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Objective:To investigate clinical characteristics and potential risk factors of very preterm/very low birth weight infants with bronchopulmonary dysplasia (BPD).Methods:A retrospective epidemiological study was performed in 341 neonates with birth weights<1 500 g or gestational age between 23 + 0 to 31 + 6 weeks, who were born in Foshan Women and Children Hospital and were admitted to neonatal intensive care units (NICU) within 24 hours of birth. These neonates were divided into non-BPD group and BPD group. Clinical characteristics and potential risk factors were comparatively analyzed between groups. Risk factors for BPD were identified by binary logistic regression analysis. Results:Among the total of 341 enrolled neonates, including 255 neonates without BPD and 86 neonates with BPD, the total incidence of BPD was 25.2%. The incidences of BPD in the infants with gestational age of <30 weeks, 30-32 weeks, and >32 weeks, as well as birth weight <1 000 g, 1 000-1 499 g, and ≥1 500 g were 43.8%(63/144), 15.1%(22/146), 2.0%(1/51), 80.0%(36/45), 20.2%(41/203), 9.7%(9/93), respectively. The gestational age, birth weight, the proportion of cesarean section, and extubation rate within 7 days were lower in BPD group than those in non-BPD group [(28.5±2.4)weeks vs (30.7±1.8)weeks, (1 087.9±312.8)g vs (1 418.4±247.9)g, 54.6%(47/86) vs 75.7%(193/255), 57.1%(44/77) vs 90.0%(108/120), all P<0.05]. Compared to the non-BPD group, the proportion of Apgar score of ≤7 points 5 minutes after birth [16.3%(14/86) vs 2.4%(6/255)], postnatal endotracheal intubation rate [62.8%(54/86) vs 27.4%(70/255)], volume of red blood cell transfusion ≥3 times [31.4%(27/86) vs 6.3%(16/255)], pulmonary surfactant (PS) utilization [82.6%(71/86) vs 44.7%(114/255)], rate of conventional mechanical ventilation [89.5%(77/86) vs 47.0%(120/255)], combined with hemodynamically significant patent ductus arteriosus (HsPDA) [34.9%(30/86) vs 8.2%(21/255)], diagnosed with neonatal respiratory distress syndrome (NRDS) [94.2%(81/86) vs 5.9%(15/255)], combined with clinically diagnosed sepsis [17.4%(15/86) vs 7.0%(18/255)], combined with ≥3 stage retinopathy of prematurity (ROP) [20.9%(18/86) vs 2.7%(7/255)] and mortality [10.5%(9/86) vs 0.8%(2/255)], length of conventional mechanical ventilation, duration of oxygen consumption, and length of hospital stays were higher in the BPD group (all P<0.05). The results of multivariate logistic regression analysis showed that small gestational age ( OR=1.285, 95% CI: 1.010-1.633), Apgar score ≤7 points within 5 min of birth ( OR=5.712, 95% CI: 1.411-23.115), mechanical ventilation duration ( OR=1.113, 95% CI: 1.043-1.188) and oxygen duration ( OR=1.139, 95% CI: 1.092-1.188) were high risk factors for the development of BPD, while heavier birth weight ( OR=0.996, 95% CI: 0.994-0.998) was protective factor for BPD. Conclusions:The smaller the gestational age and the lower the birth weight, the higher the incidence of BPD, Apgar score≤7 points within 5 min of birth, long conventional mechanical ventilation time, and long duration of oxygen consumption are the risk factors for BPD. Prevention of premature delivery, reduction of asphyxia at birth, reduction of endotracheal intubation and invasive ventilation duration, and reduction of oxygen use time are effective measures to reduce the occurrence of BPD.
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Objective To study the relationship between single nucleotide polymorphisms (SNPs) of vascular endothelial growth factor A (VEGFA) gene and neonatal necrotizing enterocolitis (NEC).Method From August 2014 to December 2016,preterm infants with a ≥ Ⅱ stage (Modified Bell staging criteria) of NEC admitted to our hospitals were assigned as NEC group.Preterm infants without NEC with similar gestational age and body weight during the same period were assigned as the control group.SNPs of VEGFA including rs1005230,rs833067,rs3025010,rs3025035,rs3025036,rs10434,and rs6905288 were analyzed using SEQUENOM MassARRAY platform and multiplex allele-specific PCR.The concentration of VEGFA in the plasma of the two groups was examined using enzyme-linked immunosorbent assay (ELISA).Result A total of 110 infants were reviewed,including 30 infants in NEC group and 80 infants in the control group.The results showed a significant association of the minor allele frequency (MAF) for T in rs1005230 and C in rs833067 with NEC.The frequencies of C/T (OR=4.810,95％CI 1.742～13.278) and C/T-T/T (OR=4.892,95％CI 1.801～13.246) genotypes in rs1005230,and frequencies of T/C (OR=4.373,95％CI 1.578～12.129) and T/C-C/C (OR=4.000,95％CI 1.484～10.828) genotypes in rs833067 were significantly higher in NEC group than the control group (P＜0.05).Infants with MAF in rs1005230 and rs833067 had significantly lower plasma level of VEGFA than infants without MAF (P＜0.01).Conclusion The SNPs of rs1005230 and rs833067 may be associated with lower level of VEGFA in plasma and higher risk for NEC.
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Objective To study the serum free carnitine level and change trend in premature infantwith hyaline membrane disease (HMD) within postnatal 7 d .MethodTotally 63 preterm newbornwith gestational age of 28-32 weekin the NICU of thihospital were selected ,among them 32 caseof HMD were taken athe observation group and othe31 preterm newbornwithouHMD athe control group .The free carnitine level wameasured within 6 h aftebirth ,on 3 ,7 d by using the tandem masspectrum method .ResultThe free carnitine level within 6 h aftebirth had no statistical difference between the observation group and the control group[(23 .57 ± 7 .45)μmol/L v.(24 .34 ± 5 .73)μmol/L ,t=0 .48 ,P=0 .630] ,the free carnitine level on 3 d in the observation group wasignificantly lowethan thain the control group [(19 .21 ± 6 .83)μmol/L v.(23 .74 ± 7 .13)μmol/L ,t=2 .57 ,P=0 .010];the free carnitine level on 7 d in the observation group waalso significantly lowethan thain the control group [(16 .62 ± 7 .95)μmol/L v.(22 .83 ± 6 .56)μmol/L ,t=3 .39 ,P=0 .001] .The free carnitine level aftebirth in the control group remained stable ,which a3 time pointof 6h ,3 ,7 d had no statistical difference(F=0 .42 ,P=0 .660);whereathe free carnitine level wagradually decreased aftebirth ,which a3 time pointof 6 h ,3 ,7 had statistical difference(F=7 .13 ,P=0 .001) .Conclu-sion The free carnitine level aftebirth in preterm newbornwith HMD igradually decreased ,which needmore carnitine fopromoting the generation of pulmonary surfactan.
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Objective To approach the risk factors of bronchopulmonary dysplasia(BPD)with very low birth weight infants whose gestational age less than 32 weeks,thus it could provide a basis direction for prevention.Methods To summarize 70 neonates with BPD in October 2012 to October 2014 in our hospital, and randomly select 70 very low birth weight infants didn't have oxygen requirement of gestation age less than 32 weeks as control group.The perinatal risk factors,oxygen therapy and use caffeine were analyzed by using the statistical analysis of Chi-square test and logistic regression,so the risk factors and prevention direc-tion of BPD could be provided.Results Male gender were more prone to BPD(P ﹦0.000).Gestational age (P ﹦0.000)and birth weight(P ﹦0.002)were statistical lower in infants with BPD compared with no BPD.Family history of asthma,fetal distress,amniotic fluid turbidity,pulmonary hemorrhage,respiratory dis-tress syndrome,use of pulmonary surfactant,patent ductus arteriosus,intrauterine infection,ventilator time,na-sal continuous positive airway pressure /nasal intermittent positive pressure ventilation time,duration of oxy-gen therapy and use of caffeine were statistical significances (P 〈0.05,respectively).Logistic regression analysis demonstrated that gender(OR ﹦3.574,P ﹦0.003),gestational age≥28 weeks(OR ﹦58.665,P ﹦0.002), birth weight 〈1 250 g(OR ﹦36.453,P ﹦0.012)and ventilator time(OR ﹦703.696,P ﹦0.000)were independent risk factors for BPD infants.Using of caffeine(OR ﹦0.025,P ﹦0.010)and nasal continuous positive airway pressure/nasal intermittent positive pressure ventilation(OR ﹦0.004,P ﹦0.002)were protective factors for BPD infants. Conclusion The incidence of BPD could be reduced by strengthening prenatal care,minimizing intrauterine in-fection and preterm delivery,reducing the patent ductus arteriosus by strict fluid management,using mechanical ventilation rationally,choosing a non-invasive mechanical ventilation and caffeine.
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Objective To investigate the clinic signification of newborn hearing screening combined with deafness susceptibility genes screening. Methods 1 440 newborns(3 ~ 5 days after birth) were screened for 8 hot spot hearing loss associated mutations from GJB2, mt12S rRNA and SLC26A4. At the same time, all infants received hearing screening. Those who failed to pass two-step test were referred to further audiological assessment. Results The carrier rate of commonmutations was 1.46% for GJB2 c.235delC, 0.35% for GJB2 c.299-300delAT, 0.42% for mt12S rRNA c.1555A > G, 0.42% for SLC26A4 c.IVS7-2A > G and 0.14% for SLC26A4 c.2168A > G. The total carrier rate was 2.78%. 10 infants were diagnosed as hearing loss in the hearing screening and follow-up audiology assessment (6.94‰) and 5 were diagnosed as severe hearing loss (3.47‰). 32 hearing loss associated mutation carriers passed the hearing screening. Conclusions Genetic screening of newborn hearing screening can be helpful to find out neonates with late-onset and progressive hearing impairment, which were significant for early intervention, regular follow-up and reduction of deafness.