ABSTRACT
OBJECTIVES@#To investigate the therapeutic efficacy of volume-guaranteed high frequency oscillation ventilation (HFOV-VG) versus conventional mechanical ventilation (CMV) in the treatment of preterm infants with respiratory failure.@*METHODS@#A prospective study was conducted on 112 preterm infants with respiratory failure (a gestational age of 28-34 weeks) who were admitted to the Department of Neonatology, Jiangyin Hospital Affiliated to Medical School of Southeast University, from October 2018 to December 2022. The infants were randomly divided into an HFOV-VG group (44 infants) and a CMV group (68 infants) using the coin tossing method based on the mode of mechanical ventilation. The therapeutic efficacy was compared between the two groups.@*RESULTS@#After 24 hours of treatment, both the HFOV-VG and CMV groups showed significant improvements in arterial blood pH, partial pressure of oxygen, partial pressure of carbon dioxide, and partial pressure of oxygen/fractional concentration of inspired oxygen ratio (P<0.05), and the HFOV-VG group had better improvements than the CMV group (P<0.05). There were no significant differences between the two groups in the incidence rate of complications, 28-day mortality rate, and length of hospital stay (P>0.05), but the HFOV-VG group had a significantly shorter duration of invasive mechanical ventilation than the CMV group (P<0.05). The follow-up at the corrected age of 6 months showed that there were no significant differences between the two groups in the scores of developmental quotient, gross motor function, fine motor function, adaptive ability, language, and social behavior in the Pediatric Neuropsychological Development Scale (P>0.05).@*CONCLUSIONS@#Compared with CMV mode, HFOV-VG mode improves partial pressure of oxygen and promotes carbon dioxide elimination, thereby enhancing oxygenation and shortening the duration of mechanical ventilation in preterm infants with respiratory failure, while it has no significant impact on short-term neurobehavioral development in these infants.
Subject(s)
Infant , Child , Infant, Newborn , Humans , Infant, Premature , Prospective Studies , Gestational Age , Carbon Dioxide , Respiratory Distress Syndrome, Newborn/therapy , High-Frequency Ventilation/methods , Respiration, Artificial , Respiratory Insufficiency/therapy , Oxygen , Cytomegalovirus InfectionsABSTRACT
Objective To explore the value of diffusion tensor imaging (DTI)-metrics (fractional anisotropy, FA; mean diffusivity, MD; axial diffusivity, AD and radial diffusivity, RD) in assessing the neonatal neurobehavioral development. Methods From November 2010 to September 2017, 101 neonates (gestational age range, 30-42 weeks;male/female, 69/32) with no abnormalities on conventional MRI were retrospectively included. DTI scalar maps (FA, MD, AD and RD) were calculated by using FMRIB's diffusion toolbox. The tract-based spatial statistics (TBSS) was used to investigate the relationships between white matter (WM) DTI-metrics and neurobehavioral scores (i.e. behavioral and active tone). Automated fiber quantification (AFQ) was used to extract the CST (corticospinal tract), OR (optic radiation), AR (auditory radiation) and thal-PSC (thalamus-primary somatosensory cortex); Pearson correlation was further used to explore the relationships between neurobehavioral scores and DTI-metrics along the four tracts. Results TBSS results indicated that behavior scores showed significant correlations with DTI-metrics in almost the whole WM, e. g. corpus callosum, CST, OR, AR and etc (P<0.05, TFCE-FWE corrected). Significant correlations of active tone with MD, AD and RD were just observed in local WM regions, i. e. cerebral peduncle, anterior and posterior limb of internal capsule (P<0.05, TFCE-FWE corrected); while FA just showed boundary significant correlations in the above regions (P=0.055, TFCE-FWE corrected). AFQ results indicated that DTI-metrics along the almost entire CST, OR and thal-PSC showed significant correlations with behavior scores (P<0.05); while significant correlations mainly located in the initial and middle segments of AR (P<0.05). For active tone, significant correlations were only observed in the initial and middle segments of CST. Conclusions Neonatal brain WM DTI-metrics in specific sensorimotor regions, to a certain extent, could reflect the corresponding neurobehavior abilities, suggesting the potential value of DTI in assessing the neonatal neurodevelopment.
ABSTRACT
@#<p><strong>BACKGROUND:</strong> To determine prevalence of delay in 5 developmental domains among Filipino children at 6, 12 and 24 months and investigate influence of socioeconomic status, maternal intelligence, gender and home stimulation. Variations and developmental domains as reliable indicators of potential delay were determined.</p><p><strong>METHODS:</strong> 754 maternal/ infant dyads were followed up until 2 years old. The Griffiths Mental Development Scales determined sub-quotient scores in locomotor, personal/social, hearing/language, eye-hand coordination and performance subscales before averaging for General Quotient(GQ) score. Score < 85 was considered delayed.</p><p><strong>RESULTS:</strong> Low GQ scores were noted in 5.4% at 6 months, 19.1% at 12 months and 11.0% at 24 months old. GQ scores were lowered by performance subscale at 6 months, hearing/language and performance at 12 months and hearing/language at 24 months. No single subscale consistently lowered GQ across time. Only 4.2% maintained low GQ scores in all three ages.</p><p><strong>CONCLUSION:</strong> Prevalence of developmental delay varied across 24 months with highest rates noted at 12 months of age. No developmental domain consistently lowered test scores and no test age was predictive of future outcome but focused early intervention according to age is suggested. Home environment, higher socioeconomic status, maternal IQ and supervision were associated with improved potential.</p>
Subject(s)
Humans , Infant , Child , PrevalenceABSTRACT
Objective Neonatal hypoglycemia is a common metabolic disease during neonatal period and a few children with neonatal hypoglycemiamay show a series of neurologic impairment.This study was to explore the neurobehavioral development of preschool children with neonatal hypoglycemia.Methods 37 children with neonatal hypoglycemia in Neonate Department of Anhui Provincal Children's Hospital from March 2009 to May 2013 were investigated by Chinese Preschool-Children Temperament Scale and Conners Symptoms Questionnaire for Parents, together with the information collection of perinatal period, clinical data and family environment.At the same time 50 controls were randomly chosed of the same period.Results The children of hypoglycemia group and control group were mainly with easy temperament and inclined easy temperament.In the nine dimensions of temperament, there was statistical difference in approach-withdraw between two groups (P<0.05).The incidence of behavioral problem in hypoglycemia group is 24%, involving learning problem and psychophysical problem, and there were statistical difference between two groups in this aspect (P<0.05).Conclusion Neonatal hypoglycemia affects the neurobehavioral development of preschool children.Individualized treatment and education intervention should be taken according to the children's temperament and neurobehavioral development.
ABSTRACT
In recent years,obesity is becoming one of the focus problems of social public concern.Maternal obesity may pose a threat on maternal health,for examble the increase of obstetrical complications,it may also affect the short-term and long-term health of the offspring.Maternal obesity may affect children's mental disorder,no review to date has discussed it systematically in China.Now,the health hazards of maternal obesity for the offspring including childhood autism spectrum disorder,attention deficit hyperactivity disorder,neural tube defects,neurobehavioral development disorders and so forth were reviewed,and to provide a reasonable guidance of obesity management.
ABSTRACT
Objective To study the effect of chronic fluorosis on neurobehavioral development,the ability of learning and memory in offspring of rats,and the antagonistic effect of antioxidant Vitamin E (Vit E).Methods According to body weight,forty-five 1-month-old Sprague-Dawley(SD) rats of 30 females and 15 males were divided into three groups by random number table,including control group,fluorosis and Vit E antagonistic groups (15 rats with 10 females and 5 males in every group).Five months after establishing the animal model with chronic fluorosis and Vit E gavage treatments (fluoride ＜ 1,50,50 mg/L,respectively; Vit E 0,0,50 mg/kg,respectively),the rats were mated in 2:1 proportion of female:male in different groups,respectively.The fertility index of female and neurobehavioral development indicators in offspring were observed.Spatial learning and memory of offspring after birth for 30 d were evaluated by using Morris Water Maze test.Results The female fertility index exposed to fluorosis and Vit E were not significantly different as compared to those of control group(all P ＞ 0.05) ; in contrast to control groups[(6.4 + 1.8),(15.1 + 1.7)d],the time that completed the surface righting reflex [(8.1 + 1.4),(7.9 + 1.5)d] and the air righting reflex [(17.7 + 2.3),(17.2 + 1.8)d] were delayed in the offspring in fluorosis and Vit E antagonistic groups(all P ＜ 0.05) ; the completed avoidance precipice reflex and the auditory consternation did not changed significantly(all P ＞ 0.05); In addition,compared with control and Vit E antagonistic groups [(31.74 + 17.78),(34.97 ± 15.44)s,(4.50 ± 2.51),(3.80 ± 1.87)time],the average escape latency and exploration platform at five days were decreased in 30 d offspring of fluorosis group[(42.03 + 16.45)s,(2.20 + 1.62)time].Conclusion Neurobehavioral development as well as learning and memory ability in rat offspring are impaired by long-term exposure to fluoride and Vit E has exhibited an antagonistic effect to the toxicities of fluoride.
ABSTRACT
Consuming an adequate amount of iodine during pregnancy is critical for fetal neurologic development.Even a mild deficiency can impair cognitive ability.The World Health Organization recently has increased their recommended iodine intake during pregnancy from 200 to 250 μg/d and suggested that a median urinary iodine concentration of 150 ～ 249 μg/L indicates adequate iodine intake in pregnant women.Whether mild-to-moderate maternal iodine deficiency produces more subtle changes in cognitive function in offspring is unclear;no controlled intervention studies have measured long-term clinical outcomes.This review summarizes the iodine nutrition of pregnant women,and the effects of iodine deficiency in pregnancy on neurodevelopment in the child.To prevent fetal damage,iodine should be given before or early in pregnancy.
ABSTRACT
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.
ABSTRACT
Objective To investigate outcome and prognosis of isolated mild fetal ventriculomegaly (IMV) of fetus in uterus. Methods From Jan. 2006 to Dec. 2009, 18 200 singleton pregnancy women from 20 weeks gestation underwent prenatal ultrasonography examination in Department of Obstetrics and Gynecology, Second Affiliated Hospital of Wenzhou Medical College. One hundred and forty-eight women with IMV (transverse diameter of the atrium of the lateral ventricle measuring between 10 and 15 mm with no other abnormalities) were studied prospectively, which were divided into two groups: 99 women with transverse diameter of the lateral ventricle of 10 - 11 mm in group A and 49 women with transverse diameter lateral ventricle of 12 - 15 mm in group B. The changes of ventriculomegaly and the associated intracranial and extracranial anomalies were observed regularly every 2 or 4 weeks until delivery. The development of neurological system was also followed up. Results ( 1 ) The overall incidence of IMV was 0. 08% (148/18 200). The rate of bilateral ventriculomegaly were 20% (20/99) in group A and 51% (25/49) in group B, which reached statistical difference (P＜ 0. 05). (2) Prognosis of fetus: 139 cases with 2 or more ultrasonographic examinations, IMV resolved throughout pregnancy in 41. 7% (58/139) ,regressed in 7. 9% (11/139) ,remained stable in 36. 7% (51/139)and progressed in 13. 7% ( 19/139). Five cases in group A and 11 cases in group B present progress, which reached significantly difference (P ＜ 0. 05). (3) One hundred and eleven cases infant were followed up for 5-12 months,the rate of psycho-motor developmental delay was 5. 4% (6/111). The rate of neuro-developmental delay in progressed group (3/15) was higher than 2. 5% ( 1/40) in resolved group, 0 (0/8) in regressed group and 4. 2% (2/48) in remained stable group, which reached significantly difference (P＜0. 05). Conclusions About 85% of cases of IMV resolved, regressed or remained stable in utero would exhibited good prognosis. IMV with a transverse atrial size ≥ 12 mm or progression in utero was usually associated with a poor prognosis, which should be observed carefully.
ABSTRACT
0.05).Conclusion:Helicid had no effects on the early development of central nervous system in rat offspring.