Assessment of survival and neonatal morbidity rates of very low birth weight infants in Türkiye: Turkish Neonatal Society SECRETS (TNS-SECRETS) study

This prospective multicenter study of the Turkish Neonatal Society includes data from a large cohort of very low birth weight (VLBW) infants from 78 referral centers in Türkiye. The objective was to evaluate survival and neonatal morbidity rates among VLBW infants. All preterm infants with a birth weight (BW) ≤ 1500 g and a gestational age (GA) between 230/7 and 316/7 weeks were included. Respiratory distress syndrome (RDS), intraventricular hemorrhage (IVH), periventricular leukomalacia (PVL) hemodynamically significant patent ductus arteriosus (hsPDA), bronchopulmonary dysplasia (BPD), necrotizing enterocolitis (NEC), sepsis and retinopathy of prematurity (ROP) were defined as neonatal morbidities. A total of 3042 VLBW infants were enrolled. The mean GA and median BW were 27 ± 2.2 weeks and 1080 g (ranges, 320 and 1500 g), respectively. The incidences of neonatal morbidities were as follows: RDS 76.3%, IVH 28%, PVL 0.9%, hsPDA 31.5%, BPD 39.5%, NEC 14%, and ROP 25%. Early and late sepsis were diagnosed in 19.3% and 44.6% of the study group. The overall mortality rate was 21.7%, and survival without major morbidity was 42.8%. Mortality among infants ≤ 28 weeks of gestation was 34.8%, whereas it was 5.5% for infants > 28 weeks of GA. This study provides a comprehensive overview of outcomes among VLBW infants in Türkiye and offers valuable insights for other developing countries. As neonatal morbidity and mortality rates remain higher than those reported in developed countries, targeted strategies to improve neonatal care practices for extremely preterm infants should be prioritized. Trial registration Clinical trials gov, Survival and Neonatal Outcomes of Very Low Birth Weight Infants in Türkiye: Turkish Neonatal Society SECRETS-TR Study (TNS-SECRETS), NCT 06,543,524, 2024-08-07

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Journal
Scientific Reports
Published
2026-05-29
DOI
https://doi.org/10.1038/s41598-026-53670-6
Primary Topic
Neonatal Respiratory Health Research
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article
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article

Assessment of survival and neonatal morbidity rates of very low birth weight infants in Türkiye: Turkish Neonatal Society SECRETS (TNS-SECRETS) study

M. Kara, A. Zenciroğlu, M. Kefeli, S. Beken et al.
Scientific Reports
Neonatal Respiratory Health Research
article

Assessment of survival and neonatal morbidity rates of very low birth weight infants in Türkiye: Turkish Neonatal Society SECRETS (TNS-SECRETS) study

M. Kara, A. Zenciroğlu, M. Kefeli, S. Beken, N. Koksal, B. Torer, D. Terek, B. Özcan, M Cetinkaya, S. Yurttutan, A. Ecevit, F. Ozlu, H. Altunhan, M. Koňák, O. Kalkanlı, F. Karaarslan, H. Çetin, H Y Yildizdaş, N. Duman, S. Tüfekçi̇, Y.E. Köstekçi, M. Karabay, S. Gündogdu, E. Özek, B. A. Dorum, S. Benli, H. Kahveci, T. Gursoy, A. Abbasoglu, G. Demirel, T. Donmez, E. KOÇ, S. Calkavur, S. Tanrıverdi, B. C. Arcagok, S. Arslanoglu, Z. S. T. Gucyetmez, O. Ozdemir, O. Saglam, M. A. Akın, S. Akar, E. Cekinmez, M. K. Kanburoglu, K. Yumlu, G. Sandal, E. Can, B. S. Karagol, F. T. Erdogan, S. Hamilcıkan, B. Orel, E. T. Unal, R. Ozdemir, S. S. Uygun, I. M. Akın, H. Ongun, F. Y. Atay, M. Aksu, O. Bulut, S. Takçı, I. G. Varal, E. Okulu, S. Kavurt, Turkish Neonatal Society SECRETS Study Group, E. Calısıcı, Y. Celik, B. L. Say, O. Altıntas, E. Onal, S. Memur, N. M. Okur, H. Ozkan, M. K. Mert, D. Armangil, E. A. Dizdar, N. Oygur, M. Alagoz, A. Y. Bas, M. Buyukeren, N. A. Ciftdemir, P. Dogan, S. Aydogan, B. Cetinkaya, M. Tutal, A. Orman, F. Narter, B. Topçu, I. Er, O. Olukman, M. Ayar, S. Arslan, S. N. Ergor, L. Bilgin, C. Tayman, T. B. Kaya, H. S. Uslu, E. Taskın, F. H. Yılmaz, A. K. Toygar, G. S. Demir, K. S. Tekgunduz
article en

Abstract

This prospective multicenter study of the Turkish Neonatal Society includes data from a large cohort of very low birth weight (VLBW) infants from 78 referral centers in Türkiye. The objective was to evaluate survival and neonatal morbidity rates among VLBW infants. All preterm infants with a birth weight (BW) ≤ 1500 g and a gestational age (GA) between 230/7 and 316/7 weeks were included. Respiratory distress syndrome (RDS), intraventricular hemorrhage (IVH), periventricular leukomalacia (PVL) hemodynamically significant patent ductus arteriosus (hsPDA), bronchopulmonary dysplasia (BPD), necrotizing enterocolitis (NEC), sepsis and retinopathy of prematurity (ROP) were defined as neonatal morbidities. A total of 3042 VLBW infants were enrolled. The mean GA and median BW were 27 ± 2.2 weeks and 1080 g (ranges, 320 and 1500 g), respectively. The incidences of neonatal morbidities were as follows: RDS 76.3%, IVH 28%, PVL 0.9%, hsPDA 31.5%, BPD 39.5%, NEC 14%, and ROP 25%. Early and late sepsis were diagnosed in 19.3% and 44.6% of the study group. The overall mortality rate was 21.7%, and survival without major morbidity was 42.8%. Mortality among infants ≤ 28 weeks of gestation was 34.8%, whereas it was 5.5% for infants > 28 weeks of GA. This study provides a comprehensive overview of outcomes among VLBW infants in Türkiye and offers valuable insights for other developing countries. As neonatal morbidity and mortality rates remain higher than those reported in developed countries, targeted strategies to improve neonatal care practices for extremely preterm infants should be prioritized. Trial registration Clinical trials gov, Survival and Neonatal Outcomes of Very Low Birth Weight Infants in Türkiye: Turkish Neonatal Society SECRETS-TR Study (TNS-SECRETS), NCT 06,543,524, 2024-08-07

Scientific Reports
Sakarya University (TR), Gebze Technical University (TR), Trakya University (TR), Tekirdağ Namık Kemal University (TR), Ministry of Health (TR), Bursa Uludağ Üni̇versi̇tesi̇ (TR), Izmir University (TR), Koç University (TR), Selçuk University (TR), Ankara University (TR), Recep Tayyip Erdoğan University (TR), Manisa Celal Bayar University (TR), Bilkent University (TR), University of Health Science (KH), Süleyman Demirel Üniversitesi (TR), Başkent University (TR), Bursa Technical University (TR), Dokuz Eylül University (TR), Akdeniz University (TR), Inonu University (TR), Ondokuz Mayıs University (TR), Konya Food and Agriculture University (TR), Bezmiâlem Vakıf Üniversitesi (TR), Istanbul Medipol University (TR), Ege University (TR), Zübeyde Hanim Maternity Hospital (TR), Gülhane Askerî Tıp Akademisi (TR), Dr. Behçet Uz Çocuk Hastalıkları Hastanesi (TR), Gaziantep Children's Hospital (TR), Adana Hospital (TR), Memorial Ankara Hospital (TR), Necmettin Erbakan University (TR), Ümraniye Eğitim ve Araştırma Hastanesi (TR), Dr Sami Ulus Çocuk Sağlığı ve Hastalıkları Eğitim ve Araştırma Hastanesi (TR), Erzurum Regional Training and Research Hospital (TR), Konya Eğitim ve Araştırma Hastanesi (TR), Başkent University Hospital (TR), Sağlık Bilimleri Üniversitesi (TR), Diyarbakır Gazi Yaşargil Eğitim ve Araştırma Hastanesi (TR), Izmir Tepecik Eğitim ve Araştırma Hastanesi (TR), Acıbadem University Atakent Hospital (TR), Kent Hastanesi (TR), Ankara Yıldırım Beyazıt University (TR), Şişli Etfal Eğitim ve Araştırma Hastanesi (TR), S.B.Ü. Bursa Yüksek İhtisas Eğitim ve Araştırma Hastanesi (TR), Kahramanmaraş Sütçü İmam University (TR), Pamukkale University (TR), Eskişehir Osmangazi University (TR), Mersin Üniversitesi (TR), Kocaeli Üniversitesi (TR), Cukurova University (TR), Istanbul Medeniyet University (TR), Atatürk University (TR), Istanbul University (TR), Marmara University (TR), University of Health Sciences Antigua (AG), Gazi University (TR)
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