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Objective To study the correlation between serum cysteine aspartate proteinase 2(CASP2)level and neonatal behavioral neurological assessment(NBNA)score in children with hypoxic-ischemic en-cephalopathy(HIE),and the value of CASP2 in evaluating prognosis.Methods A total of 114 neonates with HIE in this hospital from January 2018 to April 2022 were selected as HIE group.According to the severity of the disease,the neonates were divided into mild group(40 cases),moderate group(52 cases)and severe group(22 cases).According to the prognosis after 6 months of treatment,114 neonates with HIE were divided into poor prognosis group(26 cases)and good prognosis group(88 cases).At the same time,106 healthy neonates born in the hospital were selected as the control group.The NBNA score was recorded,and the serum CASP2 level was detected by enzyme-linked immunosorbent assay.Pearson correlation was used to analyze the corre-lation between serum CASP2 level and NBNA score in HIE children.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of NBNA score and serum CASP2 level for the prognosis of ne-onates with HIE.Results The level of serum CASP2 in HIE group was higher than that in control group,and the NBNA score was lower than that in control group(P<0.05).The level of serum CASP2 in the severe group was higher than that of the moderate group and mild group,and the NBNA score was lower than that of moderate group and mild group(P<0.05).The level of serum CASP2 in the moderate group was higher than that of the mild group,and the NBNA score was lower than that of the mild group(P<0.05).The NBNA score was negatively correlated with the serum level of CASP2 in the children with HIE(r=-0.608,P<0.05).The poor prognosis group had a significantly higher serum level of CASP2 and a significantly lower NBNA score than the good prognosis group(P<0.05).The serum level of CASP2 and NBNA score separate and joint area under the curve of the poor children with HIE prognosis were 0.875(95%CI 0.797-0.952),0.748(95%CI 0.639-0.857),0.927(95%CI 0.873-0.981).Conclusion The level of serum CASP2 increases with the severity of HIE,and is closely related to the NBNA score,which has an important prognostic value.
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Objective:To observe the effect of rich environmental rehabilitation training on the physical system and ner-vous system development of newboms with hypoxic-ischemic encephalopathy(HIE). Method:Sixty-one HIE newboms were divided into the observation group(n=31)and the control group(n=30).The control group was given the routine clinical treatment and care,and the observation group was supplemented with enriched environmental rehabilitation training on the basis of the control group for 3 weeks.The body length and weight,and the head circumference of the two groups were measured to assess the physical development at admis-sion and 3 weeks after the intervention,and the neonatal behavioral neurological assessment(NBNA)and test of in-fant motor performance(TIMP)were used to evaluate the neurological development and motor function. Result:After the intervention,the changes of body length and weight changes in the observed group were bet-ter than the control group(P＜0.05),no significant difference in head circumference(P＞0.05),and the NB-NA score and TIMP score were higher than those of the control group(P＜0.05). Conclusion:The application of rich environmental rehabilitation training can promote the rapid development of physique and nervous system of the newboms with HIE and improve the motor function.
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Objective To study the clinical value of heat shock protein (HSP)70 in the diagnosis of neonatal asphyxia and the correlation of HSP70 and Neonatal Behavioral Neurological Assessment (NBNA)score.Methods From January 2014 to June 2016,full-term neonates born in our hospital were enrolled in the study and assigned into mild and severe asphyxia groups.Normally delivered full-term infants were assigned to the control group.Blood from umbilical artery were extracted immediately after birth and HSP70 levels were detected using ELISA.The NBNA scores were recorded at the 7th,14th and 28th-day after birth.Results HSP70levels in both mild (n =46 )and severe (n =35 )asphyxia groups were significantly higher than the control group(n =50)[(14.4 ±2.7)ng/ml、(17.7 ±4.5)ng/ml than(11 .9 ± 2.3)ng/ml,P <0.05].The severe asphyxia group had even higher HSP70 levels than the mild asphyxia group (P <0.05).The NBNA scores of both asphyxia groups were significantly lower than the control group (P <0.05).The umbilical pH values of both two asphyxia groups were also significantly lower than the control group(P <0.05).Correlation analysis showed that HSP70 level was negative correlated with NBNA score (7th,14th,28th-day)(r =-0.574、-0.493、-0.208,P <0.05).The HSP70 level was negatively correlated with umbilical pH (r =-0.576,P <0.05).The area under curve(AUC)for HSP70 levels to predict asphyxia was 0.798(95%CI 0.722 ~0.874,P <0.05).Conclusions HSP70 level in umbilical cord blood can be used as an indicator for neonatal asphyxia.The more severe the asphyxia,the higher the HSP70 levels and the lower NBNA score and umbilical pH.
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Objective To observe the effect of adverse factors on neurodevelopmental development of neonates during pregnancy. Methods The prenatal stress mothers were selected by the Life Event Scale and their neonatal were as the prenatal stress group. The newborns of normal mothers were as the control group. Results The NBNA scores of the prenatal stress group were significantly lower than those in the control group(33.16±2.35 vs 38.36±2.13,t=-9.724,P<0.01),specialty in light and tone habit. Gender and mode of delivery had no effect on NBNA scoring. Conclusion Prenatal stress can result in a reduction in neonatal NBNA scores and is independent of the mode of delivery and gender.
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Objective To study the gas analysis of umbilical cord artery blood and radial artery blood on predicating the prognosis of asphyxia neonate?Methods From September 2014 to September 2015, 328 neonates were divided into groups by Apgar score:290 patients in the control group and 27 patients in the mild asphyxia group,11 patients in the severe asphyxia group?After birth,umbilical artery blood,radial artery blood gas analysis was perfomed, oxygenation index was calculated, Outcome of neonatal behavioral neurological assessment ( NBNA) in neonates with asphyxia was regular follow?uped,the relationship between pH value and umbilical artery blood gas analysis was analyzed?Results The pH, PO2, PCO2 and oxygenation index of umbilical cord blood and radial artery blood in the severe asphyxia group was(7?11±0?25,(73?93±23?35) mmHg,(51?36±16?37) mmHg,206?23±98?12),significant different than the mild group(7?24±0?05,(86?35 ±12?56) mmHg,(45?89± 9?21) mmHg,411?22±57?94) and the control group(7?28±0?08,(87?80±12?07) mmHg,(43?68± 6?45) mmHg,426?23±73?30)(P<0?05)?The pH,PO2,PCO2 and oxygenation index of umbilical cord blood and radial artery blood in the severe asphyxia group was(7?25±0?18,(74?66±24?09) mmHg,(51?42±17?83) mmHg,332?03±65?19),significant different than the mild group(7?31±0?09,(87?24 ±11?75) mmHg,(45?73±10?21) mmHg,405?67±82?65) and the control group(7?32±0?06,(87?99±11?81) mmHg,(42?84± 9?32) mmHg,439?89±60?76)(P<0?05)?The NBNA scores of the severe asphyxia group was (34?09±5?02) points,lower than the mild group(36?62±2?04)(F=21?65,P<0?05)?The NBNA scores showed significant relationship with umbilical cord blood pH in the severe asphyxia group( r=0?877,P<0?01)?Conclusion The pH,PO2 and oxygenation index of umbilical cord blood and radial artery blood was lower while PCO2 was markedly high in the severe asphyxia group than other groups?For neonates, there is a correlation between umbilical cord blood pH and NBNAs core, neonates borned with hypoxia and acidosis should monitor blood gas analysis and oxygenation index dynamically
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Objective To study the neurodevelopmental outcome prospectively at 18 months of the late preterm infants.Methods Data from 7 584 live born neonates were collected between January and December.2009 in 3 hospitals located in the north of Chengdu City,Sichuan Province were collected,89 late preterm infants were brought into study ; 170 healthy full-term infants were chosen as the controls randomly.Neurodevelopment outcome was assessed by using neonatal behavioral neurological assessment(NBNA) at 40 weeks corrected gestational age,and Bayley scales of infant development was performed to obtain the physical development index (PDI) and mental development index (MDI) at 3,6,9,12 and 18 months corrected age.Neurodevelopmental outcome of late preterm infants was studied compared with that of the term infants.Results Sixty-three neonates born at the late preterm phase and 115 neonates born at the term phase were successfully followed up.The NBNA scores of the late preterm infants at 40 weeks corrected gestationa] age were significantly lower than those of the term infants.The proportion of the late preterm infants whose scores ≥37 was significantly lower than that of the term infants(82.5％ vs 94.8％),the proportion of late preterm infants whose scores ＜35 was significantly higher than that of the term infants(4.8％ vs 0),the proportion of the late preterm infants whose scores in 35-36 was significantly higher than that of the term infants (12.7％ vs 5.2％,Z =-2.707,P ＜ 0.05) ;At 3,6,9 and 12 months corrected age,the late preterm infants showed a significant lower PDI scores(t =-4.266,-4.594,-5.663,-2.584) and MDI scores (t =-7.121,-7.829,-7.038,-6.002) than those of the term infants(all P ＜0.05).Compared with the term infants,the late preterm infants still had lower MDI scores than the term infants at 18 months corrected age(t =-4.115,P ＜0.05),but no difference was observed in PDI scores between late preterm and the term infants (t =-0.957,P ＞ 0.05).Conclusions Neurodevelopment outcome of the late preterm infants is delayed in the first year compared with term infants.At 18 months corrected age the mental development is still delayed compared with the term infants.Measures should be taken properly to improve the neurodevelopment of the late preterm infants in the early childhood.
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Objective To investigate the coagulation function,the related factors and prognosis of preterm infants with periventricular hemorrhage-intraventricular hemorrhage (PVH-IVH).Methods Eighty-one preterm infants with PVH-IVH and 81 infants with non-PVH-IVH as a control were enrolled in the study.The changes in activated thromboplastin time(PT),activated partial thromboplastin time (APTT),Fibrinogen and D-dimer were determined by enzyme-linked immunosorbent assay.Clinical factors which were related to PVH-IVH in infants were analyzed with statistical analysis and prognosis was assessed with neonatal behavioral neurological assessment (NBNA).Results The average of gestational age in PVH-IVH group was(30.9 ± 1.79)weeks,in control group were (31.36 ± 1.39)weeks,and there was significant difference between the 2 groups (F =6.52,P =0.012).There were significant differences in APTI,and D-dimer between PVH-IVH and non-PVH-IVH infants(all P ＜ 0.05).Multivariate Logistic regression analysis showed that the related factors included gestational age,neonatal respiratory distress syndrome(NRDS),hyperoxia,and mechanical ventilation(OR =3.98,1.72,2.99,5.65,all P ＜ 0.05).The NBNA scores of the 2 groups were also significantly different(t =9.16,P ＜ 0.05).Conclusions The occurrence of PVH-IVH is very complex resulted from gestational age,NRDS,hyperoxia,mechanical ventilation and other factors.In order to avoid the occurrence of intracranial hemorrhage and improve the life quality of preterm infants,the NRDS was prevented as far as possible,coagulation abnormalities were managed positively and the mechanical ventilation was shortened.
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@#Objective To observe the effect of Rood therapy intervened very early on development of premature infants. Methods 148 hospital-born infants gestated 32 weeks with high risk of brain injury were divided into intervention group (n=74) and control group (n=74).All the cases accepted routine treatment and nursing, and the intervention group accepted Rood therapy in addition. They were followed up to 28th day, assessed with Neonatal Behavioral Neurological Assessment (NBNA). Results The NBNA score was more in the intervention group than in the control group (P<0.05) in all the sub-scores except primitive reflexes. Conclusion Rood therapy is useful to improve the neural development in premature infants in 32 to 36 weeks.
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Objective To explore perinatal risk factors associated with the neurobehavioral development of small for gestational age (SGA) full-term neonates.Methods This prospective cross-sectional study included 111 full-term newborn infants from Apr 2008 to Apr 2010 born in Yan-tai Yuhuangding Hospital.Detailed clinical data in perinatal period of all subjects were recorded.Infants aged 3 ～ 7 days were assessed with neonatal behavioral neurological assessment (NBNA) for neurobehavioral development.Logistic regression analysis was used to explore risk factors associated with the score of NBNA.Results Significant differences (P ＜ 0.05) were found between full-term SGA (10.72 ± 1.41,7.13 ± 0.96,7.32 ± 0.74,37.16 ±1.32) and normal neonates (11.27 ± 1.04,7.89 ± 0.72,7.62 ± 0.64,39.12 ± 0.76) in terms of capacity,active and passive muscle tension and NBNA score.Full-term SGA neonates had lower score than control.Univariate logistic regression showed that delivery,placenta abnormalities,umbilical cord abnormalities,infection in perinatal period,gestational hypertension,twin pregnancy,hyperbilirubinemia affected neurobehavioral development of full-term SGA infants.Multivariate logistic regression showed that mothers' infection in perinatal period (OR =2.175,95 ％ CI 1.981 ～ 2.408,P ＜ 0.05),twin pregnancy (OR =1.936,95％ CI 1.517 ～2.368,P ＜ 0.05) and hyperbilirubinemia (OR =1.518,95％ CI 1.072-2.149,P ＜ 0.05) were risk factors for neurobehavioral delay of full-term SGA infants.Conclusion Full-term SGA neonates showed poorer quality in neurobehavior.Risk factors associated with neurobehavior of full-term SGA infants included mothers' infection in perinatal period,twin pregnancy and hyperbilirubinemia.
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Objective To analyse the associativity among serum thyroid hormone level,brain injury and neuroethology in preterm infants by testing the thyroid hormone level and neuro-behaviour assessment.Methods Fifty-two preterm infants were continuously admitted in neonatal department of Shanghai Children's Hospital from Dec 2009 to Apr 2010. Radio-immunity was used to determine the serum level of T3,T4, TSH within 6 h after birth. Each case received cranial ultrasonic examination within 3 d after birth and rechecked every week. Before discharge, every infant received a cranial MRI examination. The 52 cases were devided into three groups according to the result of ultrasound and MRI:no brain damage group (33 cases),intraventricular hemorrhage greup (10 cases) ,and white matter injury group (9 cases). At the corrected gestation age 40±2 weeks,every infant received a neonatal behavioral neurological assessment (NBNA). Results The level of serum TSH in all the three groups of preterm infants were normal, which could reject congenital hypothyroidism. Eight preterm infants(15.4% ,8/52) had normal thyroid hormone level,another 44 preterm infants(84. 6% ,44/52) got lower thyroid functions. The levels of T3 and T4 were higher in the no brain damage group than those in intraventricular hemorrhage group and white matter injury group. And the preterm infants who had white mauer injury got the lowest level of thyroine hormone T3 and T4. Thyroxine hormone levels had significant difference among three groups (P ＜ 0. 05). The preterm infants who had no brain damage got higher scores in capability, passive muscle tonus,initiative muscle tonus and total score than the other two groups. Intraventricular hemorrhage group always got higher scores in NBNA than the white matter injury group (P ＜ 0. 05). The NBNA scores had significant difference among three groups (P ＜ 0. 05). Conclusion Premature infant who has more severe brain injury always has lower levels of thyroxine hormone. Premature infants with brain injury get lower scores in NBNA test than those without brain injury.
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Objective To study the clinical curative and protective effects of erythropoietin (EPO)on treating the premature infants with brain damage. Methods Forty-two premature infants with periventricular leukomalacia were divided into the EPO treatment group (n = 22) and control group (n = 20). From postnatal day 3 to 5 ,the EPO treatment group received EPO for 4 weeks. Neonatal behavioral neurological assessments (NBNA) for all infants were performed separately in 40 weeks after correcting gestational age. All infants were followed up until 6 month after birth, MRI and electroencephalogram were performed. The developmental quotient(DQ) was evaluated at the age of 3 and 6 months. Results The NBNA scores of EPO group in 40 weeks and DQ were significantly higher than those of control group (P ＜ 0.05). Conclusion EPO can rehabilitate the damaged neurological system of premature infants with brain damage. Early EPO therapy can promote development of the neurobehavioral and improve prognosis.
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Objective To investigate the relationship of placental vascular anastomosis and physical development and morbidity of the disease in twin neonates.Methods Fourteen pairs of twin neonates deliveried from Sep.2005 to Aug.2009 were enrolled in Newborn Intensive Care Unit,the Third Affiliated Hospital of Zhengzhou University.These twins were divided into 2 groups according the conditions of placental vascular anastomosis:significant placental vascular anastomosis group(group A) and no significant vascula anastomosis group(group B).Birth weight,head circumference,length,the morbidity of disease were all investigated in 2 groups.Clinic follow-up included neonatal behavioral neurological assessment(NBNA) and children′s development center of China(CDCC).The correlation of neonates placental vascular anastomosis between twin neonates were compared.Results There were statistically significant differences between group A and group B in birth weight,head circumference and body length(t=6.070,5.237,5.784,Pa
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0.05),there were significant differences on NBNA scores in HIE neonates with moderate and severe degree between the two groups(P
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@#ObjectiveTo discuss the effect of neonatal behavioral neurological assessment (NBNA) and developmental screening test (DST) on newborns with hypoxic ischemic encephalopathy (HIE). MethodsNBNA was performed for 60 newborns with HIE within 12-14 days and DST was also performed at 6th month after birth.ResultsMild and severe degree HIE newborns with low NBNA scores had unfavorable prognosis. Conclusions NBNA and DST can provide evidence for early interference for newborn's HIE.