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    Growth Velocity and Breastfeeding Rates of Preterm Infants After Hospital Discharge
    (Wiley, 2025) Say, Birgul Livaoglu; Demir, And; Akdag, Arzu; Uras, Nurdan
    [Abstract Not Available]
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    Impact of Short-Term Freezing at-20°C on Macronutrient Content in Human Milk from Preterm Infants
    (Mary Ann Liebert, Inc, 2025) Livaoglu Say, Birgul; Hatipoglu, Halil Ugur; Uras, Hatice Buse; Uras, Nurdan
    Objectives: Breast milk is an ideal food for newborns born term and preterm. The short-term storage of human milk (HM) involves freezing at low temperatures; however, its effects on macronutrients remain unclear. The macronutrients in HM are generally thought to be unaffected by short-term freezing. This study aimed to analyze the impact of freezing HM from preterm infants at -20 degrees C for 5 days on macronutrient content. Methods: HM samples were collected from 54 mothers of preterm infants. Each sample was divided into three aliquots and stored at -20 degrees C for 1 and 5 days. After thawing and homogenization, energy and macronutrient contents were measured using a HM infrared spectroscopy analyzer. Results: We analyzed 162 samples (from 54 mothers of preterm infants). Mean baseline concentrations in fresh milk were protein 1.55 +/- 0.61 g/100 mL, carbohydrates 6.87 +/- 0.81 g/100 mL, fat 4.29 +/- 2.16 g/100 mL, and energy 75.9 +/- 27.3 kcal/100 mL. Freezing at -20 degrees C reduced protein to 1.33 +/- 0.35 g/100 mL after 24 hours and 1.21 +/- 0.38 g/100 mL after 5 days (14.2% and 21.9% decrease, p < 0.001), fat to 3.23 +/- 1.15 g/100 mL and 3.04 +/- 1.40 g/100 mL (24.7% and 29.1% decrease, p < 0.001), and energy to 64.3 +/- 12.8 kcal/100 mL and 61.7 +/- 16.1 kcal/100 mL, respectively (p < 0.001); carbohydrate content remained unchanged (p = 0.41). Conclusions: Freezing HM at -20 degrees C for 5 days can significantly reduce critical nutrients, including fat and protein, suggesting the need for individualized fortification strategies to ensure optimal growth in preterm infants.
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    Nasal CPAP and BiPAP as the Initial Respiratory Support in Preterm Infants: A Randomized Controlled Trial
    (Georg Thieme Verlag Kg, 2025) Arayici, Sema; Simsek, Gulsum Kadioglu; Say, Birgul; Oncel, Mehmet Yekta; Sari, Fatma Nur; Uras, Nurdan; Dizdar, Evrim
    Objective This study aimed to compare the nasal continuous positive airway pressure (nCPAP) and bi-level positive airway pressure (BiPAP) in preterm infants with respiratory distress syndrome (RDS). Method Preterm infants (<= 32 weeks of gestation) were randomly assigned, at birth, into two study groups: nCPAP or BiPAP. Primary outcomes (surfactant administration and failure of non-invasive respiratory support within the first 72 hours), and secondary outcomes (duration of ventilation support, pneumothorax, bronchopulmonary dysplasia, patent ductus arteriosus, necrotizing enterocolitis, intraventricular haemorrhage, retinopathy of prematurity, time to total enteral feeding, length of hospital stay, and mortality) were assessed. Results A total of 188 preterm infants with RDS were analysed. Mean gestational age was 28.8 +/- 1.8 weeks (nCPAP) versus 29 +/- 1.9 weeks (BiPAP). There were no statistically significant differences between groups in the failure of non-invasive respiratory support (25% vs. 33%, RR: 0.74, 95% CI: 0.47-1.17) or surfactant administration (35% vs. 38%, RR: 0.92, 95% CI: 0.49-1.71). No significant differences were observed in secondary outcomes between the two groups. Subgroup analysis of infants<30 weeks yielded similar results. Conclusion Although two-level CPAP theoretically offers benefits, BiPAP was not superior to nCPAP as initial support in preterm infants with RDS. This underscores the continued value of the simpler, well-established nCPAP and the need for multicentre trials involving preterm infants of varying gestational ages.