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Objective:To investigate the effects of gestational diabetes mellitus (GDM) on neonatal metabolites.Methods:This retrospective cohort study recruited 580 singleton newborns who were born to women with GDM from January 2018 to December 2018 in Foshan Maternal and Child Health Care Hospital as the GDM group. Another 580 counterparts born to non-GDM singleton mothers with matching age were selected as the non-GDM group with an allocation ratio of 1 to 1. Neonatal genetic metabolic disease screening was performed within 3-7 days after birth. Two independent sample t-test, and multiple linear regression model were used for statistical analysis. Results:There were significant differences in seven amino acids and 10 fatty acids levels between the GDM and non-GDM group. The serum levels of six amino acids and eight fatty acids were increased in the GDM group, while the levels of piperamide [(140.79±32.60) vs (150.26±35.46) μmol/L, t=－4.733, P<0.001], palmitoyl carnitine [(2.59±0.81) vs (2.73±0.82) μmol/L, t=－2.940, P=0.003], and carbamate [(0.066±0.022) vs (0.069±0.022) μmol/L, t=－1.937, P=0.042] were decreased compared with the non-GDM group. After adjusting for maternal gravidity, parity, neonatal birth weight, and gender, multivariate linear regression analysis showed that GDM was positively correlated with three amino acids levels, which were cysteine ( ?=0.012), homocysteine ( ?=0.263) and leucine ( ?=4.225); and was negatively correlated with glycine ( ?=－6.271) and piperamide level ( ?=－9.885). With regard to the fatty acids, GDM was positively correlated with the neonatal propionyl carnitine ( ?=0.214), butyryl carnitine ( ?=0.014), 3-hydroxybutyryl carnitine ( ?=0.006), isovaleryl carnitine ( ?=0.009), 3-hydroxyisovaleryl carnitine ( ?=0.024), hexadecanoyl carnitine ( ?=0.001), decadienoyl carnitine ( ?=0.045), octadecadienyl carnitine level ( ?=0.128), but was negatively correlated with palmitoyl carnitine ( ?=－0.119), and carbamate ( ?=－0.002) (all P<0.05). Conclusions:Correlations between maternal GDM and the levels of amino acids and fatty acids in neonates was noted in this study, suggesting that maternal GDM may affect the metabolism of amino acids and fatty acids in offspring at early stage of life.
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Objective@#To investigate the prognostic effect of neonatal morbidities on poor outcomes at 12 months corrected age in very low birth weight (VLBW) premature infants .@*Method@#From November 2013 to October 2014, a multi-center retrospective study was conducted in 8 tertiary Maternal and Children′s hospitals in Guangdong, Hunan and Fujian. The premature infants survived to a postmenstrual age (PMA) of 36 weeks with birth weight less than 1 500 g and without congenital diseases were included, and divided into two groups according to poor outcomes. The birth weight, gestational age, morbidities and poor outcomes (death, cerebral palsy, cognitive delay, et al) were recorded. Data were analyzed with Chi-square test to investigate the relationship between morbidities and poor outcomes. And the predictive effect of the top three morbidities were analyzed by Logistic regression analysis.@*Result@#Total of 834 VLBW premature infants (473 boys and 361 girls) finished the follow-up, whose average gestational age and birth weight were (30.6±1.8) weeks and (1 189±159)g. The incidences of BPD, severe ROP, NEC, brain injury and sepsis were 207 (24.8%), 119 (14.3%), 58 (7.0%), 281 (33.7%) and 124 (14.9%), respectively. There were significant differences between the two groups in the incidences of BPD, severe ROP, NEC, brain injury and sepsis(χ2=42.10, 47.20, 4.81, 44.28, 18.63, all P<0.01), which had significant correlation with poor outcomes at 12 months corrected age. The three top morbidities were severe ROP, BPD and brain injury(OR=3.82, 2.90, 2.80). Combined morbidities with BPD, severe ROP and brain injury correlated with higher risk of poor outcomes (one morbidity, OR=3.14, β=1.15; two morbidities, OR=7.31, β=1.99; three morbidities, OR=22.41, β=3.11; all P<0.01).@*Conclusion@#BPD, severe ROP, NEC, brain injury and sepsis were the risk factors of poor outcomes at 12 months corrected age in VLBW infants. And the more combined morbidities with severe ROP, BPD and brain injury, the higher risk of poor outcomes in this population. Trial registration Clinical Trails, NCT03104946.
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Objective To investigate the prevalence of congenital digestive tract malformation in Foshan city ,and to investi‐gate the influential factors on congenital digestive tract malformation .Methods A total of 17 hospitals in Foshan city were moni‐tored from 2011 to 2014 ,the data of digestive tract malformation defects of neonates were analyzed .Results A total of 308 530 newborn infants were monitored ,among them ,189 cases were diagnosed with digestive tract malformation ,the incidence rate was 0 .61‰ .The high risk factors for digestive tract malformation were as follows :infant‐mother aged or more than 30 years old ,smok‐ing or passive smoking ,adverse pregnancy history of infant‐mother ,male gender of neonate and infant born at full term . Conclusion The age of infant‐mother ,smoking or passive smoking ,adverse pregnancy history of infant‐mother ,gender of neonate and gestational age could influence the incidence of gastrointestinal malformations .
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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 explore the clinical value of color Doppler ultrasoundcardiogram in the screening of congenital heart disease(CHD) in neonates. Methods 29568 neonates were examined by color Doppler ultrasoundcardiogram. Results 369 CHD patients were identified, the overall incidence of CHD was 12.48‰. The incidence in 2009 or 2010 were significantly higher than those in 2005 or 2004 ( all P ＜ 0. 05 ), the mean incidence of four years from 2007 to 2010 was significantly higher than that from 2003 to 2006( 13.78‰ vs 10.17‰,P ＜0. 01 ). Of 369 CHD cases,most of them were ventricular septal defect( occupied 48.24% ) ,next was atrial septal defect( occupied 44.17% ). Conclusion The incidence of CHD ascended rapidly from 2003 to 2010,and color Doppler ultrasoundcardiogram was an important method to diagnose CHD in newborns.