cDepartment of Pathology School of Veterinary,Kirikkale University, TurkeydDepartment of Pharmacology School of Medicine,Kirikkale University, TurkeyeDepartment of Pediatric Surgery School of Medicine,Kirikkale University, Turkey

Aim

The photodynamic effect of phototherapy is considered to causediseases, such as pulmonary oxygen damage, intraventricularhemorrhage, retinopathy of the premature, and necrotizing enter-ocolitis. Phototherapy was also shown to be associated with increaseddysplastic nevus risk, DNA damage in the cells, oxidative stress, andincreased gametocide effect. There are few studies which investigatedthe cytotoxic effects of phototherapy. This study aimed to investigatethe cytotoxic effect by assessing apoptosis in liver and kidney innewborn rats receiving phototherapy.

Materials and methods

FifteenWistar albino rats of both sexes were included in the study.All rats were in the first 7 days of life and were accommodated understandardized conditions of light and temperature. The rats wererandomized into three groups (n=5) as follows: group 1, exposure toconventional phototherapy device; group 2, exposure to LED device;and group 3, control (without phototherapy). After exposure to light,the liver and kidney tissues were examined for apoptosis. Apoptoticcells were detected by terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) assay, by immunohisto-chemistry for caspase-3, and by light microscopy. Tissue sectionsdetected for TUNEL and caspase activity were analyzed with BABBs200Pro image analysis system. SPSS Version 16 was used instatistical analysis, and apoptosis scores were given as percentage.

Results

The highest apoptosis scores with Caspase staining were in conven-tional phototherapy group. Apoptosis scores in the liver and kidney were15.6±3.72%and10.2±1.51%, respectively, in this group, 3.63±1.84%and3.7±2.39% in LEDphototherapygroup, and1.27±0.52%and1.35±0.29%in the control group. The difference between the groups was significant.The highest apoptosis scores with TUNEL staining were in conventionalphototherapy group (1.73±0.82% and 1.2±0.16%), but the differencebetween the groups was insignificant.

Conclusions

We detected that phototherapy significantly increased apoptosisin the liver and kidney tissues of newborn rats.

doi:10.1016/j.earlhumdev.2010.09.322

PP-267. Serum intestinal fatty acid binding protein level for earlydiagnosis and predicts severity of necrotizing enterocolitis

Cumhur Aydemir, Dilek Dilli, Serife Suna Oguz, Hulya Ozkan Ulu,Nurdan Uras, Omer Erdeve, Ugur DilmenZekai Tahir Burak Maternity Hospital, Neonatology, Turkey

Aim

Intestinal fattyacidbindingprotein (I-FABP) is foundwithin cells at thetip of the intestinal villi, an area commonly injured when necrotizing

enterocolitis (NEC) occurs. In this studywe aimed to estimate the value ofserum I-FABP in early diagnosing and predicts severity of NEC.

Materials and methods

The prospective study was performed between April and November2009. Infants with the suspected of NEC were included. Three bloodsamples from infants evaluated for NEC were obtained at symptomonset and after 24 and 72 h. Infants were classified by the final andmostsevere stage of NEC, and I-FABP levels were compared between infantswith stage I, II and III NEC and compared to those of the controls.

Results

Fourty one preterm infants with NEC (22 infants stage I, 11 infantsstage II, 8 infants stage III) were included in the study group, while 31preterm infantswithout NECwere enrolled in the control. Serum I-FABPconcentration was 324.0±165.8 pg/ml at the onset of disease, 112.5±84.2 pg/ml and 25.4±42.4 pg/ml, at 24th and 72nd hours in the stage INEC. It was 764.7±465.1 pg/ml, 269.4±269.8 pg/ml and 56.2±91.4 pg/ml, respectively at the onset, 24th and 72nd hours in the stageII NEC. Serum I-FABP concentration was 360.2±439.5 pg/ml, 317.4±365.3 pg/ml and 503.4±326.7 pg/ml, at the onset, 24th and 72ndhoursin the stage III NEC. It was 76.9±115.9 pg/ml in the controls. Thereweresignificant difference between NEC and control groups (p<0.001). Theinitial serum I-FABP level was significantly decreased at 24th and 72thhours in the stage I–II NEC, whereas it was significantly increased at72nd hours in the stage III NEC (p=0.001).

Conclusions

Serial measurements of I-FABP levels may be a useful marker forearly detection of severe NEC and early diagnosis and treatment ofintestinal necrosis.

doi:10.1016/j.earlhumdev.2010.09.323

PP-268. Palivizumab prophylaxis: Comparative study betweenimmunized and non immunized infants admitted with respiratorysyncytial virus infection

Tania Marques, Katia Cardoso, Manuela Ferreira, Manuel Cunha,Marta Ferreira, Rosalina BarrosoHospital Prof. Doutor Fernando Fonseca, E. P .E., Neonatal Intensive CareUnit (NICU), Portugal

Aim

Palivizumab (PVZ) prophylaxis has demonstrated efficacy againstrespiratory syncytial virus (RSV) infection, but its cost necessitatestargeting high risk children. Evidence suggests that 32–35 weeksgestational age (wGA) infants may benefit from PVZ. We aimed toanalyze clinical and related cost of RSV infection in 32–35 wGAinfants with and without PVZ prophylaxis.

Materials and methods

Retrospective study of premature infants admitted with RSVinfection during two consecutive seasons. Two groups were identi-fied: Group A (GA-without prophylaxis) and B (GB-with prophy-laxis). National Portuguese guidelines were used (based on 2003American Academy of Pediatrics statement) and only infants withprophylaxis recommendation (≥2 risk factors) were evaluated.Demographics, therapy and outcome were analysed.

Abstracts S123

Results

From a total of 94 children (52-GA; 42-GB), 26/52(50%) and 30/42(71%) infants of group A and B, respectively, had indication for PVZprophylaxis. In GB, 14/30(47%) were immunized. The estimated costof prophylaxis (5 doses) was 26,000€-GA and 30,000€-GB. Teninfants (17.8%) were admitted with RSV bronchiolitis: 8(31%)-GA and2(6.6%)-GB, median age 4 months (range 1–22) and 80% male. In GA,4(50%) children were admitted to paediatric intensive care unit(PICU), 3 needing mechanical ventilation. One infant was re-admitted. In GB, one infant, admitted for 11 days in the PICU withoutmechanical ventilation, was infected 13 days after 2 doses of PVZ. Theother, was admitted in the nursery 40 days after the fifth dose of PVZ.The total cost of admission was 36,129€-GA and 27,318€-GB.Comparing both groups, mechanical ventilation was only neededfor GA (1.62 vs. 0; p=0.003). No differences occurred between totaland PICU length of stay (8.8 vs. 10.5; p=0.07) (3.5 vs. 5.5; p=0.12).

Conclusions

In this study, although the limited sample size, results suggest thatthe cost of admission, as well as the clinical severity is higher in nonimmunized infants. Although indirect costs were not analyzed, itseems reasonable to use PVZ in this population.

doi:10.1016/j.earlhumdev.2010.09.324

PP-269. Neonatal morbidity of late preterm neonates

Fani Anatolitou, Helen Bouza, Niki Lipsou, Marina AnagnostakouB' Neonatal Intensive Care Unit, “Aghia Sophia” Children's Hospital,Athens, Greece

Aim

Late preterm neonates (34–36+6 weeks gestation) are lessmature compared to full term neonates. Thus, they are at increasedrisk of morbidity and mortality. The aim of the study was to evaluatethe problems of late preterm neonates that needed admission in aNeonatal Intensive Care Unit (NICU).

Materials and methods

Late preterm neonates hospitalized in our Neonatal Intensive CareUnit between 2005 and 2009 were evaluated regarding the morbidityand mortality and the reasons for late preterm delivery.

Results

Out of 1801 neonates admitted in our unit within the period studied,257 neonates were late preterm. Gestational age was 35.2±0.83 weeksand Birth Weight 2388.75±536.08 g. 168(65.3%) neonates were bornwith cesarean section.The indications for cesarean section varied,including maternal medical conditions, complications of pregnancy,abnormal conditions of the foetus, or high risk pregnancies due to IVF ormultiple gestation. 38 (14.78%)were born following IVF, 51(20.7%)wereborn aftermultiplepregnancies. 25(9.7%)were small for gestational age.Mortality and morbidity during hospitalization in the NICU: 16(6.2%)neonates died. 96(37.5%) presented respiratory problems (respiratorydistress syndrome or wet lung disease — 36 needed mechanicalventilation) 9(3.5%) presented pulmonary hypertension, and 4(1.56%)apneas.13(5%) neonates developed necrotizing enterocolitis.(6 needingsurgical intervention.). 8(3.1%) presented neonatal encephalopathy, and6(2.3%) intraventricular haemorrhage on Ultrasound, mainly grade I. 81

(31.6%) developed hyperbilirubinemia and 11(4.2%) feeding difficulties.11(4.2%) neonates had congenital hypothyroidism. Finally, 38(14.8%)presentedsepticemia, 3(1.17%)urinary infection,6(2.34%)viral infectionand 8(3.1%) bronchiolitis.

Conclusions

Late preterm neonates may develop severe illness during theneonatal period. It is important to follow thoroughly the high riskpregnancies and reconsider the indications of preterm delivery ofthese neonates. It is a population that besides morbidity during theneonatal period may present long term difficulties and need to beincluded in follow up programs.

doi:10.1016/j.earlhumdev.2010.09.325

PP-270. HLA and bronchopulmonary dysplasia susceptibility

Gustavo Rochaa, Hercilia Guimaraesa, Elisa Proencab, Augusta Areiasb,Fatima Freitasc, Bruno Limac, Teresa Rodriguesd, Helena AlvescaDivision of Neonatology, Department of Pediatrics, Hospital De São João,Faculty of Medicine of Porto University, PortugalbDivision of Neonatology, Maternity Júlio Dinis, Porto Hospital Centre,PortugalcCentre of Histocompatibility of Porto, PortugaldDepartment of Hygiene And Epidemiology, Faculty of Medicine of PortoUniversity, Portugal

Aim

Background — There is little data on the association betweenHuman Leucocyte Antigen (HLA) alleles and BronchopulmonaryDysplasia (BPD) of the preterm newborn. Aim — To assess associa-tions between HLA alleles and BPD susceptibility.

Materials and methods

We studied 156 preterm neonates (82 M/74 F) <32 weeksgestational age, alive at 36 weeks gestational age. Detailed clinical datawere collected. HLA typing was performed by PCR-SSO. HLA allelefrequencies where determined by direct counting for BPD and no-BPDgroups. Comparison between BPD and no BPD groups was performedusing t-test, χ2 test or Fisher exact test and logistic regression asappropriate. Relative risks (RR) and their 95% confidence intervals (95%CI) were also calculated as association measures.

Results

We diagnosed 56 (35.9%) neonates with mild BPD and 27 (17%)with moderate/severe BPD. We found a significant associationbetween HLA-DRB1*01 and mild BPD (OR=3.48]1.23–10.2[).Thealleles HLA-A*24, -A*68, -B*51,-Cw*07, -Cw*14, -Cw*15 and -DRB1*01presented a significant association with moderate/ severe BPD. Whenadjusted to gestational age and birth weight HLA-A*68 (OR=5.41]1.46; 20.05[), -B*51 (OR=3.09]1.11; 8.63[) and -Cw*14 (OR=4.94]1.15; 21.25[) were significantly associated with moderate/severe BPD.

Conclusions

Our findings suggest an association between HLA-A*68, -B*51 and-C*14 and BPD susceptibility.

doi:10.1016/j.earlhumdev.2010.09.326

AbstractsS124