A multicenter study of the birth condition of preterm infants and the causes of preterm birth in Henan Province, China / 中国当代儿科杂志

OBJECTIVE@#To investigate the birth condition of preterm infants and the causes of preterm birth in Henan Province, China, and to provide a basis for the prevention and treatment of preterm birth.@*METHODS@#An epidemiological investigation was conducted for live-birth preterm infants who were born in 53 hospitals in 17 cities of Henan Province from January 1, 2019 to December 31, 2019 to investigate the incidence rate of preterm birth, the distribution of gestational age and birth weight, the use of antenatal glucocorticoids, and the causes of preterm birth.@*RESULTS@#The incidence rate of preterm birth was 5.84% (12 406/212 438) in the 53 hospitals. The proportions of preterm infants with gestational ages of < 28 weeks, 28 - < 32 weeks, 32 - < 34 weeks, and 34 - < 37 weeks were 1.58% (196/12 406), 11.46% (1 422/12 406), 15.18% (1 883/12 406), and 71.78% (8 905/12 406) respectively. The proportions of preterm infants with birth weights of < 1 000 g, 1 000- < 1 500 g, 1 500- < 2 500 g, 2 500- < 4 000 g, and ≥ 4 000 g were 1.95% (240/12 313), 8.54% (1 051/12 313), 49.53% (6 099/12 313), 39.59% (4 875/12 313), and 0.39% (48/12 313) respectively. The infants born by natural labor accounted for 28.76% (3 568/12 406), and those born by cesarean section accounted for 70.38% (8 731/12 406). The rate of use of antenatal glucocorticoids was 52.52% (6 293/11 983) for preterm infants and 68.69% (2 319/3 376) for the preterm infants with a gestational age of < 34 weeks. Iatrogenic preterm labor was the leading cause of preterm birth[40.06% (4 915/12 270)], followed by spontaneous preterm birth[30.16% (3 701/12 270)] and preterm birth due to premature rupture of membranes[29.78% (3 654/12 270)]. The top three causes of iatrogenic preterm birth were hypertensive disorders of pregnancy[47.12% (2 316/4 915)], fetal intrauterine distress[22.85% (1 123/4 915)], and placenta previa/placental abruption[18.07% (888/4 915)].@*CONCLUSIONS@#There is a relatively low incidence rate of preterm birth in Henan Province, and late preterm infants account for a relatively high proportion. Iatrogenic preterm birth is the main cause of preterm birth in Henan Province, and hypertensive disorders of pregnancy and fetal intrauterine distress are the main causes of iatrogenic preterm birth.

Clinical features and prognosis of preterm infants with varying degrees of bronchopulmonary dysplasia / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the clinical features and prognosis of preterm infants with varying degrees of bronchopulmonary dysplasia (BPD).</p><p><b>METHODS</b>The clinical data of 144 preterm infants with a gestational age of <32 weeks who were admitted to the neonatal intensive care unit from March 2014 to March 2016 and were diagnosed with BPD were collected. According to the severity of BPD, these preterm infants were divided into mild group with 81 infants and moderate/severe group with 63 infants. The two groups were compared in terms of perinatal risk factors, treatment, comorbidities, complications, and prognosis of the respiratory system.</p><p><b>RESULTS</b>Compared with the mild BPD group, the moderate/severe BPD group had a significantly higher gestational age and rate of small-for-gestational-age (SGA) infants (P<0.05), as well as a significantly higher rate of severe preeclampsia and a significantly lower rate of threatened preterm labor (P<0.05). Compared with the mild BPD group, the moderate/severe BPD group had a significantly higher percentage of infants who needed mechanical ventilation at 2 weeks after birth, longer duration of mechanical ventilation, total time of oxygen therapy, and length of hospital stay, and higher incidence rates of pneumonia and cholestasis (P<0.05), as well as a significantly lower application rate of caffeine citrate (P<0.05). The multivariate logistic regression analysis showed that SGA birth (OR=5.974, P<0.05), pneumonia (OR=2.590, P<0.05), and mechanical ventilation required at 2 weeks after birth (OR=4.632, P<0.05) were risk factors for increased severity of BPD. The pulmonary function test performed at the corrected gestational age of 40 weeks showed that compared with the mild BPD group, the moderate/severe BPD group had significantly lower ratio of time to peak tidal expiratory flow to total expiratory time, ratio of volume to peak tidal expiratory flow to total expiratory volume, and tidal expiratory flow at 25% remaining expiration (P<0.05). The infants were followed up to the corrected gestational age of 1 year, and the moderate/severe BPD group had significantly higher incidence rates of recurrent hospital admission for pneumonia and recurrent wheezing (P<0.05).</p><p><b>CONCLUSIONS</b>SGA birth, pneumonia, and prolonged mechanical ventilation are associated with increased severity of BPD. Infants with moderate or severe BPD have poor pulmonary function and may experience recurrent infection and wheezing.</p>

Effect of Intrauterine Infection and Interuterine Asphyxia to Fetal Rats′ Brain Damage,Cell Apoptosis and Expression of Glial Fibrillary Acidic Protein / 实用儿科临床杂志

Objective To find out the associated effect of intrauterine infection and interuterine asphyxia to fetal rat′s brain damage,cell apoptosis,and expression of glial fibrillary acidic protein(GFAP).Methods Pregnant rats of gestation 18 days were randomly divided into four groups:1.NS plus sham operation,2.intrauterine infection,3.intrauterine asphyxia,4.intrauterine infection plus intrauterine asphyxia.The fetal rats′ brains were taken out 72 h after different disposal and given HE coloration,immunohistochemistry of TUNEL and GFAP,respectively.Results The level of brain cell edema and tissue disorganization of group intrauterine infection plus intrauterine asphyxia were more serious than those of group intrauterine infection or group intrauterine asphyxia.TUNEL and GFAP had the same results:The number of positive cells in group intrauterine infection plus intrauterine asphyxia more than that in group intrauterine infection,and which in group intrauterine asphyxia more than that in group NS plus sham operation.There was significant difference between the first three groups and the group NS plus sham operation(P=0).There was also significant difference between group intrauterine infection plus intrauterine asphyxia and group intrauterine infection or group intrauterine asphyxia(P=0).Conclusions Both intrauterine infection and intrauterine asphyxia may induce premature rat brain damage,the association of intrauterine infection and intrauterine asphyxia may aggravate the degree of fetal rat brain damage,also increase the number of apoptosis cell and the expression of GFAP.

Effect of Intrauterine Asphyxia on Expression of Tissue-Type Plasminogen Activator in Fetal Rat′s Brain / 实用儿科临床杂志

0.05),but there were significant difference between the two groups from 12 hours to 48 hours after operation(all P

Influence of Preterm Premature Rupture of Membranes on Neurological Development of Preterm Infants / 实用儿科临床杂志

Objective To investigate the influence of preterm premature rupture of membranes (PPROM) on neurological development of preterm infants.Methods The preterm infants were classified into 2 groups( PPROM group and control group).The neonatal behavioral neurological assessment (NBNA) and CDCC of infants in two groups were measured and compared after retrieved:gestational age 40 weeks,3 months and 6 months.Results Psycho-moter developmental index(PDI) of PPROM group after retrieved gestational age 3,6 months was significantly lower than that of control group(Pa