Growth retardation and its influencing factors in infants aged 0‒3 in Minhang District， Shanghai / 上海预防医学

ObjectiveTo investigate the detection rate and main influencing factors of growth retardation in infants aged 0-3 in Minhang District， and to provide relevant evidence for early intervention， nutrition promotion and health guidance in the future. MethodsFrom September 1， 2020 to August 31， 2021， the height， weight， basic information of parents， feeding methods， and lifestyle habits of infants who received systematic healthcare aged 0‒3 in community health service centers and Minhang maternal child health hospital were collected， and the current situation and influencing factors of infant growth retardation were analyzed. ResultsAmong the 68 637 infants who underwent a systematic physical examination in Minhang District， the total detection rate of growth retardation was 5.03% （3 453/68 637）. The detection rates in the 0-year-old， 1-year-old， 2-year-old， and 3-year-old groups were 6.57% （1 636/24 885）， 3.90% （664/17 031）， 4.62% （827/17 905）， and 3.72% （326/8 773）， respectively. There was no difference in the detection rate of growth retardation between boys and girls （P>0.05）， and a multinomial logistic regression analysis of 13 influencing factors （infant birth weight， birth length， parental weight， height， education level， mother’s childbearing age， delivery mode， household registration， feeding mode within 6 months， infant sleep， etc.） in univariate analysis showed that birth weight <2 500 g （OR=3.99， 95%CI： 2.809‒5.674） or ≥4 000 g （OR=12.78， 95%CI： 8.868‒18.443）， maternal height <150 cm （OR=7.10， 95%CI： 4.294‒11.753）， paternal height <160 cm （OR=5.65， 95%CI： 2.792‒11.422）， maternal education level of junior high school and below （OR=1.31， 95%CI： 1.087‒1.588）， paternal education level of junior high school and below （OR=1.02， 95%CI： 0.838‒1.236）， mixed feeding （OR=1.15， 95%CI： 1.031‒1.288）， and sleep duration exceeding the recommended time （OR=1.58， 95%CI： 1.466‒1.710） were risk factors for growth retardation in infants aged 0‒3. Infants with a birth length <50 cm or with household registration in Shanghai had a higher incidence of growth retardation. ConclusionGrowth retardation in infants aged 0‒3 is influenced by a combination of genetic， environmental， and sleep factors. It is essential for parents to realize the impact of growth retardation on the future of their children early on and actively participate in the early detection， screening， and intervention of growth retardation.

Research progress on the association between responsive feeding practices and infant and toddler′s eating behavior / 中华实用儿科临床杂志

The eating habits of children developed during infancy and toddlerhood is the foundation of their eating behaviors in later life, and have great influence on their nutritional status and health.Caregivers′ feeding practices affect children′s eating behaviors.Feeding practices are modifiable and can be used as an intervention.In recent years, responsive feeding practices have been extensively recommended.In order to expand knowledge of responsive feeding practices, and promote optimal feeding practices and children′s healthy eating behaviors, evidence about the associations between responsive feeding and infant and toddler′s eating behaviors was summarized in this paper.

The texture analysis of MRI diffusion-weighted imaging for predicting prognosis of neonatal hypoglycemic encephalopathy / 中华全科医师杂志

Objective:To investigate the prognostic value of texture analysis of MRI diffusion weighted imaging (DWI) for neonatal hypoglycemic encephalopathy (HE).Methods:The clinical data and MRI data of 119 patients with neonatal HE admitted to Children′s Hospital of Nanjing Medical University from July 2013 to September 2020 were retrospectively analyzed. The children were followed up to 7—8 months and scored by Bayley scales of infant and toddler development. According to the overall development index, the children were divided into three groups: normal group (≥85, group A, n=42), mild developmental retardation group (70－84, group B, n=46) and developmental retardation group (≤69, group C, n= 31). The whole brain region (except sulcus and cisterna) was delineated as region of interest (ROI) by LIFEx 3.4 software in MRI apparent diffusion coefficient images. A total of 37 parameters were calculated automatically by the software, The clinical data, including gender, gestational age, age at MRI scan, birth weight, mode of delivery, history of asphyxia at birth, maternal preeclampsia or diabetes, minimum blood glucose, duration of hypoglycemia, neonatal behavioral neurological assessment (NBNA), presence or absence of polycythemia); the texture parameters, including histogram, volume, gray level co-occurrence matrix (GLCM), gray level run length matrix (GLRLM), neighborhood gray tone difference matrix (NGTDM), gray level size zone matrix (GLSZM), in the three groups were analyzed; and the diagnostic efficacy of clinical parameters and texture parameters was analyzed. Multivariate Logistic regression was used to analyze statistically significant clinical parameters and texture parameters, and receiver operating characteristic curve (ROC) was used to evaluate the prognostic efficacy of these parameter for neonatal HE. Results:There were no significant differences in gender, gestational age, age at MRI scan, delivery mode and blood glucose minimum among the three groups ( P>0.05). There were significant differences in birth weight [(3 150±130)g, (3 020±220)g, (2 880±140)g, F=-0.31, P=0.015], history of suffocation (10 cases, 18 cases, 20 cases, P=0.001), history of maternal diabetes or preeclampsia (14 cases, 29 cases, 21 cases, P=0.002), blood glucose duration [(5.0±0.2)d, (8.0±0.4)d, (14.0±1.7)d, F=-3.09, P=0.030] and NBNA scores (32.0±3.2, 28.0±2.6, 22.0±1.9, F=-4.21, P=0.010) among three groups. There were significant differences in kurtosis and entropy of histogram (2.57±1.12, 3.66±0.98, 4.23±0.37, F=3.54, P=0.010;5.89±1.09, 7.67±2.12, 8.92±1.62, F=-4.42, P=0.020); energy, contrast and dissimilarity of GLCM (0.48±0.01, 0.36±0.02, 0.23±0.01, F=-3.12, P=0.001;2 419±21, 3 354±31, 4 313±26, F=-4.16, P=0.020;126±14, 153±23, 344±43, F=-3.50, P<0.001); long run emphasis of GLRLM (0.78±0.15, 1.12±0.12, 1.76±0.31, F=-4.13, P=0.006), run length non-uniformity and run percentage (71.7±13.9, 96.6±10.7, 104.1±13.5, F=-0.98, P=0.001;0.91±0.05, 0.84±0.21, 0.72±0.17, F=2.97, P=0.010); coarseness and busyness of NGTDM [0.09±0.01, 0.13±0.03, 0.26±0.07, F=-1.95, P=0.003;0.16(0.04, 4.14), 0.32(0.05, 9.84), 0.45(0.15, 10.14), H=-3.24, P=0.030], short-zone emphasis and short-zone high gray length emphasis of GLSZM (4.74±0.45, 3.44±1.03, 1.88±0.67, F=-3.14, P=0.040; 278 963±239, 164 607±544, 111 653±618, F=-3.84, P=0.001) among three groups. Multivariate Logistic regression showed that duration of hypoglycemia, NBNA score, energy, kurtosis, run percentage and short zone effect were independent risk factors for poor prognosis of neonatal HE ( OR=7.43, 4.09, 1.10, 2.11, 1.36, 1.68, P=0.002, 0.027, 0.001, 0.006, 0.007, 0.010, respectively). ROC curve showed that for combined hypoglycemic duration, NBNA and texture parameters, the area under the curve (AUC) was the highest (AUC=0.94, P<0.001). Conclusion:Texture analysis of the MRI diffusion weighted imaging can predict the prognosis of neonatal hypoglycemic encephalopathy at an early stage, which has better prediction efficiency when combined with clinical features.

Role of maternal drug use and environmental exposure during pregnancy and delivery pattern in allergic infants and toddlers / 中华流行病学杂志

Objective To understand correlation between maternal drug use and environmental exposure during pregnancy and delivery pattern and allergy in infants and toddlers,and provide theoretical bases for the early prevention and intervention of infantile allergies.Methods Case control study based on cross-sectional investigation was conducted.Thirty-three cities were selected in China.Randomly cluster sampling method was used to select a community in each city as the study sample,the women with infants aged 0-24 months were interviewed in the form of face-to-face questionnaire survey.Infants and toddlers were divided into two groups:case group,including 2113children who had allergic symptoms and were diagnosed with allergic disease,and control group,including 6303 children who never had symptoms of allergic disease.Results Children whose parents had allergic disease histories were more likely to have allergic disease (OR=3.950) compared with the children whose mother or father had allergic disease histories (0R=2.277).Maternal use of antibiotics (OR=1.396),disinfector exposure (0R=1.386),smoking exposure (OR=1.301) during pregnancy and cesarean delivery (OR=1.255) were risk factors for allergic disease in infants and toddlers,the differences were significant (P＜0.05).Conclusion It is essential to conduct primary prevention of infant allergy during pregnancy,and it is necessary to avoid unnecessary cesarean delivery and irrational antibiotic use,disinfector and smoking exposures during pregnancy.

Role of maternal drug use and environmental exposure during pregnancy and delivery pattern in allergic infants and toddlers / 中华流行病学杂志

Objective To understand correlation between maternal drug use and environmental exposure during pregnancy and delivery pattern and allergy in infants and toddlers,and provide theoretical bases for the early prevention and intervention of infantile allergies.Methods Case control study based on cross-sectional investigation was conducted.Thirty-three cities were selected in China.Randomly cluster sampling method was used to select a community in each city as the study sample,the women with infants aged 0-24 months were interviewed in the form of face-to-face questionnaire survey.Infants and toddlers were divided into two groups:case group,including 2113children who had allergic symptoms and were diagnosed with allergic disease,and control group,including 6303 children who never had symptoms of allergic disease.Results Children whose parents had allergic disease histories were more likely to have allergic disease (OR=3.950) compared with the children whose mother or father had allergic disease histories (0R=2.277).Maternal use of antibiotics (OR=1.396),disinfector exposure (0R=1.386),smoking exposure (OR=1.301) during pregnancy and cesarean delivery (OR=1.255) were risk factors for allergic disease in infants and toddlers,the differences were significant (P＜0.05).Conclusion It is essential to conduct primary prevention of infant allergy during pregnancy,and it is necessary to avoid unnecessary cesarean delivery and irrational antibiotic use,disinfector and smoking exposures during pregnancy.

Application of two scales in screening of postoperative cognitive dysfunction in children after general anesthesia / 中华行为医学与脑科学杂志

Objective To assess the application of Chinese children's intelligence equation (CCIE) and Bayley Scales of infant and toddler development-Ⅲ (BSID-Ⅲ) in screening of postoperative cognitive dysfunction (POCD) in children after general anesthesia.Methods The study group (Group A),including 50 ASA-Ⅰ participants of 1-3 years old who would undergo hernia repair laparoscopic surgery,was assessed on one day (1 d) before and three days (3d) after the surgery respectively by both of CCIE and BSID-Ⅲ according to their ages of month.The control group (Group C),including 50 healthy participants with the matched age,was assessed in the same period by the same method.Both of Group A and C were assessed by the Z score method to diagnose POCD and both scales were used to analyze the results of POCD screening and their agreement.Results (1) Compared with preoperative 1 d,the CCIE score of Group A on 3d after surgery was relatively decreased (21.22±4.96 vs 18.65±4.74,P＜0.05) and the POCD rate was 12.0％.While in Group C,the CCIE score and the POCD rate had no statistical significance (20.83±4.97 vs 21.22±5.21,P＞0.05).(2) Compared with preoperative 1d,the scores of cognition,language,motion,social-emotion and adaptive behaviors in BSID-Ⅲ of Group A decreased (100.00±4.58 vs 96.44± 4.20,103.22±4.99 vs 96.24± 5.75,102.06±4.01 vs 95.28±4.27,101.22±7.38 vs 91.06±7.10,98.52±9.11 vs 90.5±8.47,P＜0.05) and the POCD incidence was 20.0％.While in group C,the BSID-Ⅲ score and the POCD rate had no statistical significance (104.61±5.48 vs 103.79±5.38,107.68±5.60 vs 107.11 ±6.05,108.29±5.91 vs 108.29±4.21,101.11±7.61 vs 101.86±6.99,99.00±7.99 vs 100.82±7.36,P＞0.05).(3)Reasonable agreement of the CCIE and BSID-Ⅲ was observed (Kappa value was 0.70;P＜ 0.05).Conclusion There is considerable agreement between BSID-Ⅲ and CCIE.While BSID-Ⅲ is relatively more sensitive to the POCD and more efficient in the diagnosis of POCD than the CCIE.Thus,BSID-Ⅲ is more likely to provide better evaluation of the postoperative cognitive functions of children within 1-3 years old and should be recommended to the health professionals in China.

Early start denver model for young children with autism / 中华实用儿科临床杂志

Autism spectrum disorders(ASD) effect on children's physical and mental health has been paid more and more attention,and is widely recognized on the importance of early intervention for young children with ASD,effective intervention for the young children with ASD has become a hot pot in this field.This paper introduced the early start denver model,which was highly respected in early intervention for young children with ASD.

Study on the correlation between social emotion and temperament in infants and toddlers / 临床儿科杂志

Objectives To study the correlation between social emotion and temperament in infants and toddlers. Me-thods The Brief Infant-Toddler Social and Emotional Assessment (BITSEA) and Toddler Temperament Questionnaire (TTQ) were used to evaluate the social emotional problems and temperament of 657 infants and toddlers 1 to 3 years old. Results The temperament dimensions were correlated with behavior and competence factors. The infants and toddlers in dififcult type group had more behavior problems or deifcits/delays in competence than those in easy type group (χ2=26.49, 10.48, P<0.01). Conclu-sions Infants and toddlers with negative temperament traits have more behavior problems and weaker social emotional compe-tences. The temperament should be considered in dealing with emotional problems.

A Survey on the Experience of Accident of Infant, Toddler and Preschooler, and the Education about Emergency Care for Parents / 아동간호학회지

The purpose of this study was to investigate the experiences of accident and visiting emergency center, and the experiences of education about emergency care for parents. The subjects of this study were 117 mothers whose children are attending 9 different nursery schools or kindergartens. The instrument used in this study was developed by researchers and validated by nursing professor, first aid doctor and the president of nursery school, and consisted of 'most important thing in child rearing' ,'experiences of accident and visiting emergency center', 'type of trauma' and 'need for parent education program' the result of this study were as followed ; 1.There were 70.09% of the experience of visiting emergency center among the subjects. The cause of visiting emergency center were high fever and convulsion (42.86%), and trauma by accident (28.04%) 2. The most common type of the indoor accident were fall down and slipping(76.92%), the common type of trauma were contusion (76.92%), abrasion (47.01%), laceration (29.06%), dislocation or fracture (12.82%), burn (10.26%), piercing (8.55%). 3.47.01% of subjects had the experience of education about emergency care for parents. They were educated by child rearing journals (32.72%), small books which were published by hospitals or community health center (25.45%), mass media(21.8%), parent seminar (12.72%), nursery school or kindergarten (5.45%). In conclusion, the need of emergency care for children was strongly found. Therefore, on the basis of above results, the parent education program which fits their cognitive level and their health care needs So, it must be directed on the further study of parents' knowledge about emergency care for children. To enhance the effectiveness of program and accomplish the children's health promotion, advanced instructional media and demonstration must be included.

Factors influencing colonization of Mutans streptococci on teeth in infants and toddlers / 实用口腔医学杂志

Objective:To explore the factors influencing colonization of Mutans streptococci (MS) on teeth of children.Methods:Dental colonization of MS was investigated in 123 children aged from 7 to 42 months in Beijing. Oral examination was performed. Information of nursing habits, diet history etc. was obtained from parent questionnaires.Results:Logistic regression analysis showed that the number of erupted teeth and the intake of sugar-containing food were positively related with MS colonization, their WALD values were 17.411(P=0.000) and 5.637(P=0.018) respectively,OR values were 3.287 and 2.739 respectively.Conclusion:The main factors influencing the colonization of MS were the number of erupted teeth and the intake of sugar-containing food.