Incidence of extrauterine growth retardation and its risk factors in very preterm infants during hospitalization: a multicenter prospective study / 中国当代儿科杂志

OBJECTIVES@#To investigate the incidence of extrauterine growth retardation (EUGR) and its risk factors in very preterm infants (VPIs) during hospitalization in China.@*METHODS@#A prospective multicenter study was performed on the medical data of 2 514 VPIs who were hospitalized in the department of neonatology in 28 hospitals from 7 areas of China between September 2019 and December 2020. According to the presence or absence of EUGR based on the evaluation of body weight at the corrected gestational age of 36 weeks or at discharge, the VPIs were classified to two groups: EUGR group (n=1 189) and non-EUGR (n=1 325). The clinical features were compared between the two groups, and the incidence of EUGR and risk factors for EUGR were examined.@*RESULTS@#The incidence of EUGR was 47.30% (1 189/2 514) evaluated by weight. The multivariate logistic regression analysis showed that higher weight growth velocity after regaining birth weight and higher cumulative calorie intake during the first week of hospitalization were protective factors against EUGR (P<0.05), while small-for-gestational-age birth, prolonged time to the initiation of total enteral feeding, prolonged cumulative fasting time, lower breast milk intake before starting human milk fortifiers, prolonged time to the initiation of full fortified feeding, and moderate-to-severe bronchopulmonary dysplasia were risk factors for EUGR (P<0.05).@*CONCLUSIONS@#It is crucial to reduce the incidence of EUGR by achieving total enteral feeding as early as possible, strengthening breastfeeding, increasing calorie intake in the first week after birth, improving the velocity of weight gain, and preventing moderate-severe bronchopulmonary dysplasia in VPIs.

Clinical efficacy of heated humidified high-flow nasal cannula in preventing extubation failure in neonates: a Meta analysis / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of heated humidified high-flow nasal cannula (HHHFNC) in preventing extubation failure in neonates.</p><p><b>METHODS</b>A literature search was performed using PubMed, Cochrane Library, FMRS, and CNKI to collect the randomized controlled trials (RCTs) and quasi-RCTs which compared the clinical efficacy of HHHFNC and nasal continuous positive airway pressure (NCPAP) in preventing extubation failure in neonates. The identified studies were finally selected after full-text search and quality assessment and then subjected to a Meta analysis using RevMan 5.3.</p><p><b>RESULTS</b>Five eligible trials involving 1040 neonates were included in the Meta analysis. The Meta analysis showed that there was no significant difference in treatment failure rate between the HHHFNC and the NCPAP groups. The HHHFNC group had significantly lower incidence rates of nasal trauma (OR=0.49, 95% CI: 0.34-0.71, P=0.0001) and pneumothorax (OR=0.27, 95% CI: 0.07-0.97, P=0.04) than the NCPAP group, but there were no significant differences in the duration to reach full oral feedings and the incidence rates of serious adverse events or other complications between the two groups, such as in-hospital mortality, bronchopulmonary dysplasia, intraventricular hemorrhage, necrotizing enterocolitis, and retinopathy of prematurity.</p><p><b>CONCLUSIONS</b>HHHFNC is safe and effective in preventing extubation failure in neonates.</p>