OBJECTIVE:This study aimed to evaluate the association between serum magnesium levels and the risk of symptomatic patent ductus arteriosus in premature infants. MATERIAL AND METHOD:This retrospective single-centre cohort study analysed the medical records of patients. Neonates were categorised into two groups based on the presence or absence of symptomatic patent ductus arteriosus. Demographic factors including gender, gestational age, type of birth, birth weight, multiple pregnancies, medical treatment for duct closure or surgical ligation, length of hospital stay, and mortality and neonatal outcomes were compared between the groups. The relationship between serum magnesium levels at 24 hours of age and the risk of symptomatic patent ductus arteriosus and other neonatal morbidities was assessed. RESULTS:This study found no significant relationship between symptomatic patent ductus arteriosus and serum magnesium levels. Additionally, no significant differences were observed between serum magnesium levels and ductal diameter, nor in the need for medical or surgical intervention for symptomatic patent ductus arteriosus. However, neonates with serum magnesium levels greater than 3 mg/dL exhibited a significantly higher incidence of respiratory distress syndrome. Conversely, the prevalence of bronchopulmonary dysplasia was significantly lower in this group, with both findings reaching statistical significance (p < 0.05). CONCLUSION:These results suggest that while serum magnesium levels may not be a reliable marker for symptomatic patent ductus arteriosus, they could have clinical implications in the modulation of neonatal respiratory outcomes. Further research is warranted to explore the underlying mechanisms and assess the potential therapeutic role of magnesium in the management of neonatal morbidities.

OBJECTIVE:To investigate early metabolic biomarkers in neonates born to mothers with gestational diabetes mellitus (GDM), focusing on amino acid and acylcarnitine profiles to assess metabolic risk, including obesity and future metabolic syndrome. METHODS:This retrospective study analyzed dried blood spot samples from 184 GDM and 167 control neonates. GDM was categorized as large-for-gestational-age (LGA) or appropriate-for-gestational-age (AGA). Amino acid and acylcarnitine concentrations at 24-48 h postnatal age were measured using liquid chromatography-tandem mass spectrometry (LC-MS/MS). Neonatal hypoglycemia was defined and managed according to standard guidelines. Principal component analysis (PCA) was performed to identify clustering patterns. RESULTS:Tyrosine concentrations were significantly lower in the GDM-LGA group compared to the control-AGA group (p = 0.018). Total carnitine levels were higher in GDM-LGA infants relative to controls (p < 0.05), reflecting increased fatty acid mobilization in larger infants. Specific long-chain acylcarnitines, such as C18:1 and C18:2, were lower in GDM group. whereas stearoyl carnitine (C18:0) was elevated, indicating an altered fatty acid oxidation profile. PCA revealed distinct metabolic patterns, suggesting early metabolic heterogeneity in GDM. CONCLUSION:The study identifies distinctive early metabolic profiles in neonates of gestational diabetic mothers, including lower tyrosine and altered acylcarnitine patterns, which may signal a predisposition to metabolic disorders. These findings support early metabolic screening protocols and targeted follow-up for high-risk infants. Longitudinal studies are warranted to confirm the predictive value of these biomarkers and to clarify the long-term impacts of metabolic disturbances in GDMs.

Background/Objectives: Intrahepatic cholestasis of pregnancy (ICP) is associated with adverse perinatal outcomes. However, its metabolic consequences on newborns remain inadequately characterized. This study investigated amino acid, carnitine, and acylcarnitine profiles in neonates born to mothers with ICP. Methods: This retrospective study encompassed 299 neonates born to mothers with ICP. For comparative analysis, term infants without additional complications (ICP-term, n = 150) were compared with term controls (n = 150). Capillary blood samples collected at 24–48 h of life as part of newborn screening were analyzed using LC–MS/MS for acylcarnitine and amino acid profiles. Results: The ICP cohort exhibited a high preterm delivery rate (46.2%), with maternal bile acids negatively correlating with gestational age (r = −0.266, p < 0.001). No inborn errors of metabolism were observed. Elevated levels of amino acids (alanine, leucine/isoleucine, valine, tyrosine, arginine, glycine, and ornithine) and specific acylcarnitines (C5, C5-OH, C10:1, and C18:2), along with decreased levels of amino acids (argininosuccinic acid and glutamic acid) and specific acylcarnitines (C3, C5-DC, C6-DC, C14, C14:1, C16, C16:1, and C18:1-OH), were observed in ICP-term neonates (p < 0.05). Receiver operating characteristic curve analysis identified ornithine (area under the curve [AUC] = 0.74) and leucine/isoleucine (AUC = 0.73) as strong discriminators. A multivariable model integrating multiple metabolites achieved high accuracy (AUC = 0.86 ± 0.03). Conclusions: This first comprehensive characterization of neonatal metabolic alterations in ICP reveals amino acid metabolism, fatty acid oxidation, and mitochondrial function disruptions, suggesting fetal adaptation to a cholestatic intrauterine environment. Metabolomic profiling may improve understanding of maternal–fetal interactions and inform strategies for risk stratification and long-term monitoring.

Aim: Although indirect hyperbilirubinemia is the most common neonatal problem in term newborns, it is rarely observed in newborns with some inherited metabolic diseases. Therefore, we aimed to compare the frequency of indirect hyperbilirubinemia in newborns with these diagnoses and compare them with healthy newborns. Materials and Methods: In the study group, term newborns with inherited metabolic diseases characterized by metabolic acidosis and/or hyperammonemia were included retrospectively and prospectively between January 1st, 2001, and December 31st, 2014. Healthy-term newborn infants were prospectively included in the control group. Results: In the study group (n=106), 63.2% of the patients had organic acidemia, 20.8% urea cycle disorders, 4.7% mitochondrial diseases, 5.7% fatty acid oxidation disorders, and 5.7% other diseases, while the control group included 126 healthy term newborns. Mean serum indirect bilirubin levels were significantly lower in the study group compared to the control group (5.8±5.4 mg/dL vs 13.9±4.1 mg/dL, p<0.00, respectively). The frequency of phototherapy was 11.3% in the study group and 23.8% in the control group (p<0.05). While the incidence of jaundice was significantly lower in organic acidemia, urea cycle disorder, and fatty acid oxidation disorders (p<0.05), there was no difference in mitochondrial disease compared to the control group (p>0.05). Conclusion: This was the first epidemiological study aiming to determine a very low incidence of neonatal jaundice in newborns with inherited metabolic diseases characterized by metabolic acidosis and/or hyperammonemia. The exact pathophysiological mechanism of this strikingly low incidence of indirect hyperbilirubinaemia in these newborns should be investigated with prospective biochemical, enzymatic, molecular, and genetic studies.

Pyloric atresia is a rare gastrointestinal anomaly with an incidence of 1/100,000 in live births. It is usually seen as an isolated condition or in combination with other congenital or hereditary anomalies. Autosomal recessive inherited either fatal or non-fatal variants of pyloric atresia with epidermolysis bullosa are known due to mutations in ITGA6, ITGB4, and PLEC genes. ITGB4 gene mutation was recently identified in 5 siblings in 2 families associated with familial isolated pyloric atresia. Herein, we present two siblings who had pyloric atresia together with a homozygous variant in the ITGB4 gene and without epidermolysis bullosa. The development of isolated familial pyloric atresia without epidermolysis bullosa may occur due to homozygous variants of the ITGB4 gene. Detection of more variants in this gene may help to establish a genotype-phenotype correlation and may suggest the ITGB4 gene in patients who have pyloric atresia without epidermolysis bullosa.

IntroductionRare and ultra-rare genetic conditions significantly contribute to infant morbidity and mortality, often presenting with atypical features and genetic heterogeneity that complicate management. Rapid genome sequencing (RGS) offers a timely and cost-effective approach to diagnosis, aiding in early clinical management and reducing unnecessary interventions. This pilot study represents the inaugural use of next-generation sequencing (NGS) as a diagnostic instrument for critically ill neonatal and pediatric ICU patients in a Turkish hospital setting.MethodsTen infants were enrolled based on predefined inclusion criteria, and trio RGS was performed. The mean age of the participants was 124 days, with congenital abnormalities being the most common indication for testing. Three patients had consanguineous parents. The mean turnaround time from enrollment to delivery of results was 169 h, with a diagnostic yield of 50%.ResultsThree patients received a definitive molecular diagnosis, impacting their clinical management. Two patients benefited from the exclusion of Mendelian conditions, leading to alternative diagnoses.DiscussionThis study demonstrates the feasibility and results of RGS in Turkish hospital settings, emphasizing the importance of timely genetic diagnosis in reducing the diagnostic odyssey for families and improving patient care. Further research is needed to evaluate the cost-effectiveness and applicability of RGS in the Turkish healthcare system for children with diseases of uncertain etiology.

İnvaziv fungal enfeksiyonlar çok düşük ve aşırı düşük doğum ağırlıklı prematüre bebeklerde sık görülen, morbidite ve mortaliteye neden olabilen nozokomiyal enfeksiyonlardır.Yenidoğanlarda en sık etken Candida albicans'tır.Yenidoğan bebeklerde sepsis bulguları varlığında invazif fungal enfeksiyonlar mutlaka akla getirilmelidir.Santral sinir sistemi (SSS) tutulumuna rağmen kan kültüründe etken saptansa da beyin omurilik sıvısında kültür pozitifliği gösterilemeyebilir bu sebeple invaziv kandidiazis olgularında tedaviye SSS'yi kapsayacak şekilde başlanmalıdır

Background: Nucleic acid-based assays provide an opportunity to screen for genetically encoded diseases like spinal muscular atrophy (SMA), before the onset of symptoms. Nowadays, such assays could be easily utilized as high-throughputs in SMA to detect a homozygous deletion of exon 7 of the survival motor neuron 1 gene (SMN1) that is responsible for >95% of SMA patients. Methods: We developed a new line method (NLM) as a direct real time PCR test procedure without nucleic acid extraction in dried blood spots (DBS) to screen for homozygous deletion of exon 7 of the SMN1 gene. Performance of this setup was evaluated on 580 DBS newborn samples and air dried 50 DBS from whole blood including 20 samples for homozygous deletion of the SMN1 gene detected earlier with MLPA. Results: We found all 580 newborn DBS samples as wild type. DBS prepared from 50 whole blood samples also including 20 affected people were correctly identified as homozygous deletions and 30 wild types of exon 7 of SMN1 as before with MLPA. When the MLPA method was taken as the gold standard, the sensitivity and specificity of the NLM test were found 100% for the detection of SMN1 exon 7 homozygous deletion. Conclusion: In the NLM, the total test duration has been reduced to less than 75 min without requiring any extra process such as DNA extraction step and sample plate preparation after the punching step. Thereby, newborn SMA screening with the NLM has gained an environmentally friendly feature with not requiring additional tedious steps.

The incidence of invasive candidiasis (IC) in neonatal intensive care units (NICUs) has significantly increased. Although C. albicans is still the most common pathogen detected in IC cases (60-75%), the increase in the use of prophylactic antifungal therapies and empirical echinocandin has led to a shift in detected pathogens to non-albicans candida species such as C. glabrata (2-8%). In the past, C. glabrata was considered one of the relatively non-pathogenic saprophytes of the normal flora. However, mucosal and systemic C. glabrata infections have escalated with the increase in the survival rates of premature newborns, prolonged hospitalization, and the widespread use of immunosuppressives and broad-spectrum antibiotics and started to appear more frequently as an important nosocomial pathogen, especially with its natural resistance to the azole antifungals. In this article, we aimed to draw attention to the importance of C. glabrata in NICUs by presenting extremely low-birth-weight premature twins with severe clinical course.

Introduction: While the World Health Organization (WHO), the American Academy of Pediatrics (AAP) and the United Nations Children's Fund (UNICEF) recommend exclusive breastfeeding in the first 6 months of life, the AAP recommends continuity of breastfeeding beyond the age of 1 and WHO beyond the age of 2 years. We aimed to determine the rate, causes and contributing risk factors of early formula milk supplementation (FMS) both in hospital setting during early postpartum and post-discharge follow-up in a baby friendly hospital. Materials and Methods: The study was done retrospectively by collecting the recorded data of mothers and their healthy infants that were born in a private baby-friendly hospital from January 2020 to January 2021. Results: FMS rate during hospital stay was 13.78% (n=128). C/S delivery is significantly higher in formula milk supplemented group. While breast milk insufficiency was determined as the most common cause for FMS, as a result of logistic regression analysis, pregnancy with assisted reproductive technique, multiple pregnancy, birth weight less than 2500 g, gestational age less than 37 weeks, maternal/obstetrical diseases, gestational diabetes mellitus and smoking mother were determined as potent factors on FMS. Conclusion: The negative effects of possible risk factors can be significantly reduced if adequate support is given to the mother by health professionals after birth, the hospital's written breastfeeding policy is followed, FMS is not given other than medical indications and breastfeeding counseling continues after discharge.

A premature female infant, born after 23 weeks of gestation through a cesarean section of a 23-year-old mother, was admitted to the neonatal intensive care unit with a birth weight of 600 g. On the postnatal day 103 (corrected gestational week, cGW, 37+4), labial edema and clitoral swelling were observed (Fig. 1A). Blood tests showed high follicle-stimulating hormone (FSH) and luteinizing-hormone (LH) concentrations (19.5 mIU/mL [normal range 1.2–12.5] and 35.4 mIU/mL [<7]), and extremely high estradiol (138 ng/L [<20]) levels. Pelvic sonography showed multiple ovarian follicles in both ovaries, the largest was 11 mm in diameter (Fig. 2), and an enlarged uterus with a size of 34 × 20 × 9 mm. The patient was diagnosed with preterm ovarian hyperstimulation syndrome (POHS). The external genitalia swelling, and gonadotropin and estradiol concentrations started regressing by postnatal day 165 (corrected age 46 days) with no medical intervention (Fig. 1B). No vaginal bleeding was detected during observation. The infant's follow-up laboratory results showed a decrease in FSH, LH, and estradiol concentrations (cGW, 44), 17.7 mIU/mL (1.2–12.5), 4.13 mIU/mL (<7), and 79.6 ng/L (<20), respectively. Due to the gradual clinical resolution, no further follow-up was needed. POHS is a rare self-resolving disorder, presenting with increased levels of gonadotropins in preterm infants, that occurs due to hypothalamic–pituitary–gonad axis immaturity with diminished negative feedback and early disappearance of placental steroids.1Durst M.A. Wicklow B. Narvey M. Atypical case of preterm ovarian hyperstimulation syndrome.BMJ Case Rep. 2017; 2017bcr2016217517PubMed Google Scholar It manifests in preterm newborns with edema in the vulva, upper leg, hypogastric region, and ovarian cyst/cysts, and with elevated gonadotropin and estradiol levels.2Altuntas N. Turkyilmaz C. Yuce O. Kulali F. Hirfanoglu I.M. Onal E. et al.Preterm ovarian hyperstimulation syndrome presented with vaginal bleeding: a case report.J Pediatr Endocrinol Metab. 2014; 27: 355-358Crossref PubMed Scopus (10) Google Scholar The differential diagnoses include clitoromegaly, which is most commonly related to androgen excess, and less well-known nonandrogenic disorders, such as neurofibromatosis, epidermoid cysts, and other tumors, and conditions including Apert and Fraser syndromes. In this case, hyperandrogenism was excluded through laboratory testing of testosterone and dehydroepiandrosterone sulfate (DHEAS) levels. Misdiagnosing the clitoral swelling as clitoromegaly in these patients causes unnecessary laboratory tests for hyperandrogenism.3Lee Y.L. Jamli F.M. Preterm ovarian hyperstimulation syndrome presenting as clitoromegaly in a premature female infant.Arch Dis Child. 2022; 107: 166-167Crossref PubMed Scopus (1) Google Scholar However, virilization can be excluded by the absence of labial fusion, the most important finding of antenatal hyperandrogenism, and the presence of separate vaginal and urethral openings. The clinical diagnosis of POHS is important to prevent unnecessary laboratory testing in infants with clitoral swelling.Figure 2Pelvic ultrasonography showed large ovarian follicles in the right ovary. The largest diameter was 11 mm.View Large Image Figure ViewerDownload Hi-res image Download (PPT) ZAA: writing up the report, SA: named consultant, writing up the report, obtaining parenteral consent, SB: named consultant, writing up the report, AK: named consultant, writing up the report. The authors haven't received a specific grant for this research from any funding agency in the public, commercial, or not-for-profit sectors.

Taskires play a significant role in the dissemination of knowledge on a variety of topics, including the birth, death, education, and artistic sense of poets.In addition to these, they're also among the sources consulted by disciplines such as sociology and history in terms of the information they contain about the social, economic and cultural life of the period and the content that will help history.In this study, first of all, the 16th, 17th and 18th century poets' taskires have been analyzed in terms of the expressions used in describing the birth of the poets and their style of expression.The findings obtained as a result of the analysis have been categorized and divided into sub-headings.It's observed that some of the expressions related to birth were created using metaphorical and figurative elements, while others were used literally.While there are very few expressions about birth in some taskires, it's noteworthy that some taskires have a high number of birth expressions.At the same time, it's seen that some of the birth expressions have a very plain and unimaginative, realistic structure, while others are shaped by the authors' broad imagination, rich vocabulary and artistic sense.While it isn't possible to find information about the poets' birth dates in all of the examples, the place of birth is mentioned in almost all of them.It can be said that this situation in specifying dates may have a mystical substructure or may have developed based on a lack of knowledge considering the conditions of the period.At the end of the review, the findings and inferences are discussed in the conclusion section.Accordingly, it has been observed that some of the authors of taskire describe the birth event using atypical metaphors, while others express birth with tropes and idioms.

Background Data on the long-term effects of neonatal acute kidney injury (AKI) are limited. Methods We invited 302 children who had neonatal AKI and survived to hospital discharge; out of 95 patients who agreed to participate in the study, 23 cases were excluded due to primary kidney, cardiac, or metabolic diseases. KDIGO definition was used to define AKI. When a newborn had no previous serum creatinine, AKI was defined as serum creatinine above the mean plus two standard deviations (SD) (or above 97.5 th percentile) according to gestational age, weight, and postnatal age. Clinical and laboratory features in the neonatal AKI period were recorded for 72 cases; at long-term evaluation (2–12 years), kidney function tests with glomerular filtration rate (eGFR) by the Schwartz formula, microalbuminuria, office and 24-h ambulatory blood pressure monitoring (ABPM), and kidney ultrasonography were performed. Results Forty-two patients (58%) had stage I AKI during the neonatal period. Mean age at long-term evaluation was 6.8 ± 2.9 years (range: 2.3–12.0); mean eGFR was 152.3 ± 26.5 ml/min/1.73 m 2 . Office hypertension (systolic and/or diastolic BP ≥ 95 th percentile), microalbuminuria (> 30 mg/g creatinine), and hyperfiltration (> 187 ml/min/1.73 m 2 ) were present in 13.0%, 12.7%, and 9.7% of patients, respectively. ABPM was performed on 27 patients, 18.5% had hypertension, and 40.7% were non-dippers; 48.1% had abnormal findings. Female sex was associated with microalbuminuria; low birth weight (< 1,500 g) and low gestational age (< 32 weeks) were associated with hypertension by ABPM. Twenty-three patients (33.8%) had at least one sign of microalbuminuria, office hypertension, or hyperfiltration. Among 27 patients who had ABPM, 16 (59.3%) had at least one sign of microalbuminuria, abnormal ABPM (hypertension and/or non-dipping), or hyperfiltration. Conclusion Even children who experienced stage 1 and 2 neonatal AKI are at risk for subclinical kidney dysfunction. Non-dipping is seen in four out of 10 children. Long-term follow-up of these patients is necessary.

BACKGROUND:Our objective in this study was to assess the association between eNOS gene, that achieves synthesis of nitric oxide especially in the endothelial cells known to have an important role in angiogenesis and vasculogenesis, G894T, intron 4 VNTR (27-bp repeat) and T786C functional polymorphisms and retinopathy of prematurity (ROP), which is an important cause of morbidity in premature or low birth weight babies.METHODS:A total of 139 babies who were followed up in our neonatal intensive care unit because of premature birth in our hospital or admitted to our unit. 69 of them had retinopathy of prematurity and comprised the patients group. The remaining 70 babies who did not have ROP comprised the control group. An additional of 1 ml of blood samples were drawn from babies who were in the study groups during routine laboratory analysis. eNOS gene polymorphisms were determined by using polymerase chain reaction method.RESULTS:eNOS G894T, intron 4 VNTR and T786C gene polymorphisms did not differ between the patient and control groups (p > 0.05). Using logistic regression analysis; while gender did not differ between two groups; gestational age, birth weight, time on mechanical ventilation differ between two groups. After adjustment for variables other than eNOS gene polymorphisms, we found no significant difference in the genotype distribution of eNOS G894T, intron 4 VNTR and T786C polymorphisms (p > 0.05).CONCLUSION:We observed no association between ROP and eNOS gene polymorphisms but needs more investigation.

The peer review history for this article is available at https://publons.com/publon/10.1111/pai.13460.

Background Acute kidney injury (AKI) is a common complication of congenital heart diseases (CHDs) after cardiac surgery. This study aimed to define the frequency and critical course, risk factors and short-term outcomes of AKI in postoperative CHD neonates. Methods Postoperatively followed term CHD newborn infants were enrolled in the study. Infants with congenital anomalies of the urinary tract and other major congenital anomalies were excluded. Neonatal modified KDIGO criteria were used to assess AKI. Results A total of 199 postoperatively followed newborn infants were included in the study. Acute kidney injury was detected in 71 (35.6%) patients. Of these patients, 24 (33.8%) were in stage 1, 14 (19.7%) in stage 2, and 33 (46.5%) in stage 3. Acute kidney injury occurred within the first week (median 1 day [IQR 1-2 d ays]) of cardiac surgery in 93% of the patients. The duration of invasive respiratory support and extracorporeal membrane oxygenation (ECMO) and mortality were significantly higher in stage 3 patients. Higher vasoactive-inotropic score (OR, 1.02; 95% CI, 1.0-1.04; p = 0.008) and receiving ECMO (OR, 7.9; 95% CI, 2.6-24.4; p = 0.001) were associated with risk for the development of AKI. The mortality rate was 52.1% in the AKI (+) patients, and having AKI (OR 7.1; 95% CI, 3.5-14.18) was significantly associated with mortality. Conclusion Acute kidney injury, a common early complication after critical neonatal CHD cardiac surgery, is associated with increased morbidity and mortality. Stage 3 AKI is associated with significantly higher mortality rates.

Introduction: Restricted or enhanced intrauterine growth is associated with elevated risks of early and late metabolic problems in humans. Metabolomics based on amino acid and carnitine/acylcarnitine profile may have a role in fetal and early postnatal energy metabolism. In this study, the relationship between intrauterine growth status and early metabolomics profile was evaluated. Materials and Methods: A single-center retrospective cohort study was conducted. Three hundred and sixty-one newborn infants were enrolled into the study, and they were grouped according to their birth weight percentile as small for gestational age (SGA, n = 69), appropriate for gestational age (AGA, n = 168), and large for gestational age (LGA, n = 124) infants. In all infants, amino acid and carnitine/acylcarnitine profiles with liquid chromatography-tandem mass spectrometry (LC-MS/MS) were recorded and compared between groups. Results: LGA infants had higher levels of glutamic acid and lower levels of ornithine, alanine, and glycine (p < 0.05) when compared with AGA infants. SGA infants had higher levels of alanine and glycine levels when compared with AGA and LGA infants. Total carnitine, C0, C2, C4, C5, C10:1, C18:1, C18:2, C14-OH, and C18:2-OH levels were significantly higher and C3 and C6-DC levels were lower in SGA infants (p < 0.05). LGA infants had higher C3 and C5:1 levels and lower C18:2 and C16:1-OH levels (p < 0.05). There were positive correlations between free carnitine and phenylalanine, arginine, methionine, alanine, and glycine levels (p < 0.05). Also, a positive correlation between ponderal index and C3, C5-DC, C14, and C14:1 and a negative correlation between ponderal index and ornithine, alanine, glycine, C16:1-OH, and C18:2 were shown. Conclusion: We demonstrated differences in metabolomics possibly reflecting the energy metabolism in newborn infants with intrauterine growth problems in the early postnatal period. These differences might be the footprints of metabolic disturbances in future adulthood.

Central diabetes insipidus (CDI) is a water homeostasis disorder characterized by an inability to concentrate urine because of insufficient production of antidiuretic hormone.Dehydration with hypernatremia can occur during the neonatal period in preterm neonates in association with insensible water loss, high urine output, and reduced sodium excretion.A high index of suspicion is required to diagnose CDI in preterm neonates.We report two cases, who presented persistent hypernatremia with polyuria despite increased fluid supply and low sodium intake.CDI diagnosis was confirmed by the therapeutic test with oral vasopressin analog.Investigations were all normal; CDI was considered idiopathic.Persistent hypernatremia despite increased fluid intake with polyuria, hyposthenuria, low urine output, and high plasma osmolality is the key point for the diagnosis.

Introduction: The exact definition of small-for-gestational-age (SGA) infant is still controversial among clinicians. In this study, we aimed to understand which definition is better in terms of establishing both early postnatal problems and growth. In this way, we compared early neonatal problems and infancy growth of term infants with birth weight (BW) < -2 SDS and with BW between 10th percentile (−1.28 SDS) and −2 SDS. Methods: A single center retrospective cohort study was conducted. Preterm infants, multiple gestations and newborns with any congenital anomalies were excluded from the study. Study group was defined as Group 1 (n = 37), infants BW < −2.00 SDS; Group 2 (n = 129), between −1.28 and −2.00 SDS; and Group 3 (n = 137), randomly selected newborns with optimal-for-gestational-age (BW between −0.67 and +0.67 SDS) as a control group. Results: The incidence of severe hypoglycemia was highest in Group 1 (%10.8) and Group 2 and 3 had similar rates of severe hypoglycemia (0.8 and 0.7%, respectively). The incidence of polycythemia was 5.4% in Group 1 and was significantly higher than Group 3 (0.0%) while it was 2.3% in Group 2. Short stature (length < −2 SDS) ratio at the age of 1 and 2 years were similar in each group. Overweight/obesity ratio at the age of 1 were 9.5, 20.8 and 16.7% in each group, respectively (p = 0.509). Conclusion: This study was planned as a pilot study to determine potential differences in the problems of hypoglycemia, polycythemia, and growth according to the differences in definition. Short term disturbances such as hypoglycemia and polycythemia are found to be higher in infants with a BW SDS below −2. From this point of view, of course, it will not be possible to change the routine applications immediately, however this study will be an initiative for discussions by making long-term studies.