a convenient option for treating this condition.

Premature birth is an important issue in developed and developing countries. Surfactant replacement therapy of respiratory distress syndrome (RDS) causes a change in the normal pattern of the disease and increases the likelihood of survival of more premature newborns with chronic pulmonary damage. The purpose of this study was to investigate the effects of budesonide and surfactant on the treatment of respiratory distress syndrome and the prevention of bronchopulmonary dysplasia.

In a randomized clinical trial, 128 preterm infants less than 1250 g or gestational age of 26-30 weeks that were admitted to Al-Zahra Hospital from 2017 to 2018 with RDS and needed surfactant replacement therapy were enrolled. They were randomly allocated into two groups. In one group (group Surfactant), the surfactant was administered intratracheally 2.5 cc/kg and in the second group (group Surfactant + Budesonide), budesonide was administered 0.25 mg/kg in addition to the intratracheal surfactant. The primary outcome was bronchopulmonary dysplasia and the secondary outcome was complications of prematurity.

In this study 128 neonates including 48 (60.9%) boys and 50 (39.1%) girls were studied. The mean gestational ages of studied neonates were 28.32±1.60 weeks. The mean duration of mechanical ventilation, continuous positive airway pressure (CPAP), high flow nasal cannulae (HFNC), and need for supplemental oxygen were significantly shorter in the group that received surfactant and budesonide combination. The required FiO2 at four hours after surfactant treatment was significantly lower in group Surfactant + Budesonide than the Surfactant group (p = 0.01). In the group Surfactant, 38 neonates (59.4%) and in group S+B, 24 cases (37.5%) developed bronchopulmonary dysplasia (BPD), (p = 0.04). The mortality rate was 15 neonates that 6 cases were in group S+B (p =0.29).

In our study, using surfactant with budesonide combination in comparison with surfactant alone is associated with less respiratory support and BPD rate. Future studies with a larger number of patients before routine use of surfactant and budesonide combination is recommended.

Hyperbilirubinemia is a common and often benign problem in neonates.
Severe neonatal indirect hyperbilirubinemia associated with neurological developmental disabilities, including auditory, cognitive and motor disorders. Motor disorders include dystonia, athetosis that is consistent with lesions of core nuclei. The tone and coordination abnomality are signs of lesion in cerebellum. Hyperbilirubinemia and kertnicterus-induced hearing loss include hearing processing imparment and sensorineural hearing loss. The goal of this study was to determine the neurological developmental  outcome and kernicterus in children at ages 24-36 months who had severe neonatal hyperbilirubinemia.

In a longitudinal study, newborns  that admitted to hospital with severe neonatal indirect  hyperbilirubinemia were followed. In one year, 181 neonates were admited and treated for severe jaundice. At the age 24 to 36 months, 121 cases were followed and evaluated for kernicterus.

In this study 121 patients were followed that 52 patients (43%) were girls and 69 (57%)  were boys. The age of newborns at admission was 4.14±1.27 days and their birth weight was 3102 ±559 grams. The mean values of billirubin was 21.29±4.21 mg/dl at the time of hospitalization. Twenty eight patients (19.83%) had underwent exchange transfusion in addition to intensive phototherapy, of which 8 neonates(6.61%) had evidence of ABO incompatibiliry. These 8 patients had received intravenous immunglobolin to prevent the need for second exchange transfusion. Among the followed patients,  3 infants (2.47%) had developmental delay and diagnosed as kernicterus, of which 2 neonates had exchange transfusion due to ABO incompatibility.

In this study, less than 3% of infants with severe neonatal hyperbilirubinemia developed  kernicterus. It is necessary to inform parents about neonatal jaundice and its complications. Severe jaundice should be taken serious in the first days of life because of risk for kernicterus. Severe neonatal hyperbilirubinemia, if not treated properly and quickly, can cause developmental delay.

Neonatal jaundice is an increase in serum bilirubin that is the most common cause of hospitalization in newborn infants. Often the cause of the jaundice is unknown, but many predisposing factors are involved in the development of jaundice. This study was conducted to determine the relationship between the type of delivery and the incidence and severity of jaundice in the neonates.

This descriptive cross-sectional study was performed on 170 newborns in Al-Zahra and Children’s hospitals, Tabriz, Iran in 2016. The data was collected through a questionnaire and included sections: infant information, maternal information, and questions about mother's disease, history of jaundice in the siblings and the type of management. Data were analyzed by appropriate statistical tests and the value of P<0.05 was considered as a meaningful level.

A total 170 Infants with jaundice were enrolled that 60.1% were boys and 39.9% girls. The route of delivery were vaginal birth in 39.8% of the patients and 60.2% were delivered by cesarean section. There was a significant relationship between hyperbilirubinemia (10-14.9 mg/dl) and type of delivery (P =0.01). The jaundice was appeared between days 4 to 7 of birth in 41.4% of cases and in 25% of patients was observed in the first 24 hours after birth. The most common blood group among mothers were A and O (35.2%) and their Rh type in 98.8% cases were positive. The gestation age in 70.3% of newborns was ranged from 34 to 37 weeks with a significant correlation with the incidence of jaundice.

This study showed, delivery by cesarean section is associated with jaundice in the newborn. Therefore, the promotion of normal vaginal delivery in the country is recommended as a fundamental policy to improve the health of mothers and reduce the rate of cesarean section.

Necrotizing entrocolitis is the most common emergency of the gastrointestinal tract in the newborn period and leading to mortality and morbidity in preterm newborns. Because there is no specific test for diagnosis of necrotizing entrocolitis, now only clinical and radiological findings are using for diagnose.With finding a reliable biomarker for earlier diagnosis of necrotizing entrocolitis, mortality and morbidity will be decreased.The aim of this study is evaluation of diagnostic value of fecal calprotectin level in necrotizing entrocolitis.

In a case_control study, 20 preterm newborn with necrotizing entrocolitis and 20 preterm newborn without necrotizing entrocolitis for 14 months were investigated. Level of fecal calprotectin was checked by ELISA method in both groups and the data’s were compared.

Findings of statistical analysis of level of fecal calprotectin between two groups show significant differences. (p

Fecal calprotectin can be used as a reliable biomarker for diagnosis of NEC.

Gastroesophageal reflux is a common condition among premature infants, which causes problems such as reduced weight gain and prolonged length of hospital stay. Body status is an appropriate way to reduce this condition. However, there have been few studies conducted in this regard. The objective of this study was therefore to investigate the effect of body status on gastroesophageal reflux in premature infants.
The present research was a crossover study conducted on premature infants with a gestational age of 33-36 weeks in Al-Zahra Hospital in Tabriz, Iran, from January to March 2015. In this clinical trial, thirty-two premature infants hospitalized in this center were selected as the sample. The initial selection of the participants was based on the simple random sampling. Then the participants were allocated to groups using randomized block procedure. Each infant was under study for 4 days. After each feeding and about two hours before the beginning of next feeding, the infants were randomly and not repeatedly put in one of the following four status for 12 hours (8 am -8 pm) every day: facilitated fetal tucking posture in lateral position, free body posture in lateral position, facilitated fetal tucking posture in supine position, and free body posture in supine position. Then, the incidence of gastroesophageal reflux was measured in each of these statuses. SPSS software, version 21 (SPSS Inc., Chicago, IL, USA) was used to analyze the data at significant level of P The results showed that there was a significant difference between facilitated fetal tucking posture in lateral position and other status (P The findings of this study revealed that facilitated fetal tucking posture and lateral positioning reduced the incidence of gastroesophageal reflux in hospitalized premature infants.

Introduction and Infantile colic is a very common condition in apparently healthy infants with considerable burden on parents and health system. The characteristic of the condition is an excessive, inconsolable crying, which is defined as paroxysms of crying lasting more than 3 hours a day, occurring more than 3 days in any week for 3 weeks in a healthy infant aged 2 weeks to 3 months. Recently, it has been suggested that probiotics may alleviate symptoms of infantile colic, but available data are still conflicting. This study aims to evaluate the effect of a combination of probiotics on infantile colic in comparison with a conventional treatment.
In a clinical trial study a total of 60 infants with colic were randomized in two equal groups. The first group received a sachet of probiotics per day containing 1 billion CFU of Lactobacillus casei, Lactobacillus rhamnosus, Streptococcus thermophilus, Bifidobacterium breve, Lactobacillus acidophilus, Bifidobacterium infantis, Lactobacillus bulgaricus and fructooligosacharide along with a conventional treatment for two consecutive weeks. The second group received the conventional treatment only. Infant crying frequency, sleep duration, weight gain, number of defecation, change in appetite, and vomiting frequency, carminative use, number of medical advice seeking, and the number of parents’ off-day due to the infant’s condition were statistically compared between the two groups every 2 weeks for 4 weeks using t-test.
Intragroup analyses showed significant favorable changes in all study variables except for seeking emergency intervention, frequency of defecation and change in appetite after treatments. Intergroup analyses, however, showed similar changes in the outcome variables after two weeks of intervention (p>0.05), except for the number of carminative use, which was significantly lower in the group that received probiotics (11.18±3.73 times vs. 7.03±4.73 times, p Treatment with probiotics is at least as effective as using a conventional therapeutic method for infantile colitis. This probiotic is even superior to the conventional method in terms of decreasing the need for carminative use

Renal calcification (nephrocalcinosis and nephrolithiasis) are common in both term and preterm infants who have had difficult neonatal courses. Multiple factors including some medications may cause hypercalciuria and nephrocalcinosis in premature neonates. The aim of this research was to determine the rate of renal calcification and its relation with neonatal clinical course and medications in preterm neonates under 1500 grams birth body weight

In a cross sectional and descriptive–analytical study, 250 premature neonates with birth weight less than 1,500 grams who hospitalized in the neonatal intensive care unit of Alzahra Hospital of Tabriz/Iran from 2012-2013 were studied. Data including gender, gestational age, birth weight, first and fifth minute APGAR score, delivery type and receiving mechanical ventilation, CPAP and drugs were recorded. Renal ultrasound examination was done in all neonates at one month of age and was repeated at 40 weeks corrected gestational age.

The mean weight and gestational age of neonates were 1233.45±634.45 gram and 29.34±3.7 weeks respectively. One hundred and four neonates (41.6%) were male and 146 cases were female. Renal calcification was reported in the first ultrasound scan in 11 neonates (4.4%) and in the second one in 74 cases (29.6%). There was not significant association between renal calcification and sex, gestational age, receiving surfactant, aminoglycosides and calcium (P>0.05). There was a significant relationship between renal calcification and low birth weight, mechanical ventilation, CPAP, receiving diuretics, methyl xanthines, vancomaycin and corticosteroids (p

We found renal calcification in less than one third of studied neonates. Renal calcification was more common in infants with less birth body weight and those receiving mechanical ventilation, CPAP, diuretics, methyl xanthines, vancomycin, and corticosteroids.

Neonatal hypoglycemia is an emergency condition requiring immediate treatment to prevent serious outcomes. Today, blood glucose meter is a current method for detecting blood glucose in the health centers of our country, while the hypoglycemia can not be confirmed or denied certainly with glucometer. This study aimed to evaluate the accuracy of blood glucose meter in comparison to that of laboratory method and determine the optimal cut- 0ff point in detecting neonatal hypoglycemia by glucometer. This cross-sectional study was conducted in the neonatal intensive care unit of Al Zahra Hospital from September 2013 to March 2014. In infants with risk factors of hypoglycemia blood glucose was tested with blood glucose meter (ACCU CHEK - Performa), if the blood glucose was under 60 mg/dl. Simultaneously, the venous blood glucose values were done on (Selectra2) auto analyzer by glucose oxidase method. Sensitivity, specificity, and positive and negative predictive values of glucometer were determined. Hypoglycemia was observed in 32% and 33% of neonates, respectively with glucometer and laboratory methods. A weak correlation was observed between the results of glucometer and laboratory methods (r=0.275). In this study, the optimal cut – off point by glucometer was found to be 54 mg/dl and sensitivity, specificity, accuracy, positive predictive value and a negative predictive values of glucometer were 45.45%, 74.6%, 65%, 46.8% and 73.5% respectively. According to ROC curve area under the curve (AUC) was 0.616. According to the results obtained in this study, glucometer has not sufficient diagnostic value to detect neonatal hypoglycemia. Blood Glucose meter results should be confirmed using a laboratory method.

Nurses are responsible for a noticeable number of invasive procedures of hospitalized neonates in ICU, and recently, making error has risen in guarding endangered infants. Nurse has maximum relational friction surface, care and therapeutic contact with human client; therefore, they could be one of the most problematic parts of the management of human errors.
The purpose of this study is determining the types of nursing errors in gastric tube insertion procedure of preterm infants in neonatal intensive care units in Sanandaj in 2013.
In this descriptive study, 28 employed nurses were chosen in neonatal intensive care units in Besat and Tamin Ejtemaei hospitals. The data were gathered through a researcher-made checklist by direct observations of the nurses. Each nurse was observed four times. The data were analyzed through SPSS software version 13.
The findings revealed that in all observations the most common error in gastric tube insertion of preterm infants is related to implementation stage, registration stage, and preparation stage respectively.
The results showed that the most common type of nursing error in gastric tube insertion of preterm infants occurs in implementation stage. These errors can be prevented to a large degree by changing and improving the educational process and through an educational planning by officials of nursing education.

premature and low birth weight infants are one of the high risk population in the community. After discharge، they are more vulnerable than full-term infants and in comparison with full-term born infants need more care. The aim of discharge planning، preparing families for the care of premature infants at home after discharge. a randomized controlled trial study was conducted on 92 mothers of preterm infants (gestational age: 320/7 -366/7 weeks) in neonatal ICU of Tabriz Alzahra hospital in 2013. Discharge planning was done for intervention group and mothers of control group received routine and usual cares. discharge planning program Includes two group training sessions with practical training and lectures، and videotape training for mothers of premature infants. Maternal stress was measured in both admission and discharge time in two groups by using Parental stress scale. Data analysis was performed using the T-test and X2 test. There was not any meaningful difference about rate of stress between 2 groups before the intervention. However، after implementation of discharge planing، maternal stress was lower in intervention group than in control group (p≤0. 001) Implementation of discharge planning reduces stress levels of mothers of premature infants. Its implementation could facilitate to return infants from acute care units to family

Premature and low birth weight infants are among the high risk population in the community and after discharge, they are more vulnerable than full-term infants and need more care compared to term infants.
The aim of discharge planning is preparing families for the care of premature infants at home after discharge
A randomized controlled trial study was conducted on 92 mothers of preterm infants (gestational age: 32 -36 weeks) in neonatal ICU of Tabriz Alzahra hospital in 2013. discharge planning was done for intervention group and mothers of control group received routine and usual cares. Maternal satisfaction was measured in both admission and discharge time in two groups by using Parental satisfaction questionnaire (Likert scale) . Data analysis was performed using the T-test and X2 test.
The mean scores of the intervention and control groups before the intervention, and after discharge planning were 39.60 and 34.58, respectively, which was not statistically significant, but after the intervention difference between the two groups, before and after, were 45.95 and 36.80in the control test and a statistically significant difference was observed (P=0.000). ­
Providing discharge planning increase satisfaction among preterm infant's mothers. Discharge planning is a fundamental element to facilitate transtion of infants from acute care units to home. Therefore implementation of discharge planning has the positive impact on patient's outcomes and commitment and family adaptation after returning home.

Backgrounds and Preterm infants are at risk for respiratory distress syndrome. In several studies Continuous Positive Airway Pressure (CPAP) in combination with surfactant is more effective comparing with just CPAP method. This type of treatment is known as Intubation، SURfactant، Extubation (INSURE). This study was aimed to determine the risk factors for the INSURE failure. This descriptive analytic study was conducted in NICU of Al Zahra Hospital. All preterm neonates with gestation age less than 37 weeks who need surfactant replacement therapy according clinical manifestations were investigated. Infants intubated in delivery room were excluded from study. All neonates received surfactant according to INSURE method. Patients who intubated in first 72 hours of INSURE were considered as failure group and neonates without need for intubation were allocated as success group. There were not statistically significant differences regarding gender، mode of delivery، maternal risk factors، and first blood gas analysis between groups. The mean birth weight and gestation age were significantly lower in the failure group were 1342±545g and 28. 7±2. 9 wk، respectively، which were significantly lower than success group (1688±472g and 31±2. 2wk، p<0. 001). Apgar score at 1 and 5 minutes were 5. 7±2. 1 and 7. 5±1. 3 in failure group and 7. 6±1. 5 and 8. 8±1 in success group (p<0. 001). The Fraction of inspired oxygen (FiO2) requirement، severity of disease in chest x-ray، need for repeated doses of surfactant، packed cell transfusion، patent ductus arteriosus and intra-ventricular hemorrhage were significantly different between groups (p<0. 05). preterm neonates with lower gestation age and birth weight، low Apgar score at 1 and 5 minute، higher Fio2 requirement، and higher RDS score are increase the risk for INSURE failure.

neonatal hyperbilirubinemia is a common problems during neonatal period that may be associated with neurodevelopmental later in life. There are several known risk factors for bilirubin encephalopathy، including total serum bilirubin levels and bilirubin albumin ratio. The aim of this study was to determine relationship between neurodevelopmental delay and total serum bilirubin and bilirubin albumin ratio. In a descriptive analytic method، 186 neonates who had serum bilirubin levels more than 18mg/dl and were treated with phototherapy or exchange transfusion were studied. Total serum bilirubin and bilirubin albumin ratio were determined and they were followed for one year and during this period Ages & Stages Questionnaires، ASQ score was determined in five neurodevelopment domains at their 4، 8 and 12 months of age. One hundred sixty four neonates were treated with phototherapy and 22 with exchange transfusion. The mean bilirubin albumin ratio was 5 and 6. 6 in phototherapy treated and exchange transfusion groups respectively (p=0. 01). ASQ score was less than cut off point in two domains in 5 (2. 8%) of these patients. ASQ score in its communication domain at 8 months age was lower in patients with bilirubin-albumin ratio more than 7 [47. 1±10. 9 vs. 51. 8±7. 3 (p=0. 03)]. In patients with total bilirubin greater than 25mg/dl the ASQ score in its communication domain was significantly lower than it in neonates with total bilirubin less than 25mg/dl (48. 4±8 vs. 44. 2 ±9. 8 p=0. 05). There was not significant relation between ASQ score in other domains at 4، 8 and 12 months ages of measurement and total serum bilirubin or bilirubin albumin ratio. The ASQ score in its communication domain was decreased at 8 mo in patients with higher bilirubin-albumin ratio and at 12 mo in patients with higher total serum bilirubin. It is recommended future studies to determine the relationship between neurodevelopment domains and total bilirubin and bilirubin-albumin ratio.

Optimal entral feeding methods in preterm infants have not been well defined. Controversy exists regarding when feedings should be started، whether minimal entral feedings should be used routinely in small preterm infants، and how fast to advance entral feedings. Preterm infants can exhibit delayed gastric emptying and often have feeding residuals. So، entral feedings are frequently advanced slowly in these neonates. However، recent data challenged this idea. The goal of this study was to compare outcomes of different feeding volumes advancing in preterm infants. Methods & Materials: In this controlled randomized clinical trial، 140 preterm infants with gestation age 30-34 weeks were enrolled in Tabriz Alzahra Teaching Hospital in a 12-month period of time. They randomized in three groups; feeding of milk advanced at 20ml/kg/day (group one، 60 neonates)، feeding of milk advanced at 24ml/kg/day (group two، 40 neonates)، and feeding of milk advanced at 30ml/kg/day (group three، 40 neonates). Outcomes were compared between the three groups. Weight gain was not significantly different between the three groups in a 7-day period. Age of commencement of oral intake، time to achieve the milk volume of 150ml/kg، duration of intravenous fluid therapy، duration of antibiotic therapy، total hospital stay، time to achieve the birth weight، NPO duration، full entral feeding time، duration of oxygen need and duration of mechanical ventilation were all significantly better in the third group comparing with the first one. This condition was present for the second group comparing with the first group except for the age of commencement of oral intake and NPO duration. The condition was better in the third group comparing with the second group regarding the time to achieve the milk volume of 150ml/kg and full entral feeding time. The complications were minimal in all neonates. Increase of entral feeding at a rate of 30ml/kg/day is safe and superior to 20ml/kg/day and 24ml/kg/day in preterm infants. It is necessary future studies with large number of patients before recommendation of this increase rate for entral feeing.

IntroductionRetinopathy of prematurity (ROP) is a postnatal disorder of retinal vessels that develops in the incompletely vascularized retina of preterm infants. This disorder regresses in most patients but can lead to severe visual impairment. There is evidence that leptin stimulates angiogenesis. This study was conducted to determine blood levels of leptin in premature infants with proliferative ROP.Materials and MethodsBlood samples were obtained 6-8 weeks after birth from 71 preterm infants born at or before 32 weeks of gestation. These infants consisted of two groups according their eye examination results. The control group consisted of 41 neonates without evidence of ROP and the case group included 30 patients with proliferative ROP at stage III or more. Plasma leptin concentrations were measured using enzyme-linked immunosorbent assay (ELISA).ResultsThe mean gestation age of studied patients at birth were 28.4±1.6 wk and 28.8±1.6 in case and control group respectively (P=. 25). The mean post menstrual age of studied patients at blood sampling was 34.9±1.2 wk in the case group and 34.6±1.3 wk in the control group (p=0.33). Mean blood levels of leptin were not significantly different among patients of the two groups (0.64±0.41 ng/ml in case group and 0.79±0.83 ng/ml in control group respectively,p=0.39). ConclusionOur data demonstrated that plasma leptin concentrations were not significantly different in premature infants with proliferative ROP at 6-8 weeks after birth from premature infants without ROP at this age.

Retinopathy of prematurity (ROP) is one of the most causes of retinal detachment and blindness. Although many studies have been conducted on the pathophysiology of ROP, the exact mechanism is yet under investigation. This study aimed at evaluating the role of serum vascular endothelial growth factor (VEGF), insulin like growth factor-I (IGF-I), and its binding protein (IGFBP-3), and leptin in ROP. In this case-control setting, 30 premature neonates with ROP (case group) and 41 premature without ROP (control group) were recruited during an 18-month period in Tabriz Alzahra Teaching Hospital. Patients with congenital or chromosomal anomalies were excluded. Serum VEGF, IGF-I, IGFBP-3 and leptin were measured by immunoassay method one month after birth. Finally, these serum parameters were compared between two groups.. The mean levels of serum VEGF, leptin, IGF-I and IGBFP-3 were 267.35±103.43 pg/ml, 0.64±0.41 ng/ml, 18.48±11.79 µg/l, and 592.51±472.85 ng/ml in the case group and 237.52±130.92 pg/ml, 0.79±0.83 ng/ml, 16.75±13.74 µg/l, and 995.46±422.19 ng/ml in the control group, respectively. The mean levels of serum VEGF, leptin and IGF-I were comparable between the two groups (p=0.305, 0.392 and 0.580, respectively). The median of serum IGFBP-3 was significantly lower in the case group (622.9 ng/ml vs. 868.2 ng/ml, p=0.001). The best cut-off point of serum IGFBP-3 in indiscriminating between the case and controls was ≤770.45ng/ml, with sensitivity and specificity of 65.9% and 66.7%, respectively. Based on our findings, supplementation with IGFBP-3 analogues may be beneficial in prophylaxis against or treatment of ROP.

Umbilical vascular catheters are routinely inserted in critically ill newborn infants in most neonatal intensive care units (NICU). This study aims at assessing the incidence and risk factors of umbilical catheter associated thrombosis in newborn infants using color Doppler. In a cross-sectional analytic-descriptive study, 256 newborn infants with umbilical catheters were evaluated in Tabriz Children Hospital during a 15-month period. Color Doppler ultrasonography was employed for detection of vascular thrombosis associated with the umbilical catheter placement in the first 24-48 hours after admission, weekly until discharge and 72 hours after discharge. Accordingly, the patients categorized into two groups; those with or without thrombosis and possible risk factors were investigated. Among 256 newborns, 12 cases (4.7%) had vascular thrombosis. One hundred and forty four catheters were placed in umbilical artery, 35 catheters in umbilical vein and 77 catheters in umbilical artery and vein. The rate of thrombosis was 6.9 and 5.7% in the umbilical artery and vein catheters, respectively. There was no significant relation between sex, birth weight, delivery age, type and size of catheter, location of catheterization, underlying disease and type of administered drugs with thrombosis formation. The only significant risk factor was duration of the catheterization (5.3 days in thrombosis vs. 3.3 days in non-thrombosis groups; P=0.005). In 75% of the cases, thrombosis was detected 72 hours after extraction of catheters. Prolonged duration of the umbilical catheters is accompanied with increased risk of thrombosis. Assessment of the patient by color Doppler ultrasonography is recommended after extraction of the catheters.

Goldenhar syndrome or oculoauriculovertebral dysplasia is a non-accidental association of hemifacial microsomia, auricular anomalies, epibulbar dermoid and vertebral malformations. Etiology of this syndrome is unknown. Although some malformations are more frequent in infants of diabetic mothers, developmental defects of first and second bronchial arch are not frequent findings in these patients. Here, we report an infant of diabetic mother with manifestations of Goldenhar syndrome.