ABSTRACT
Objective To understand the influence of family integrated care (FICare) model to the human breastfeeding rate of preterm infants in neonatal intensive care units (NICUs).Method It is a multicenter cluster randomized controlled trail for intervention and prognosis.According to inclusion and exclusion criteria,preterm infants with gestation age 28 ～ 35 weeks in 9 NICUs of tertiary hospitals in 8 provinces in China were enrolled and divided into FICare and control group.Mothers of FICare infants were invited to stay in NICU ward at bedside for no less than 3 hours per day.Under the supervision of nurses,FICare infants'mothers complete 13 items of infants'caring skills including Six-step Hand Washing and hand hygiene,positioning the baby,changing diapers and estimating urine output,skin and mouth caring,kangaroo care and so on.The primary outcome is the human breastfeeding rate.Secondary outcomes include feeding parameters and FICare-related parameters.SPSS 20.0 software is used for the data analysis.Result (1) There were 212 infants and 215 infants enrolled in FICare group and control group,respectively.There was no significant difference between 2 groups in gender,gestational age,birth weight (BW),Z-score of BW,singleton percentage,antenatal steroid completion,diagnosis,day of life (DOL) for starting feeds (P ＞ 0.05).(2) There was no significant difference between 2 groups in DOL for full feeding (P ＞ 0.05).The median age of starting breastfed in both groups was DOL 4.There were 202 cases (87.3％) in FICare group and 80 cases (34.9％) in control group be successfully breastfed.The rate of formula feeding,incidence of nosocomial infection,DOL for regaining BW,decrease of BW AZ score in FICare group was significantly lower than the control group,and the weight gain velocity after regaining BW in FICare group was significantly higher than the control group (P ＜ 0.05).(3) The implementation of FICare and completion of antenatal steroid were the independent protective factors for breastfeeding (OR =27.703,95％ CI 14.531 ～ 52.816;OR =9.496,95％ CI 4.768 ～ 18.912),while nosocomial infection and delayed DOL for starting breastfeeding were the independent risk factors for breastfeeding (OR =0.380,95％CI 0.182 ～0.795;OR =0.847,95％ CI 0.734 ～0.977).Conclusion FICare is significantly beneficial to the breastfeeding rate of preterm infants in NICUs.FICare may decrease the severity of extrauterine growth retardation.
ABSTRACT
Bronchopulmonary dysplasia (BPD) is one of the most common serious chronic respiratory diseases in premature infants.In recent years,BPD has been significantly increasing with the improved survival rate of extremely preterm babies.About 10％ of neonates with mechanical ventilation might suffer from BPD,and this may lead to a great burden and costs to both the family and the society.A variety of risk factors has been proposed to be associated with BPD in preterm infants.However recent abroad researches indicated that genetic factors might predispose to BPD of preterm neonates,and initial results of domestic related researches inferred that several susceptibility genes might contribute to BPD development in Han preterm infants.This review focuses on recent publications related to genetic factors that may potentially contribute to BPD.
ABSTRACT
Objective To investigate whether antenatal administration of dexamethasone would provide protection against cerebral hypoxic ischemic damage in asphyxiated fetal rats. Methods Fifty seven fetal rats of twenty day gestational age were randomly divided into five groups: sham operation (normal control, n =11), asphyxiated control (group E, n =10), and group D 1?D 2?D 3 of different timings of intravenous dexamethasone treatment (1 mg/kg) in pregnant SD rats ( n =15, 12, and 9 respectively). The times assigned for dexamethasone injection were thirty minutes before clamping, the time aroung clamping and the beginning of reperfusion respectively. Intra and extra cellular concentrations of calcium, sodium and potassium in fetal rat brains were measured in each group after thirty minutes of reperfusion. Results (1)Intracellular free calcium concentrations of fetal rat brains in group E,D 1, D 2 and D 3 were 552?94, 438?105, 445?57, and 456?110 nmol/L respectively, and all significantly higher than that in the normal control 315?87 nmol/L ( P