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Objective:To study the clinical characteristics and risk factors of intrauterine Ureaplasma urealyticum (UU) infection in very low birth weight preterm infants.Methods:From March 2019 to February 2022, very low birth weight preterm infants with gestational age 28~32 weeks admitted to our hospital were enrolled in this single-center retrospective study. According to the UU test results of respiratory tract samples obtained within 24 h after admission, the infants were assigned into the UU group (UU-PCR positive) and the non-UU group (UU-PCR negative). SPSS 26.0 statistical software was used to compare the clinical characteristics, laboratory indices, and complications between the two groups. Risk factors of UU infection were calculated.Results:A total of 327 preterm infants were included: 45 in the UU group and 282 in the non-UU group. No significant differences existed in gender, gestational age, birth weight and delivery pattern between the two groups ( P>0.05). Compared with the non-UU group, the UU group had significantly higher incidences of premature rupture of membranes (PROM) and chorioamnionitis, elevated white blood cell and platelet counts, procalcitonin and C-reactive protein levels, total duration of oxygen use and ventilation, bronchopulmonary dysplasia, necrotizing enterocolitis and metabolic osteopathy ( P<0.05). Multivariate logistic regression analysis showed that PROM ( OR=5.444, 95% CI 2.749-10.781, P<0.001) and chorioamnionitis ( OR=2.161, 95% CI 1.048-4.454, P=0.037) were independent risk factors for UU infection. Conclusions:PROM and chorioamnionitis are risk factors for UU infection in very low birth weight preterm infants. For high-risk premature infants, the UU test should be completed as soon as possible after birth.
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Objective To compare the efficacy and safety of caffeine combined with humidified high-flow nasal cannula(HHHFNC) and nasal continuous positive airway pressure(nCPAP) on the treatment of apnea in very low birth weight (VLBW) preterm infants.Methods Totally 80 VLBW preterm infants with neonatal apnea,who were enrolled in the NICU of Hebei Province Children Hospital from September 2013 to March 2014,were randomly assigned to either HHHFNC group(39 cases) or nCPAP group(41 cases) according to respiratory support mode by random number table method,both groups were given caffeine.The incidence of severe apnea,incidence of reintubation,oxygen exposure time,duration of non-invasive ventilation time,feeding conditions and incidence of adverse events were compared.Results There were no significant differences in male/female ratio,gestational age,age at randomization and birth weight between the two groups(P ＞0.05).There were no significant differences in the incidence of severe apnea[15.4％ (6/39) vs 12.2 ％ (5/41)],incidence of reintubation [17.9 ％ (7/39) vs 19.5 ％ (8/41)],oxygen exposure time [(183.1 ± 31.2) h vs (175.9 ± 32.1) h],duration of non-invasive ventilation time [(163.3 ± 25.1) h v s (153.0 ± 26.2) h] between the two groups (P ＞ 0.05).The occurrence of abdominal distention [7.7 ％ (3/39) vs 24.4％ (10/41)],nasal trauma[2.6％ (1/39) vs 19.5 ％ (8/41)],head shaping [0.0％ (0/39)vs 29.3％ (12/41)] during treatment were lower in HHHFNC group than those of nCPAP group (P ＜ 0.05).Age began feeding was earlier in HHHFNC group than nCPAP group [(67.5 ± 19.1) h vs (96.3 ± 18.7) h,P ＜ 0.05],and day to full oral feeding was reduced in HHHFNC group than nCPAP group [(346.8±28.6) h vs (371.0 ±29.4),P ＜0.05].Conclusion HHHFNC combined with caffeine is effective on the treatment of apnea in VLBW preterm infants,and easier to make newborn tolerated.HHHFNC is an effective non-invasive respiratory support mode with few side effects.
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OBJECTIVE: To evaluate intraocular pressure in very low birth weight preterm infants and correlate it with postconceptional age. METHODS: The intraocular pressure in a prospective cohort of very low birth weight premature infants (defined as a birth weight <1,500 g and gestational age <32 weeks) admitted to Hospital de Clínicas de Porto Alegre , Brazil was evaluated weekly. The evaluated outcome was the variation in the intraocular pressure following changes in the postconceptional age (defined as the gestational age at birth plus the age in weeks at the time of examination) in the weeks following preterm birth. Mixed-effects models were used for the statistical analysis to determine the intraocular pressure variation according to postconceptional age, and means and 10th and 90th percentiles were calculated for the intraocular pressure values. RESULTS: Fifty preterm infants with a mean gestational age of 29.7 ± 1.6 weeks and a mean birth weight of 1,127.7 ± 222.7 g were evaluated. The mean intraocular pressure for the entire cohort considering both eyes was 14.9 ± 4.5 mmHg, and 13.5% of all recorded intraocular pressure values were greater than 20 mmHg. The analysis revealed a mean reduction in the intraocular pressure of 0.29 mmHg for each increase in postconceptional age (p = 0.047; 95% CI: -0.58 to -0.0035). The mean intraocular pressure (P10-P90) decreased from 16.3 mmHg (10.5222.16) at 26.3 weeks to 13.1 mmHg (7.28-18.92) at 37.6 weeks of postconceptional age. CONCLUSIONS: The mean intraocular pressure in very low birth weight preterm infants was 14.9 ± 4.5 mmHg. This value decreased 0.29 mmHg per week as the postconceptional age increased.