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@#AIM: To explore the incidence and high risk factors of retinopathy of prematurity(ROP).<p>METHODS:Retrospective study. A total of 161 neonates in Gaozhou People's Hospital from January 2018 to January 2021 who met the screening guidelines for retinopathy of prematurity in China(2014)were selected as subjects. Retcam Ⅲ was used for fundus screening. Clinical data of neonates and their mothers were analyzed retrospectively. Univariate analysis and Logistic regression analysis were used to analyze the risk factors for ROP.<p>RESULTS: Among 161 neonates meeting the inclusion criteria, 26(16.1%)were in the ROP group and 135(83.9%)were in the non-ROP group. Gestational age, neonatal red blood cell count, birth weight, maternal age, gestational hypertension, method of conception showed statistical significance between the two groups(<i>P</i><0.05)in Univariate analysis. Multivariate Logistic regression analysis revealed that age(<i>OR</i>=0.549, 95%<i>CI</i>: 0.391-0.770, <i>P</i>=0.001)is a protective factor of ROP, however, hypertension during pregnancy(<i>OR</i>=3.947, 95%<i>CI</i>: 1.049-14.852, <i>P</i>=0.042)and assisted reproductive(<i>OR</i>=4.632, 95%<i>CI</i>: 1.112-19.305, <i>P</i>=0.035)are risk factors of ROP.<p>CONCLUSION: Gestational age is a protective factor for ROP, and assisted reproduction is a risk factor for ROP. High attention should be paid to the neonates with low gestational age, assisted reproductive technology and whose mother has hypertensive disorders of pregnancy. Early screening, early detection, and early treatment of neonatal fundus may reduce blindness caused by ROP.
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The decision whether or not to resuscitate extremely low gestational age (GA) infants is recommended to be individualized according to antenatal counseling with parents, neonatologists, and obstetricians. A GA of 22(0/7)–23(6/7) weeks is generally considered as the lower end of the range where infants can be candidates for selective resuscitation. Below this lower end of periviable gestation, resuscitation is usually not considered and survivors are rarely reported. To date, the youngest survivor is an infant with a GA of 21(6/7) weeks reported in the English medical literature. Here, we report the case of a female infant, the first twin conceived through in vitro fertilization, with a GA of 21(5/7) weeks, who was resuscitated initially according to strong parental wishes after antenatal counseling and is still surviving at 43 months of age with fairly good neurodevelopmental outcome.
Subject(s)
Female , Humans , Infant , Pregnancy , Counseling , Fertilization in Vitro , Gestational Age , Parents , Resuscitation , Survivors , TwinsABSTRACT
Objective To evaluate neurodevelopmental outcome of very preterm(gestational age ＜ 32 weeks) and very low birth weight infant (VLBWI) (weight ＜ 1 500 g) and to examine the effectiveness of an early intervention program till 12 months corrected age.Methods Seventy followed-up very preterms and VLB-WI in Jinan Maternity and Childcare Hospital were enrolled in this study from January 2012 to and were divided into two groups by birth weight.All infants received 20 items of behavioral neurological assessment at 1 to 12 months corrected age and tested mental and psychomotor development with the use of CDCC at 6,12 months corrected age.The preterms who were abnomal in the 20 items of behavioral neurological assessment would receive early intervention (including kinesitherapy, physiotherapy, cereal circulation therapeutic equipment) by physiotherapists and their parents who received an intervention program training and were strongly encouraged to participate in the intervention sessions.The intervention method was adjusted according to the neurological assessment.The SPSS statistical software package for Windows, version 15.0, was used to run Fisher's exact test and t-test on the data presented,and P value of less than 0.05 was regarded as statistically significant.Results The average gestational age of infants was (30.4 ± 1.8) weeks,and average birth weight (1 463.7 ± 307.5) g.The incidence of extrauterine growth restriction was 57.1％ at first follow-up.The incidence of neurodevelpmental impairment NDI) and cerebral palsy tendency at 6 corrected months were 14.3％ ,8.6％ respectively.At 12 months corrected age,the incidence of NDI decreased to 2.9％ and cerebral palsy to 2.9％.There was significant difference in the incidence of NDI between 6 and 12 corrected months.There was no significant difference in the incidence of psychomotor developmental index ＜ 70, mental developmental index ＜ 70, NDI and cerebral palsy between the two groups.Conclusion The early intervention program can improve VLBWI neurodevelopmental outcomes at 12 months' corrected age and reduce the incidence of cerebral palsy.
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Introducción: La tasa de mortalidad infantil en el Distrito Capital para el 2006 fue de 13,5 casos por 1.000 nacidos vivos. Aunque ha venido disminuyendo levemente en los últimos cinco años, la tendencia es a mantenerse estable. Para Bogotá era necesario caracterizar los factores asociados a la mortalidad infantil, que facilitaría las intervenciones de prevención y atención en la niñez menor de un año. Objetivo: Identificar algunos factores asociados a la mortalidad infantil en la ciudad de Bogotá en el 2008, mediante las variables incluidas en los certificados de defunción y los certificados de nacidos vivos. Método: Estudio de casos y controles. 1) Casos: defunciones en menores de un año durante el 2008 en Bogotá, y 2) controles: los nacidos vivos en el 2007 en Bogotá. Se utilizó un análisis bivariado estratificando por bajo peso y edad gestacional. Se empleó un modelo de regresión logística que incluía las variables con un valor de p < 0,10 en el análisis bivariado. Resultados: Los factores de riesgo para mortalidad infantil fueron: la edad gestacional menor de 37 semanas, el peso al nacer menor de 2.500 g, el niveleducativo de la madre con primaria o sin educación, la afiliación al régimen subsidiado y el sexo masculino. Conclusiones: Se identificaron factores de riesgo propios del recién nacido y del control prenatal, así como de la vinculación al Sistema de Seguridad en Salud. Estos factores son potencialmente modificables. Palabras clave: factor de riesgo, mortalidad infantil, peso bajo al nacer, baja edad gestacional, estudio caso-control.
Introduction: Infant mortality in the Bogota for 2006 was 13.5 cases per 1,000 live births. While it has been declining slightly over the past five years the trend has been stable. For Bogota its necessary to characterize the factors associated with infant mortality which facilitate the prevention and care interventions in this type of population. Objective: To identify some factors ssociated with infant mortality in Bogotá in 2008 through the variables included in 1death certificates and certificates of live births. Materials and methods: Case-Control Studies: (1) Case: eaths under one year old in 2008 in the Capital District, and (2) control: live births in 2007 in the Capital District. It was used a bivariate analysis, stratified by weight and gestational age. It was used a logistic regression model including the variables with p < 0.10 in the bivariate analysis. Results: The risk factors for infant mortality were: gestational age less than 37 weeks, birth weight less than 2,500 g, mothers educational level with primary or no education, affiliation to the subsidized regime and males. Conclusions: There are risk factors that can be modified hrough the maternal health care which will prevent preterm births and children with low birth weight. It can reduce the risk of infant mortality, ensuring a good education of the population, improving the quality of care in health services and giving greater attention to males, which is not only risk factor for infant mortality but for some morbidities. Key words: Risk factors, infant mortality, low birth weight, low gestational age, case-control study.