ABSTRACT
Objective:To study the short-term clinical outcomes of different courses of antenatal corticosteroids (ACS) for preterm twins.Methods:From January 2017 to December 2021, preterm twins with gestational age (GA) 24-34 weeks admitted to the neonatal ward of our hospital and received ACS were retrospectively studied. The infants were assigned into single-course group, partial-course group and multiple-course group according to ACS courses. The short-term clinical outcomes were compared among the groups. SPSS software version 25.0 was used for statistical analysis.Results:A total of 286 infants were enrolled in this study, including 128 in single-course group, 89 in partial-course group and 69 in multiple-course group. Compared with single-course group, the risks of neonatal respiratory distress syndrome (RDS) in both partial-course group ( OR=2.332, 95% CI 1.028-5.293, P=0.043) and multiple-course group ( OR=3.872, 95% CI 1.104-13.584, P=0.034) were higher. The birth length in multiple-course group ( β=-0.016, 95% CI -0.029 - -0.002, P=0.024) was lower than single-course group. Conclusions:The risks of neonatal RDS in preterm twins are higher in partial-course and multiple-course of ACS. A full course of ACS should be used to prevent neonatal RDS until further evidence of effectiveness is available.
ABSTRACT
Objectives To investigate the prevalence of childhood asthma in 2000～2010,to find the changes of childhood asthma in distribution characteristics,precipitating factors,diagnosis and treatment status,and to provide scientific data for the improvement of the prevention and management of asthma in children in Kunming city,China.Methods Children were selected by random cluster sampling.Standardized preliminary questionnaire was used for screening out possible patients in the two surveys of 2000 and 2010.Diagnosis of asthma was confirmed by diagnostic criteria in suspected asthmatic children.Asthmatic children were further asked for past diagnosis and treatment with the questionnaire of asthma in children.Double entry and validation were adopted for all data and analysis was carried out using Epi-Info software.Results Compared with 2000,the total asthma incidence rate increased significantly from 0.88％ to 1.40％ (x 2=12.52,P＜0.05),the coincidence rate of final diagnosis and previous diagnosis increased from 22.8％ to 51.3％ (x2 =19.23,P ＜0.05) and the proportion of acute exacerbation of asthma reduced from 40.2％ to 19.3％ (x 2 =12.54,P＜0.05) in 2010.Compared with 2000,Antibiotics use rate reduced from 97.8％ to 80.0％ (x 2=14.28,P ＜0.05) and the proportion of inhaled corticosteroid increased from 12.0％ to 64.0％ (x 2=60.53,P＜0.05).Conclusion Compared with 10 years ago,the total asthma incidence of childhood asthma aged 0 ～ 14 year old in Kunming city was significantly increased.The coincidence rate of final diagnosis and previous diagnosis increased and the proportion of acute exacerbation of asthma reduced.Antibiotics use rate reduced and the proportion of inhaled corticosteroid increased.The treatment and management of asthma in children awaits improvement as well,especially in reducing the rate of missed diagnosis in children with asthma and regulating the use of corticosteroids and bronchodilators inhaling treatment and reduces the use of the proportion of antibiotics.
ABSTRACT
Objective To explore the neuropsychological development in twin premature infants,and to analyze the risk factors for the retardation of development.Methods The premature infants hospitalized in the Neonatal Ward First Affiliated Hospital of Kunming Medical University from Jun.2010 to Jun.2012 were divided into study groups of twin premature infants and a control group of singleton premature infants.The neuropsychological development of 88 premature infants was evaluated at corrected gestational age of 1 year old by Bayley scales of infant development.According to normal lab findings of the Bayley scales of infant development,the premature infants were then divided into abnormal neuropsychological development group [mental development index(MDI) ≤79 scores] and normal neuropsychological development group (MDI ＞ 79 scores),and the data of 2 groups were statistically analyzed.Results The frequency distribution of MDI score in study group showed a skewed distribution,of which 59％ (27/46 cases) had abnormal neuropsychological development (MDI ≤ 79 scores); However,the frequency distribution of MDI score in control group showed an approximate normal distribution,of which only 12％ (5/42 cases) for abnormal neuropsychological development.Head circumference,body length,body weight,MDI,psycho-motor development index of twin premature infants of one-year old were lower than those of the singleton premature infants of the same age,and the differences were statistically significant (all P ＜0.05).The single factor analysis demonstrated that the risk factors for abnormal neuropsychological development (MDI ≤ 79 scores) of twin premature infants were gestational age,birth weight,mother' s gcstational age,the cultural degree of parents,mode of feeding,neonatal hyperbilirubinemia,neonatal hypoglycemia and neonatal sepsis.Multiple regression analysis showed that neonatal hyperbilirubinemia was the independent risk factor for abnormal neuropsychological development of twin premature infants.Conclusions At same gestational age,neuropsychological development of twin premature infants lagged behind singleton premature infants.Neonatal hyperbilirubinemia may be the risk factors for neuropsychological development of twin premature infants,so the earlier management of neonatal hyperbilirubinemia may be beneficial for the neuropsychological development of twin premature infants.