We read with great interest the above original article by Zahra Shafizadeh et al. published in the IJN about antenatal hydronephrosis. We think it is very valuable, and the investigation is appropriate and convincing. The causes of fetal hydronephrosis include idiopathic, VUR, UPJO, UVJO, PUV, and ureterocele, and 5%–15% of infants with antenatal hydronephrosis have VUR (1). Infant follow-up is usually recommended only if the diameter of the pelvis of the fetal kidney is greater than a certain cutoff (e.g., 7 or 10 mm) at or beyond 34 weeks. If the measurement is less, most of them are considered physiologic or normal (2). There are some points worth discussing in this study. First: In this study, the causes of hydronephrosis were reported as idiopathic, polycystic kidney disease, PUV, VUR, and UVJO (3). It seems that polycystic kidney disease (PCKD) is not a cause of fetal hydronephrosis, and there is a weak possibility of the two co-occurring. On the other hand, autosomal dominant polycystic kidney disease occurs in 1 in 800 live births, and autosomal recessive PCKD is much rarer, with an incidence of 1 in 20,000 live births. Therefore, the possibility that we have two patients with PCKD and hydronephrosis in this study is weak (4). Second: In this study, adverse outcomes from fetal hydronephrosis included the need for surgery, initiation of antibiotic prophylaxis, failure to improve hydronephrosis after 6 months, and death (3). It is not known whether the death was related to hydronephrosis because mortality from hydronephrosis is rare, except in cases of Potter syndrome. It is normal for moderate and severe hydronephrosis to last more than 6 months and to decrease with age and especially with the height of children, and this is not considered an adverse outcome. Third: In this study, the reasons for the difference in spontaneous recovery rates of fetal hydronephrosis included inclusion and exclusion criteria, sample classification, and the infants' follow-up time (3). However, it seems that the duration of follow-up and differences in the causes of secondary hydronephrosis, including VUR, PUV, and UPJO, could be the reason for this difference in various studies. Fourth: One of the main symptoms of severe kidney diseases is oligohydramnios, which is seen in cases of severe PUV, bilateral kidney dysplasia, and Potter syndrome. The combination of fetal hydronephrosis with oligohydramnios indicates a poor prognosis.
Background: Prematurity poses a significant health concern, and it is crucial to identify the factors associated with it in order to reduce the burden on neonatal care units and prevent associated mortality. To determine the prevalence of premature delivery and identify the associated risk factors at Alramadi Teaching Hospital for Maternity and Children. Methods: A prospective cross-sectional study was conducted at Ramadi Teaching Hospital for Maternity and Children. The study included all live births that were at least 20 weeks into gestation, while excluding stillbirths and cases where information on gestation length was missing. Checklist was used to collect the necessary information. Logistic regression was employed to analyze the risk factors. Results: This study involved 1327 neonates, of which 204 were preterm, resulting in a prevalence of preterm delivery of 15.4%. By using logistic regression to analyze the associated variables, the study found that mothers under the age of 25 had a significant impact with an odds ratio of 4.2. Additionally, a history of prematurity was found to be significant with an odds ratio of 5.71, multiple pregnancies were also significantly associated with an odds ratio of 7.22, and complications during pregnancy showed significance with an odds ratio of 6.41. Conclusion: The prevalence of prematurity at Ramadi Teaching Hospital for Maternity and Children in Anbar, Iraq, is 15.4%. The most associated risk factors were identified as younger maternal age, maternal history of prematurity, multiple pregnancy, and complications during pregnancy.
Background: Ring chromosome 13 is a rare cytogenetic disorder resulting from breakage and reunion of the distal ends of the chromosomal arms. The incidence of this disorder is about 1 in 58,000 live births. This syndrome usually presents with particular clinical features, including developmental delay, microcephaly, genital malformation in males, and dysmorphism, such as hypertelorism, broad nasal bridge, thin lips, up-slanting palpebral fissure, and ear anomalies. Case Report: We report a 2-month-old girl who was referred to a clinical geneticist because of growth retardation and distinctive facial features. Her parents were consanguineous (second-cousins). The patient had a history of IUGR and was the product of a normal delivery at 39 weeks of gestation. At presentation, hypotonia, microcephaly, micrognathia, low-set ears, bilateral palmar single transverse creases (simian creases), broad nasal bridge, and thin lips were observed. Conclusion: The karyotype revealed the presence of mosaic ring chromosome 13. This is the first report of a case of ring chromosome 13 with bilateral palmar single transverse creases.
Background: Necrotizing enterocolitis is the most common gastrointestinal emergency in infants. If not treated promptly, it can progress to necrosis, rupture, peritonitis, sepsis, and death. Therefore, the use of probiotics can have health benefits. Methods: This double-blind clinical trial was conducted on 86 premature infants admitted to the neonatal intensive care unit of Bentolhoda Hospital in Bojnurd, Iran, in 2021-2022. In this study, premature infants were randomly assigned to control and intervention groups. In the intervention group, after the infant's feeding volume reached 5 cc per kilogram of body weight per day, oral probiotics at a dose of one drop per kilogram of body weight, diluted with normal saline to a volume of 0.5 cc, were administered every 12 hours for 3 weeks. Results: There was no statistically significant difference between the two groups in terms of variables such as weight at admission, weight at discharge, length at discharge, and head circumference at discharge. However, a statistically significant difference was observed in terms of the difference in weight between admission and discharge, as well as the duration of hospital stay. The average difference in weight between admission and discharge in the intervention group was approximately 90 grams greater than that in the control group. Also, the average duration of hospital stay in the intervention group was approximately 8 days less than that in the control group. Conclusion: The use of probiotics in premature infants prevents necrotizing enterocolitis and shortens the time to reach full enteral feeding and the duration of hospital stay.
Background: The study aimed to investigate the severity of Neonatal Abstinence Syndrome (NAS) complications in newborns (NBs) in the eastern region of Iran. Methods: The retrospective study was conducted among mothers and singleton live births between March 2022 and March 2023. Results: Twenty-nine mothers (53.7%) used natural opioids (NO) and 25 (46.3%) synthetic opioids (SO). The highest number with the 20-30 age range. Of the NBs from the NO, 31.03% were before 37 weeks. In contrast, in the SO, 88% were before 37 weeks (p < 0.05). In the NO, 89.65% weighed < 2.5 kg. In contrast, 100% of those in the SO weighed > 2.5 kg. In SO exhibited crying for >10 minutes at a high. Additionally, SO had a high frequency of sleep (P<0.05). The SO showed a high frequency of metabolic disorders (P<0.05). The frequency of sneezing was high in the SO (P<0.05). Nasal flaring was high in the SO (P<0.05). Respiratory rate index, defined as more than 60 breaths per minute and retractions> 60 breaths per minute, were high in the NO and SOs, respectively (P<0.05). Excessive sucking and poor nutrition were high in the NO, and SO, respectively (P<0.05). The regurgitation index (grade 3), and loose stools and watery stools were high in the SO (P < 0.05). Conclusion: The study highlighted the impact of the NB's gender and age at birth on the severity of the NAS symptoms, esprcially in SO group.
Background: Retinopathy of prematurity (ROP) is a preventable cause of blindness in children. This study evaluated the risk factors for ROP in preterm and at-risk neonates. Methods: This descriptive, analytical, cross-sectional study was conducted at Namazi and Hafez hospitals from April 2020 to March 2021. A sample size of 183 neonates was calculated based on previous studies. Data on demographic and clinical factors, including gestational age, birth weight, sepsis, respiratory support, packed cell transfusion, hypotension, Apgar score, and hypoglycemia, were collected from hospital records. Statistical analyses were performed using SPSS, employing chi-square and logistic regression tests, with a significance level set at P < 0.05. Results: The mean birth weight was 1444.9 +/- 335.59 grams, and the mean gestational age was 31.01 +/- 2.36 weeks. Lower gestational age and birth weight were significantly associated with ROP (P < 0.001). Among infants with a gestational age of less than 34 weeks, ROP severity was significantly associated with blood transfusion (P < 0.001), sepsis (P = 0.003 for zone, P = 0.03 for stage), and severe hypoglycemia (P < 0.001 for zone, P = 0.03 for stage). In infants born at or after 34 weeks, blood transfusion was the primary factor associated with ROP severity (P = 0.018 for zone). Conclusion: Our study identified lower gestational age, birth weight, blood transfusion, sepsis, and hypoglycemia as significant risk factors for ROP severity in neonates under 34 weeks of gestation. The findings underscore the importance of vigilant monitoring and management of these risk factors to prevent the progression of ROP.
Background: Congenital Pulmonary Airway Malformation (CPAM) is a rare problem in the development of the fetal tracheobronchial tree. If it is not treated properly, it can cause serious illness and even death. This report documents and emphasizes the challenges associated with postnatal CPAM diagnosis, the risks of significant surgical intervention, and the importance of meticulous clinical management to achieve the best possible patient outcomes. Case Report: This case report details the condition of a 14-day-old male neonate diagnosed with Type II CPAM, a collapsed area in his left lung, pneumonia, ASD, and VSD. The patient underwent surgery to remove his left lung on the 19th day after birth (5 days after admission). Chest tubes were placed after the operation. Although he experienced some complications after surgery, he gradually improved and was discharged 42 days after the surgery. Conclusion: Early surgery for symptomatic CPAM can lead to good outcomes, even in the presence of serious complications. To achieve the best results, it is important to have a multidisciplinary team, robust infection control, and long-term follow-up, especially in places with limited resources.
Background: The Apgar score is a widely used indicator for assessing newborn health immediately after birth. However, its predictive value for specific organ dysfunctions such as acute kidney injury (AKI) remains uncertain. This study aimed to evaluate the association between low 5-minute Apgar scores and the risk of AKI in neonates admitted to the neonatal intensive care unit (NICU). Methods: In this retrospective matched cohort study conducted between 2022 and 2024 at Amir Al-Momenin Hospital, 80 neonates (40 with Apgar <7 and 40 with Apgar >= 7) were enrolled. Neonates were matched 1:1 for gestational age and admission time. Serum creatinine was measured on days 1, 3, 5, and 7, and urine output was assessed on day 3 to diagnose AKI based on modified neonatal KDIGO criteria. Statistical analyses included the Chi-square test for categorical variables, Mann-Whitney U test for non-normally distributed continuous variables, and logistic regression analysis. Results: Low 5-minute Apgar scores were associated with a significantly higher incidence of AKI (20% vs. 5%, P = 0.043), with a 6.3-fold increased risk (OR = 6.29, 95% CI: 1.04-37.90, P = 0.045). Gestational age between 28-32 weeks independently increased the risk of AKI (OR = 13.84, P = 0.027). Although day 1 serum creatinine was higher in the normal Apgar group (P = 0.002), no differences were observed afterward. Male sex and vaginal delivery were more common in the low Apgar group but were not associated with AKI in multivariable analysis. Conclusion: A 5-minute Apgar score <7 and gestational age between 28-32 weeks are significant risk factors for AKI in NICU neonates. These findings highlight the potential of using Apgar score and gestational age for early risk stratification and targeted monitoring.
Neonatal lupus erythematosus (NLE) is a rare autoimmune condition which is caused by the passage of maternal autoantibodies through the placenta to the fetus. Manifestations of NLE in different organs are reversible and some are irreversible. Given the diverse and potentially life-threatening nature of NLE, the management of this condition requires a multidisciplinary approach. Research and clinical strategies in the treatment of neonatal lupus focus on managing symptoms and improving outcomes, especially in severe cases such as congenital heart block. Prenatal Therapies including fluorinated corticosteroid, intravenous immunoglobulin, terbutaline, plasmapheresis and hydroxychloroquine were suggested. Moreover, potential postnatal Therapies may include topical corticosteroids, blood or platelets transfusion, systemic corticosteroids, pacemaker insertion and anti-TNF drugs. Research should continue to explore novel therapies and improve our understanding of the disease mechanisms, aiming to further enhance treatment strategies in the future. The aim of this review is to provide an overview of the challenges in the diagnosis and management of NLE, typically including pathophysiology, clinical presentation, and therapeutic strategies.
Background: Neonatal sepsis and encephalopathy are life-threatening conditions marked by excessive inflammation and oxidative stress, contributing to high morbidity and mortality in newborns. Melatonin, a multifunctional indoleamine with potent antioxidant, anti-inflammatory, and immunomodulatory properties, has emerged as a promising adjunctive therapy in neonatal care. This review summarizes current evidence on melatonin’s biological functions and its potential to reduce inflammation, oxidative damage, and improve neonatal outcomes.Methods: A narrative review was conducted by searching PubMed, Scopus, Web of Science, and Google Scholar from 2000 to November 2025 using the keywords melatonin, neonatal sepsis, and methicillin-resistant Staphylococcus aureus (MRSA). Relevant experimental, preclinical, and clinical studies were identified, reviewed, and synthesized to provide an integrated overview of melatonin’s effects in neonatal sepsis and related inflammatory conditions.Results: Preclinical studies indicate that melatonin downregulates pro-inflammatory cytokines (e.g., TNF-α, IL-6) while enhancing anti-inflammatory mediators such as IL-10. It also preserves mitochondrial function, mitigating oxidative injury and neuroinflammation. Early clinical trials report that melatonin administration in septic and asphyxiated neonates reduces inflammatory biomarkers, lowers oxidative stress, and is well tolerated without major adverse effects. Challenges remain, including the distinct pharmacokinetics of neonates, variable clearance rates, heterogeneous study populations, and limited sample sizes, which complicate dose optimization and definitive conclusions on efficacy and long-term safety.Conclusion: Melatonin represents a safe and biologically potent adjunctive therapy for neonatal inflammatory disorders. Large-scale, multicenter randomized trials are warranted to establish standardized dosing, assess long-term neurodevelopmental outcomes, and confirm clinical efficacy in improving neonatal survival and recovery.
Background: Orogastric tube insertion is a painful procedure for neonates, particularly premature infants who are more vulnerable to pain and its consequences. Non-pharmacological, safe, and cost-effective pain management methods are essential in neonatal care. Tuina, a traditional Chinese massage technique, may reduce procedural pain in this population. This study aimed to evaluate the effect of Tuina massage on pain during orogastric tube insertion in premature neonates.Methods: A randomized controlled trial was conducted on 70 premature neonates admitted to a maternal and neonatal hospital in Ahvaz, Iran. Participants were randomly assigned into intervention (Tuina massage) and control (routine care) groups (n=35 each) using block randomization with R software. Pain levels, heart rate, and oxygen saturation were assessed using the Premature Infant Pain Profile (PIPP) at three time points: five minutes before, during, and five minutes after tube insertion. The intervention group received Tuina massage three times, each lasting one minute with 30-second intervals during these phases.Results: The intervention group showed a significant reduction in pain scores during and after tube insertion compared to the control group (p = 0.001, Cohen’s d = 0.927). Heart rate decreased and oxygen saturation increased significantly post-intervention in the Tuina group (p = 0.029).Conclusion: Tuina massage is an effective, accessible, and low-cost method for reducing procedural pain and improving physiological parameters in premature neonates, supporting its use as a valuable non-pharmacological intervention in NICU settings.
Background: Central venous catheter placement through a peripheral vein is considered a valuable care strategy for infants with low and very low birth weight but it can be associated with complications. This study aimed to determine the incidence of complications arising from central venous catheter placement through peripheral veins in premature infants admitted to the neonatal intensive care unit (NICU) and to identify related risk factors. Methods: This cross-sectional study was conducted on 323 premature infants with central venous catheters placed through peripheral veins who were admitted to the NICU of Shahid Sadoughi Educational Hospital in Yazd. Data were collected from March 2021 to March 2024 through the completion of a checklist assessing the catheter placement site by the nurse responsible for caring for infants during each shift. parametric and non parametric data analysis using SPSS software version 16. Results: The mean gestational age and birth weight were 30.7 +/- 2.83 weeks and 1391.63 +/- 467.47 grams, respectively. Besides, 27.2% of the premature infants with catheters experienced complications. The most common complications in order of frequency were phlebitis (6.2%), catheter occlusion (4%), and leakage of secretions (4%), while bloodstream infection had the lowest occurrence rate (0.9%). In the univariate logistic regression model, the likelihood of complications increased by 1.02 times for each additional day of NICU stay and was 4.6 times higher with improper catheter positioning. Conclusion: Continuous monitoring of the catheter insertion site for the occurrence of visible complications and the catheter's positioning should be prioritized in care. Moreover, the number of days of hospitalization could be reduced by improving the quality of treatment processes and nursing care.
Background: Oral stimulation program and non-nutritive sucking (NNS) have been introduced as a training program to promote oral feeding skills in preterm infants. However, no studies are available on the effects of different frequencies of performing this program on infants' feeding skills. The current study sought to find the more effective training frequency for this program on oral feeding skills of preterm infants. Methods: Thirty-two preterm infants were randomly allocated to two groups. Infants in Groups I and II respectively received one and two sessions of the oral stimulation program and NNS training per day for ten days. The outcome measures included transition time, dependency on tube feeding upon discharge, Preterm Oral Feeding Readiness Scale (POFRAS) score improvement, and weight gain during two weeks. Results: No significant differences were observed in the transition time and infant weight gain during two weeks. Both groups significantly improved the mean of POFRAS scores during the intervention period (22.63 +/- 4.08 to 27.69 +/- 3.14 in Group I; and from 20.13 +/- 5.89 to 28.88 +/- 3.00 in Group II; P < 0.001 for both groups). The POFRAS score was significantly more improved in Group II (P = 0.045). The ratio of infants who had reached full oral feeding upon discharge to those who were still tube-fed was almost 1.3 to 1 in Group I versus 7 to 1 in Group II. Conclusion: When the oral stimulation program and non-nutritive sucking are implemented twice a day, compared to only once, the probability of discharge of infants without a feeding tube may increase, and the level of their oral feeding readiness improves more, without having a detrimental effect on the weight gain of infants.
Background: Mother-neonate attachment is impaired when a premature neonate is hospitalized, affecting the neonate's growth and development and the mother's ability to care for the infant. This study aimed to determine the effect of horizontal neonate rocking on the attachment behaviors of mothers with premature neonates admitted to the neonatal intensive care unit (NICU). Methods: This clinical trial was conducted on 64 mothers with premature neonates hospitalized in the NICU of Hafezieh Hospital and Hazrat Zeinab Hospital in Shiraz in 2023. Participants were selected using convenience sampling and randomly assigned to control and intervention groups. In the intervention group, mothers performed horizontal rocking for two weeks, five days a week, four times a day for three minutes each time, half an hour before feeding their neonates. The Avant attachment questionnaire was completed by all participants. Data were analyzed using SPSS 24 with independent t-tests, paired t-tests, and chi-square tests. Results: After the intervention, the mother-neonate attachment score was significantly higher in the intervention group (18.58 +/- 3.85) compared to the control group (12.91 +/- 2.70) (P<0.001). In the intervention group, the mean scores for emotional behaviors increased from 4.64 +/- 1.43 to 6.84 +/- 1.93, and proximity behaviors increased from 2.61 +/- 1.45 to 7.10 +/- 1.51 (P<0.001). However, the mean score for caring behavior showed no significant difference between before (5.55 +/- 1.06) and after (4.65 +/- 1.14) the intervention (P>0.05). Conclusion: Horizontal rocking of neonates increased attachment behaviors, specifically emotional and proximity behaviors, in mothers with premature neonates. It is recommended that nurses in the NICU teach mothers the correct method of rocking premature neonates horizontally to enhance mother-neonate attachment.
Background: Accurate assessment of gestational age (GA) is important for management and monitoring of neonates. Traditional GA in neonates is assessed mother's first day of last menstrual period (LMP) which can be inaccurate in case of irregular cycle and poor y. Fetal age assessment TCD well studied but studies in neonatal period. The emerging biometric parameter, transverse cerebellar diameter (TCD), offers advantages as it remains unaffected by conditions alter skull shape and antenatal growth fluctuations. Aim to evaluate the effectiveness of TCD measurement neonatal gestational age.Methods: This prospective cross-sectional study included 112 neonates, spanning preterm and term infants, assessed within 72. Last Menstrual Period (LMP) was used to determine GA. TCD scans were conducted a GE LogiQ-V2 scanner and pediatric curvilinear probe.Results: There was a statistically significant correlation (p < 0.0001) between TCD and gestational age. Linear regression analysis showed 0.4052 change in gestational age per unit change in TCD. Spearman correlation analysis show strong positive correlations between TCD and gestational age (r = 0.8786), weight (r = 0.8242) and length (r = 0.8526). A regression equation based on TCD predict neonatal gestational age. Additionally, TCD demonstrated a very strong positive correlation with asymmetric IUGR (r = 0.9161) but a weak positive correlation with symmetric IUGR in relation to gestational age (r = 0.4761). Notably, comparisons with other studies in diverse ethnic populations revealed significant differences in TCD findings.Conclusion: Despite not directly indicating IUGR, TCD shows potential utility in estimating neonatal gestational age as it correlates significantly with advancing gestational a
Background: Aortic thrombosis represents an uncommon yet severe condition in this population, often associated with umbilical arterial or venous catheterization, sepsis, prematurity, or thrombophilia. Due to its low frequency, standardized management guidelines are lacking, and therapeutic decisions are frequently extrapolated from adult data. Available treatment options include anticoagulation, systemic or catheter-directed thrombolysis, and surgical thrombectomy, each with variable reported outcomes. Given the limited evidence and absence of consensus, individual cases contribute valuable insight into therapeutic safety and effectiveness in neonates with aortic thrombosis.Case Report: A late preterm female neonate, weighing 2,500 grams, presented with congenital pneumonia and suspected sepsis, necessitating orotracheal intubation and antibiotic administration via an umbilical venous catheter. On day five, she developed vasospasm in the right lower limb, unresponsive to catheter removal. Doppler ultrasound revealed infrarenal abdominal aorta thrombosis extending to the iliac arteries. Despite being hypotensive and in poor condition, she underwent successful thrombectomy and catheter-directed thrombolysis with alteplase, with post-procedure Doppler demonstrating improved blood flow. Outpatient management with low molecular weight heparin was continued, and follow-up revealed no further thrombotic events, with thrombophilia tests remaining normal. Due to the low incidence of thromboembolic events in children, most treatment information is extrapolated from adult guidelines, with anticoagulation, thrombolytic agents, and thrombectomy as options, though no consensus exists on their use, particularly in neonates.Conclusion: This case demonstrates the utility and effectiveness of catheter-directed thrombolysis as a safe treatment method for these patients.
Background: To investigate the possible effect of hematological parameters and other risk factors on the development of retinopathy of prematurity (ROP) in preterm infants born at 32 weeks' gestational age (GA) and older. Methods: Infants having a birth weight (BW) above 1250 g and born at 32-35 weeks' GA with any stage of ROP disease were included in the study, while infants without ROP and born at 32-35 weeks' GA were randomly selected to form the control group (non-ROP group). Complete blood cell count (CBC) parameters obtained on the first day of preterms' life were analysed, and delivery type, cause of preterm birth, total number of births and smoking status during pregnancy were recorded. Infant-related factors, such as the GA at birth, BW) and total time spent in NICU were also recorded, and all parameters were compared between groups. Results: In total, 50 preterm infants were included in the study, 20 in the ROP group and 30 in the control group (non-ROP). No significant differences in hematological parameters were found between groups, though red blood cell (RBC) transfusion was found to be more common in the ROP group (p: 0.03). Conclusion: There were no statistically significant differences in hematological parameters measured on the infants' first day of life following preterm birth at 32-35 weeks' GA and a 1250 g BW. Therefore, RBC transfusion may be a risk factor for ROP development in late preterm infants.
Background: This study aimed to evaluate whether administering low-dose hydrocortisone after the first fourteen days of life affects the incidence of bronchopulmonary dysplasia (BPD), mortality, and other short-term complications in mechanically ventilated preterm infants. Methods: A randomized clinical trial was conducted between 2019 and 2022 in the NICUs of Shariati and Valiasr hospitals in Tehran. Infants received either hydrocortisone or placebo for 10 days and were followed until a corrected gestational age of 36 weeks. Baseline characteristics, primary outcomes, and secondary outcomes were recorded for all participants. Results: The mean gestational age of infants in this study was 28.2 +/- 1.79 weeks. The cohort included 45 male infants (64.3%) and 25 female infants (35.7%). Mortality rates and the need for supportive oxygen treatment were significantly different between the two groups (P < 0.05). The rate of hypertrophic myocarditis also differed significantly (P < 0.05). Conclusion: In summary, systemic corticosteroid use led to reductions in mortality and BPD by corrected age of 36 weeks. Although there are differences between dexamethasone and hydrocortisone, hydrocortisone decreased mortality but did not significantly reduce BPD incidence. Moreover, late systemic hydrocortisone treatment significantly shortened the duration of mechanical ventilation in infants.
Background: To evaluate the diagnostic utility of Cerebrospinal fluid (CSF) Procalcitonin in the diagnosis of neonatal meningitis. Methods: We included 43 neonates with sepsis and suspected meningitis as study subjects. These neonates were categorized into meningitis and non-meningitis groups based on CSF cytology and biochemical parameters. Results: Among the subjects, 22 neonates were categorized into the meningitis group and 21 neonates were in the nonmeningitis group, based on Cerebrospinal fluid cytology and biochemical parameters. The mean CSF Procalcitonin values were 0.48 +/- 0.37 ng/ml and 0.20 +/- 0.08 ng/ml in the meningitis and non-meningitis groups, respectively. A CSF Procalcitonin cut-off value of 0.13 ng/ml demonstrated a sensitivity of 86.36% and a specificity of 23.81% in diagnosing neonatal meningitis. This cut-off value also yielded a positive predictive value of 54.29% and a negative predictive value of 62.50%, with an area under the curve of 0.789 (0.645-0.933). Conclusion: CSF Procalcitonin serves as a reliable biomarker. CSF procalcitonin levels can be utilized as an additional diagnostic marker alongside traditional markers such as CSF protein, sugar, cell count, and culture, particularly when CSF culture results are negative, lumbar puncture is traumatic, or the biochemical and cytological analysis of CSF is inconclusive.
Background: Retinopathy of prematurity (ROP) poses a serious challenge to the health of preterm infants. Given that blindness caused by this disease is treatable—and considering its higher incidence in developing countries—we investigated the prevalence and identified risk factors associated with ROP.Methods: This cross-sectional study included 100 premature infants with a gestational age of less than 37 weeks and a birth weight of less than 2500 g. All infants were examined for ROP by an ophthalmologist beginning from the fourth postnatal week. Comparisons were made between two groups: those with ROP and those without.Results: The prevalence of ROP in this study was 21%. The analysis showed a significant association between the occurrence of ROP and gestational age (P = 0.031), as well as the number of ventilator days (P = 0.05). However, no significant relationship was found between ROP occurrence and sex, age, birth weight, sepsis, oxygen therapy, Apgar score, intraventricular hemorrhage (IVH), pneumothorax, corticosteroid use, or surfactant administration (all P > 0.05).Conclusion: Preventive measures should be taken to reduce the incidence of premature deliveries. Additionally, clinicians should be aware of the increased risk of ROP when providing ventilation and adopt intelligent oxygen therapy and appropriate management strategies.
