ABSTRACT
Abstract Objectives To evaluate the therapeutic effect of Saccharomyces boulardii supplementation on jaundice in premature infants undergoing phototherapy. Methods In this article, the authors reviewed 100 hospitalized jaundiced premature infants under 35 weeks of gestational age. All infants were assigned to a control group (n= 45) and a treatment group (n= 55) randomly. The infants in the treatment group received S. boulardii supplementation by undergoing phototherapy and the infants in the control group were only treated by phototherapy. The total serum bilirubin levels were detected before and at the end of phototherapy, and transcutaneous bilirubin levels were measured on the 1st, 4th, 8th and 15th day of treatment. The duration of jaundice resolution and phototherapy, stool frequency, and characteristics were compared after phototherapy. Results The duration of jaundice resolution and phototherapy were shortened. Total serum bilirubin level was lower than the control group at the end of phototherapy (p < 0.05). Transcutaneous bilirubin levels decreased more significantly on the 8th and 15th day of treatment (p < 0.05), while there were no significant differences on the post-treatment 1st and 4th day (p > 0.05). In addition, bowel movements including stool frequency and Bristol Stool Form Scale ratings of stools also improved after treatment. Conclusions S. boulardii in combination with phototherapy is effective and safe in reducing bilirubin levels and duration of phototherapy, accelerating jaundice resolution in premature infants with jaundice. The procedure also provided an ideal therapeutic effect of diarrhea induced by phototherapy to promote compliance and maternal-infant bonding.
ABSTRACT
The pathophysiology of neonatal necrotizing enterocolitis (NEC) is not clear, but is considered to be multifactorial.Immaturity of the gut, hypoxia-ischemia, formula feeding and microbial dysbiosis play roles in inducing intestinal inflammatory response.This review discussed the development process of infant gut microbiota, the factors affecting neonatal intestinal colonization, the roles of gut microbiome in the pathogenesis of NEC, and the manifestations of early microecology disorder in NEC.In addition, studies on the use of probiotics to prevent NEC and the risks of using probiotics in preterm infants were also summarized.
ABSTRACT
Objective:To establish a prompt based feeding process for premature infants and explore its application effects.Methods:This study was a quasi-experimental research method. Firstly, the best evidence of prompt feeding for premature infants was systematically searched and summarized, and the expert consultation method and clinical practice were used to finally formulate a prompt feeding process for premature infants. The process was applied to clinical practice. A total of 82 hospitalized premature infants in the neonatal intensive care unit of Union Hospital, Tongji Medical College, Huazhong University of Science and Technology from October 2021 to March 2022 were selected as the control group, and routine feeding management was implemented. A total of 86 hospitalized premature infants from April to September 2022 were selected as the observation group. Feeding management for premature infants based on the prompt feeding process was followed, and the feeding efficiency, transition time of full oral feeding, and days of gastric tube retention, hospital stay and the incidence of feeding related complications in the two groups were compared.Results:The effective recovery rates of the two rounds of expert correspondence questionnaires were 100%, and the authoritative coefficients of expert opinions were 0.863 and 0.875, respectively. The Kendall harmony coefficients of expert opinions were 0.156 and 0.202, respectively, and the significance tests were all P<0.05. The total oral feeding rate of the observation group was 59.84%(5 256/8 784), the mixed feeding rate was 12.26%(1 077/8 784), and the tube feeding rate was 27.90%(2 451/8 784). Compared with the control group′s 52.20%(4 698/9 000), 14.68%(1 321/9 000), and 33.12%(2 981/9 000), the difference was statistically significant ( χ2 = 105.21, P<0.05). The transition time of full oral feeding, number of days of gastric tube retention, and hospitalization time in the observation group were (5.14 ± 1.67), (6.13 ± 1.62), and (12.77 ± 1.37) days, respectively. Compared with the control group′s (6.22 ± 1.59), (7.17 ± 1.55), and (13.72 ± 1.72) days, the differences were statistically significant ( t = 4.206, 4.26, 3.97, all P<0.05). The incidence of milk choking, hypoxia, and vomiting in the observation group were 9.30%(8/86), 6.98%(6/86), and 11.63%(10/86), respectively, which were lower than the 23.17%(19/82), 19.51%(16/82), and 34.15%(28/82) of the control group. The difference between the two groups was statistically significant ( χ2 = 5.99, 5.80, 12.16, all P<0.05). Conclusion:The application of prompt feeding process in premature infants can shorten the transition time of full oral feeding, promote the feeding process, reduce the complications caused by poor feeding, and ensure the feeding safety of premature infants.
ABSTRACT
Due to the development of neonatal intensive care, the survival rate of very preterm infants and very low birth weight infants has been significantly improved, and the incidence of bronchopulmonary dysplasia (BPD) has been obviously increasing year by year.The pathogenesis of BPD has not been clear, it is considered that inflammation is an important link in the occurrence and development of BPD at present.Neutrophils can use their neutrophil extracellular traps (NETs) to capture and kill pathogens and reduce inflammation, but excessive formation of NETs is easy to induce inflammatory imbalance, so as to damage normal cells or tissues and participate in the pathophysiological process of BPD.This paper reviews the structure, formation, function and regulatory role of NETs in BPD, and the targeted treatment strategies and potential research directions of NETs in BPD.
ABSTRACT
OBJECTIVE To systematically evaluate the efficacy and safety of prophylactic use of low-dose hydrocortisone （HC） for the prevention and treatment of bronchopulmonary dysplasia （BPD）， and to provide evidence-based reference for clinical treatment. METHODS PubMed， Embase， Web of Science， Cochrane Library， CJFD， VIP and Wanfang databases were searched by computer； randomized controlled trials （RCT） about prophylactic use of low-dose HC （trial group） versus placebo or dopamine （control group） in very premature infants were collected from the establishment of the database to Jun. 2022. The quality of the included literature was evaluated by using bias risk assessment tool recommended by Cochrane system evaluator’s manual （version 6.2） after screening the literature and extracting the data. Meta-analysis， sensitivity analysis and publication bias analysis were carried out with RevMan 5.3 statistical software. RESULTS A total of 1 437 very premature infants were included in 9 RCTs. Meta- analysis showed that the incidence of BPD [OR＝0.75， 95%CI（0.58，0.95）， P＝0.02] and fatality [OR＝0.72， 95%CI （0.54， 0.97）， P＝0.03] in trial group were significantly lower than control group； the survival rate without BPD [OR＝1.36， 95%CI （1.06，1.74）， P＝0.02]， the incidences of gastrointestinal perforation [OR＝2.23， 95%CI （1.31，3.78）， P＝0.003] and sepsis [OR＝ 1.27， 95%CI （1.01，1.60）， P＝0.04] in trial group were all significantly higher than control group. There was no significant difference in the incidence of necrotizing enterocolitis， paraventricular leukomalacia， intraventricular hemorrhage， patent ductus arteriosus， hyperglycemia， pneumothorax， retinopathy of premature infants between the two groups （P＞0.05）. Results of sensitivity analysis showed that study results were robust. Results of publication bias analysis showed that there was little possibility of publication bias in this study. CONCLUSIONS The early prophylactic use of low-dose HC can reduce BPD in very premature infants， reduce fatality， and improve the survival rate without BPD， but we should pay attention to gastrointestinal perforation and sepsis.
ABSTRACT
Objective:To investigate the effects of family integrated care(FICare) on positive feelings and readiness for hospital discharge among mothers of premature.Methods:From January to October 2021, a total of 100 premature infants were admitted to the neonatal intensive care unit(NICU) of General Hospital of Ningxia Medical University, and their mothers were admitted to this program.They were divided into research group (52 cases) and control group (48 cases) randomly.The premature infants in the control group received NICU routine care during hospitalization, meanwhile the premature infants and the mothers in the research group were given FICare on the routine care during hospitalization.On the 2nd day of admission (before the intervention) and 1 day before discharge (after the intervention), the positive aspects of caregiver (PAC) and the readiness for hospital discharge scale (RHDS) were used to evaluate the positive feelings and readiness for discharge of premature infants' mothers in the two groups.The t-test of two independent samples was used for measurement data between the two groups, and the paired t-test was used for intra-group comparison by SPSS 22.0 statistical software.The comparison of enumeration data between the two groups was carried out by chi-square test. Results:There were no significant differences in the scores of PAC and discharge readiness (both P>0.05) between the two groups before intervention.After the intervention, the premature mothers' total score of PAC in the research group and control group were((32.00±2.79), (27.40±3.37)), the self-affirmation dimension were ((18.55±2.39), (16.10±1.77)), the life outlook dimension were( (13.45±1.93), (11.30±2.20)), and all the scores in the research group were higher than those of the control group (all P<0.05). The total scores of readiness for hospital discharge in the research group and control group were ((106.75±6.11), (100.40±10.41)), personal status dimension were ((26.92±2.37), (25.11±3.32)), adaptability dimension were ((43.50±2.70), (40.64±4.65)), and the anticipatory support dimension were ((36.33±2.16), (34.29±3.29)). The total scores and each dimensions of the mothers' readiness for hospital discharge in the research group were higher than those in the control group (all P<0.05). After the intervention, the positive feeling total score and all dimensions score of the two groups of premature mothers were higher than before intervention (all P<0.05). After intervention, the total score of readiness for hospital discharge and the scores of all dimensions of premature mothers in the research group were higher than before intervention (all P<0.05). And there were no significant difference in the total scores of readiness for hospital discharge and other dimensions in the control group comparison before and after intervention(all P>0.05), except adaptability dimensions ( P<0.05). Conclusion:The findings suggest that FICare can improve the positive feelings of mothers of premature infants and hospital discharge readiness especially.
ABSTRACT
Objective:To study the trends and ranges of blood pressure in extremely premature infants (EPIs) during the first 7 days after birth.Methods:From January 2016 to December 2020, EPIs born in our hospital were retrospectively analyzed. Their blood pressure were monitored using umbilical arterial catheters and no patients needed anti-hypotension treatment. The clinical data of the infants and their mothers, blood pressure data during the first 7 days after birth, clinical outcomes and complications were collected. The trends of blood pressure in untreated EPIs were analyzed and the blood pressure ranges of EPIs of different gestational ages (GA) were established.Results:A total of 145 cases of EPIs were included and their systolic pressure, diastolic pressure and mean blood pressure showed upward trends during 2~168 h after birth ( P<0.001). The diastolic pressure increased significantly within 24 h after birth ( P<0.05), systolic pressure and mean blood pressure increased significantly within 72 h after birth ( P<0.05). Blood pressure increased with age and GA. Conclusions:The blood pressure of EPIs will increase spontaneously during 7 days after birth. The ranges of blood pressure are measured for infants with different GA to provide clinical evidence for blood pressure management of EPIs during early postnatal period.
ABSTRACT
Objective:To analyze the potential risk factors of periventricular-intraventricular hemorrhage(PIVH)in premature infants.Methods:A retrospective study was conducted on clinical data of 279 premature infants admitted to the Affiliated Hospital of Guizhou Medical University From January 1, 2019 to December 31, 2019, who completed cranial ultrasound during hospitalization.According to the cranial ultrasound with or without PIVH, the cases were divided into PIVH group and non-PIVH group.The premature infants with PIVH were divided into severe PIVH(grade Ⅲ and Ⅳ)group and mild PIVH(grade Ⅰand Ⅱ)group according to the PIVH grades.A total of 25 factors, which may influnce PIVH, were analyzed by univariate analysis, and then multivariate Logistic stepwise regression analysis(stepwise backwards method)was performed to determine the major risk factors.Results:(1)A total of 279 premature infants were included in the study, 133 of them in PIVH group, and 146 of them in non-PIVH group.Univariate analysis showed that there were statistically significant differences in 14 factors between two groups, including full treatment of antenatal steroid, gestation age, birth weight, neonatal asphyxia, hypothermia, early onset sepsis, metabolic acidosis, hypernatremia, anemia, respiratory distress syndrome, noninvasive ventilation, invasive ventilation, invasive ventilation within 72 hours after birth, and lumbar puncture within 72 hours after birth( P<0.05). Multivariate analysis showed that gestational age( OR=0.709, 95% CI 0.602-0.835), and full treatment of antenatal steroid( OR=0.354, 95% CI 0.189-0.664) were protective factors for PIVH in premature infants, while neonatal asphyxia( OR=2.425, 95% CI 1.171-5.023), hypothermia( OR=2.097, 95% CI 1.088~4.041), early onset sepsis( OR=12.898, 95% CI 1.433-115.264), metabolic acidosis( OR=2.493, 95% CI 1.398-4.442), invasive ventilation within 72 hours after birth( OR=5.408, 95% CI 1.156-25.297), lumbar puncture within 72 hours after birth ( OR=5.035, 95% CI 1.269-19.993) were independent risk factors for PIVH in premature infants( P<0.05). (2) Among 133 cases of premature PIVH, 20 cases were severe PIVH and 13 cases were mild PIVH.Univariate analysis showed that there were statistically significant differences in 5 factors between two groups, including antenatal magnesium sulfate, gestation age, early onset sepsis, abnormal coagulation, and lumbar puncture within 72 hours after birth.Multivariate analysis showed that early onset sepsis( OR=4.392, 95% CI 1.343-14.367) and abnormal coagulation( OR=3.502, 95% CI 1.234-9.867) were independent risk factors for severe PIVH in premature infants( P<0.05). Conclusion:Gestational age is negatively correlated with the occurrence of PIVH in premature infants, and completion of more than a course of treatment for antenatal dexamethasone is an independent protective factor of PIVH in premature infants.Neonatal asphyxia, metabolic acidosis, hypothermia(<35 ℃), early onset sepsis, invasive ventilation within 72 hours after birth, and lumbar puncture within 72 hours after birth are independent risk factors for PIVH in premature infants.Abnormal coagulation and early onset sepsis are independent risk factors for severe PIVH in premature infants.
ABSTRACT
Objective:To analyze the potential risk factors of periventricular-intraventricular hemorrhage(PIVH)in premature infants.Methods:A retrospective study was conducted on clinical data of 279 premature infants admitted to the Affiliated Hospital of Guizhou Medical University From January 1, 2019 to December 31, 2019, who completed cranial ultrasound during hospitalization.According to the cranial ultrasound with or without PIVH, the cases were divided into PIVH group and non-PIVH group.The premature infants with PIVH were divided into severe PIVH(grade Ⅲ and Ⅳ)group and mild PIVH(grade Ⅰand Ⅱ)group according to the PIVH grades.A total of 25 factors, which may influnce PIVH, were analyzed by univariate analysis, and then multivariate Logistic stepwise regression analysis(stepwise backwards method)was performed to determine the major risk factors.Results:(1)A total of 279 premature infants were included in the study, 133 of them in PIVH group, and 146 of them in non-PIVH group.Univariate analysis showed that there were statistically significant differences in 14 factors between two groups, including full treatment of antenatal steroid, gestation age, birth weight, neonatal asphyxia, hypothermia, early onset sepsis, metabolic acidosis, hypernatremia, anemia, respiratory distress syndrome, noninvasive ventilation, invasive ventilation, invasive ventilation within 72 hours after birth, and lumbar puncture within 72 hours after birth( P<0.05). Multivariate analysis showed that gestational age( OR=0.709, 95% CI 0.602-0.835), and full treatment of antenatal steroid( OR=0.354, 95% CI 0.189-0.664) were protective factors for PIVH in premature infants, while neonatal asphyxia( OR=2.425, 95% CI 1.171-5.023), hypothermia( OR=2.097, 95% CI 1.088~4.041), early onset sepsis( OR=12.898, 95% CI 1.433-115.264), metabolic acidosis( OR=2.493, 95% CI 1.398-4.442), invasive ventilation within 72 hours after birth( OR=5.408, 95% CI 1.156-25.297), lumbar puncture within 72 hours after birth ( OR=5.035, 95% CI 1.269-19.993) were independent risk factors for PIVH in premature infants( P<0.05). (2) Among 133 cases of premature PIVH, 20 cases were severe PIVH and 13 cases were mild PIVH.Univariate analysis showed that there were statistically significant differences in 5 factors between two groups, including antenatal magnesium sulfate, gestation age, early onset sepsis, abnormal coagulation, and lumbar puncture within 72 hours after birth.Multivariate analysis showed that early onset sepsis( OR=4.392, 95% CI 1.343-14.367) and abnormal coagulation( OR=3.502, 95% CI 1.234-9.867) were independent risk factors for severe PIVH in premature infants( P<0.05). Conclusion:Gestational age is negatively correlated with the occurrence of PIVH in premature infants, and completion of more than a course of treatment for antenatal dexamethasone is an independent protective factor of PIVH in premature infants.Neonatal asphyxia, metabolic acidosis, hypothermia(<35 ℃), early onset sepsis, invasive ventilation within 72 hours after birth, and lumbar puncture within 72 hours after birth are independent risk factors for PIVH in premature infants.Abnormal coagulation and early onset sepsis are independent risk factors for severe PIVH in premature infants.
ABSTRACT
Bronchopulmonary dysplasia(BPD) is an important cause of premature infant mortality and long-term organ dysfunction in survivors.There is currently no fundamental treatment for BPD, and glucocorticoids are often used clinically to reduce the risk and severity of BPD.There are systemic administration, inhalation administration and transtracheal administration of glucocorticoids for the prevention and treatment of BPD.Glucocorticoids provide benefits such as anti-inflammatory, but may also cause side effects such as neurodevelopmental impairment.There are various schemes for the dosage form, timing of administration, and cumulative dose of glucocorticoids administration.The clinical advantages and disadvantages of different schemes are inconsistent and controversial.Higher quality clinical trials are needed to provide evidence to support the use of glucocorticoids for the prevention and treatment of BPD.
ABSTRACT
Bronchopulmonary dysplasia(BPD)is a chronic respiratory disease characterized by alveolar and pulmonary microvascular dysplasia.It happens in premature infants, which is a major cause of death and long-term complications in premature infants.Chest radiology examination is essential for BPD, which not only reveals main radiological features such as pulmonary hyperinflation, pulmonary fibrosis and atelectasis, but also evaluates the severity and progression.These provide significant information for clinical treatment and follow-up study of children with BPD.
ABSTRACT
Objective:To investigate the trend of posttraumatic stress disorder (PTSD) in the mothers of preterm infants within 6 months and analyze the related factors.Methods:There were 171 mothers of premature infants selected by convenience sampling method who received outpatient follow-up from Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University from July 2018 to November 2019. The mothers were evaluated by post-traumatic stress disorder questionnaire from corrected age 1 month to 6 months of preterm infants, and the general data, maternal anxiety and family management were investigated as well. Linear regression analysis was used to determine the influencing factors of post-traumatic stress disorder for preterm infants within corrected 6 months.Results:The incidence of posttraumatic stress disorder in mothers of premature infants was significantly higher than the domestic norm. The incidence was 35.09%(60/171) in 1 month and the highest score was 4.80 ± 2.09, and then gradually decreased to 12.06%(17/141) in 6 months, with an average score of 3.41 ± 1.82. The results of linear regression analysis showed that the birth weight of preterm infants, hospital stay and the age of the mother, the maternal anxiety score, the Family Management Measure score, re-hospitalization after discharge were the influencing factors of the maternal PTSD score ( t values were -247 - 3.08, all P<0.05). Conclusions:The incidence of post-traumatic stress disorder in mothers of preterm infants within 6 months is higher. Although the incidence gradually decreases over time, it is still significantly higher than the average level, which deserves clinical attention. The mothers of premature infants with low birth weight, long hospital stay and young mothers should be alert to the occurrence of PTSD. During the hospitalization of premature infants, family participatory nursing should be provided as much as possible to improve mothers′ confidence in caring. Alleviating mother′s anxiety, maintaining good family relationship, improving family management ability and providing continuous nursing service after discharge are beneficial to prevent mother from having post-traumatic stress disorder.
ABSTRACT
Objective:To explore the characteristics and influencing factors of blood carnitine metabolism in premature infants.Methods:A retrospective analysis of 37 037 neonates with negative results of genetic metabolic disease screening at Guangxi Newborn Disease Screening Center from 2018 to 2021, of which 34 517 normal full-term infants were the control group and 2 520 preterm infants were the research group.According to gestational age, the preterm infants were further divided into three groups: extremely preterm group( n=232), moderately preterm group( n=324)and late preterm group( n=1 964). According to birth weight, they were divided into three groups: very low birth weight group( n=188), low birth weight group( n=1 276)and normal birth weight group( n=1 056). According to blood collection time, they were divided into three groups: 3~7 days group( n=1 990), 8~14 days group( n=342) and 15~28 days group( n=188). Tandem mass spectrometry was used to detect the levels of 31 carnitines in dried blood spots and analyze the differences in the levels of metabolic indicators in each group. Results:Carnitine levels in preterm infants are most affected by gestational age.Adjusting the physiological and pathological conditions of premature infants and other related factors, grouped by gestational age, there were differences in the levels of 31 carnitines among the groups(all P<0.05), the smaller the gestational age, the greater the difference in carnitine levels; grouped by blood collection time, there were statistically significant differences in carnitine levels between preterm infants with different blood collection age groups and full-term 3~7 days groups(all P<0.05), and showing age-related; there are differences among 31 carnitines grouped by body weight(all P<0.05), the smaller the body weight, the greater the difference in carnitine levels.Combined with the analysis of gestational age, birth weight and blood collection date, 17 indicators including C0, C2, C3, C4, C6DC, C10, C10∶1, C12, C12∶1, C14, C14∶1, C14OH, C16, C16∶1, C18, C18∶1 and C18∶1OH are important biomarkers of carnitine metabolism in premature infants. Conclusion:Carnitine in premature newborns has different metabolic differences at different gestational ages, birth weights and blood collection ages, which provides a strong basis for establishing reference standards and interpretation of preterm infants in the laboratory in this region, and provides reasonable and effective early diagnosis and treatment for clinical practice.Meanwhile, it provides an optimized program for timely detection of carnitine deficiency and carnitine supplementation to improve nutrition of premature infants.
ABSTRACT
Objective:To investigate and compare the clinical characteristics, pathogen distributions and outcomes of bacterial meningitis in preterm and term infants.Methods:The data of 252 cases of neonatal bacterial meningitis hospitalized in Guangzhou Women and Children′s Medical Center from January 2013 to December 2018 were retrospectively analyzed and divided into two groups according to gestational age: preterm group( n=64)and term group( n=188). The clinical manifestations, laboratory examinations, pathogen distributions and clinical outcomes of the children in two groups were compared. Results:Fever was the most common clinical manifestation in both groups, but the incidences of lethargy, apnea and feeding intolerance in preterm group were significantly higher than those in term group( P<0.05). There was no significant difference in the rate of the first hemogram/cerebrospinal fluid abnormality between two groups( P>0.05). Sepsis, subdural effusion and hydrocephalus were the main complications in both groups.The incidence of complications in premature infants was 60.9%(39/64), which was significantly higher than that in full-term infants(44.7%, 84 /188) , with a statistically significant difference ( P<0.05). Escherichia coli and Streptococcus agalactiae were the most common pathogens in the preterm infants, whereas Klebsiella pneumoniae and Streptococcus agalactiae were the most common pathogens in the term infants.There was no statistical difference in the time of positive bacteria turning negative between two groups, but the course of antibiotics in preterm group was significantly longer than that in term group( P<0.05). The clinical cure/improvement rates in the two groups was about 95%, and the difference between two groups was not statistically significant( P>0.05). Conclusion:Early clinical manifestations of bacterial meningitis in preterm infants are atypical and relatively easy to be missed.The incidence of complications is significantly higher than that of full-term infants, and the duration of antibiotic use is longer.However, the clinical cure/improvement rate of premature infants is not worse than that of full-term infants after reasonable and standardized early treatment.
ABSTRACT
Spontaneous intestinal perforation(SIP) is one of the causes of digestive tract perforation in premature infants and requires surgical intervention.Except for preterm delivery, the etiology and pathogenesis of SIP remain unclear.The studies have shown that it may be related to the application of magnesium sulfate, nonsteroidal anti-inflammatory drugs, hormones, vasoactive drugs and low perfusion status, infection, congenital intestinal dysplasia, non-invasive respiratory support, delayed nutrition initiation and other factors.In the management of premature infants, it is particularly important to improve the understanding of SIP, early diagnosis and treatment.
ABSTRACT
@#AIM:To explore the correlation between maternal iron deficiency anemia and retinopathy of prematurity(ROP)in premature infants or low birth weight infants so that to provide possible scientific basis for the prevention and control of ROP.<p>METHODS: This study was a case-control study. The clinical data of 317 premature or low birth weight infants who were diagnosed with ROP and their mothers in our hospital during January 2019 to July 2021 due to ROP screening for the first time(about 30d after birth)were analyzed. The relationship between maternal iron deficiency anemia and ROP and its stages were observed. And the relationship between Hb, blood value characteristics, mean gestational age, gestational weeks, infant birth weight of maternal iron deficiency anemia and ROP stage.<p>RESULTS: There were 235 mothers(74.1%)with iron deficiency anemia, 82 mothers(25.9%)without iron deficiency. Among them, there were 194 mothers(82.6%)with mild anemia according to anemia classification, 119 cases with stage Ⅰ ROP and 75 cases with stage Ⅱ ROP. There were 39 mothers(16.6%)with moderate anemia, 8 cases with stage Ⅱ ROP, 22 cases with stage Ⅲ ROP and 9 cases with stage Ⅳ ROP. There were 2 mothers(0.9%)of severe anemia, all of whom had stage Ⅳ ROP. No children with stage Ⅴ or threshold ROP and mothers with very severe anemia were found in this study. Compared with mothers with iron deficiency anemia, premature infants or low birth weight infants with normal iron levels were more likely to have stage Ⅰ ROP, but stage Ⅱ ROP was more pronounced in mothers with iron deficiency anemia, and the differences were statistically significant(all <i>P</i><0.05). Stage Ⅲ and stage Ⅳ ROP was not observed in the mothers with normal serum iron, but was 9.4% and 4.7% in the mothers with iron deficiency anemia, respectively. The differences were statistically significant(<i>P</i><0.05). Stage Ⅴ and threshold lesions ROP was not observed in preterm or low birth weight infants in mothers with normal serum iron values or iron deficiency anemia. Compared with mothers with normal iron levels, mothers with iron deficiency anemia had significantly lower hemoglobin, hematocrit, mean erythrocyte volume, serum iron and ferritin levels. At the same time, the higher mean gestational age, mean shorter gestational week and mean lower birth weight in the mothers with iron deficiency anemia, and the differences were statistically significant(all <i>P</i><0.05).<p>CONCLUSION:Pregnant iron-deficiency anemia is associated with the occurrence and development of ROP in premature or low birth weight infants. The more severe maternal anemia, the higher maybe stage of ROP. Therefore, monitoring and supplementation of iron during pregnancy can effectively prevent and reduce the risk of ROP.
ABSTRACT
【Objective】 To analyze the risk factors of anemia in premature infants and the status of blood transfusion. 【Methods】 Clinical data of preterm infants with age ≤48 hours and hospitalization time ≥7 days, admitted to our hospital from August 2018 to July 2019, were collected. According to the Hb value, they were divided into the anemia group and the non-anemia group. The general information, disease occurrence, and treatment measures during hospitalization of the two groups were compared, and the risk factors affecting anemia were analyzed. 【Results】 A total of 169 cases were included in this study, including 88 cases in the anemia group and 81 cases in the non-anemia group. There were statistically significant differences between two groups in assisted reproduction 47(53.409) vs 33(40.741), basic Hb value 180.395(176.282, 184.508) vs 162.841(158.596, 167.085), maternal pregnancy anemia 27(30.682) vs 12(14.815), late-onset sepsis(LOS) 64(72.727) vs 31(38.272), mechanical ventilation 46(52.273) vs 10(12.346), neonatal respiratory distress syndrome(NRDS) 51(57.955) vs 26(32.099), coagulation dysfunction 27(30.682) vs 11(13.580) and average hospitalization days 31.276(26.885, 35.666) vs 15.798(14.251, 17.344), all P<0.05. Multivariate logistic results showed assisted reproduction, maternal pregnancy anemia, mechanical ventilation, coagulation dysfunction and average hospitalization days ≥20 were risk factors for preterm anemia. A total of 40 cases(23.669%) needed RBC transfusion to correct anemia during hospitalization, including 21 cases of very low birth weight infants(VLBWI). 8 patients(38.095%) received RBC transfusion ≥3 times during VLBWI hospitalization. The incidence of bronchopulmonary dysplasia(BPD) in the multiple transfusion group(≥3 times of RBC transfusion) was higher than in the non-multiple transfusion group. 【Conclusion】 Maternal anemia during pregnancy, assisted reproduction, mechanical ventilation, coagulation dysfunction and average hospitalization days are the related factors affecting the occurrence of anemia. The occurrence of BPD may be associated with multiple blood transfusions, but there is no clear evidence to prove that blood transfusion is an independent risk factor for the development of BPD, and a large sample, multi-center study is needed.
ABSTRACT
The hypothalamic-pituitary-thyroid axis gradually becomes mature at gestational age of 30~35 weeks.With the improvement of the treatment level of premature infants, the gestational age of surviving premature infants gradually decreases, and the thyroid axis of young premature infants is immature.Meanwhile, premature infants are more prone to systemic complications, such as ischemia and hypoxia, severe infection, etc., which aggravate the influence on thyroid.Clinically, more and more premature infants are found to be complicated with congenital hypothyroidism, temporary hypothyroxemia, hyperthyrotropin, delayed thyrotropin elevation, low T 3 syndrome and other problems.Abnormal thyroid function affects the outcome of the treatment of premature infant diseases.Early detection and early treatment is the key to improve the treatment, metabolism and the development of premature infant.At present, the timing of screening and treatment of premature thyroid disease is still controversial.In this review, the thyroid function and outcome of premature infants under different pathological conditions are summarized and analyzed to provide a reliable basis for rational selection of screening opportunities and treatment strategies for thyroid diseases in clinical practice.
ABSTRACT
Objective:To compare the effect of SMOF lipids composed of soybean oil, medium chain triglycerides, olive oil, and fish oil with medium-long chain mixed fat emulsions(Lipofundin) on parenteral nutrition-associated cholestasis(PNAC) in premature infants.Methods:Clinical data were collected from premature infants hospitalized in the neonatal intensive care unit of Shanghai Children′s Hospital from January 2018 to December 2019 with gestational age ≤34 weeks, birth weight ≤2 000 g, and duration of parenteral nutrition ≥14 days.They were devided into SMOF lipid group and Lipofundin group, and the incidence of PNAC, neonatal necrotizing enterocolitis(NEC), bronchopulmonary dysplasia(BPD), retinopathy of prematurity(ROP), periventricular-intraventricular hemorrhage(PVH-IVH), late-onset sepsis and liver function were compared between two groups.Results:The incidence of PNAC in the SMOF lipid group was significantly lower than that in Lipofundin group( P=0.042). The average level of ALT and AST in SMOF lipid group were markedly lower than those in Lipofundin group( P<0.05). The time to reach full enteral feeding of SMOF lipid group was shorter than that of Lipofundin group( P=0.005). There was no significant difference in the incidence of NEC, BPD, ROP, PVH-IVH, and late-onset sepsis between two groups( P>0.05). Conclusion:Compared with lipofundin, SMOF lipid can reduce the incidence of PNAC in premature infants, and has no significant effect on the incidence of NEC, BPD, ROP, PVH-IVH and late-onset sepsis.
ABSTRACT
Objective:To explore the relationship between rs2010963, rs3025039 and rs699947 gene polymorphism of vascular endothelial growth factor(VEGF) gene and bronchopulmonary dysplasia(BPD) in Mongolian premature infants.Methods:A case-control design was used to collect 50 cases of Mongolian premature infants who were hospitalized at the Affiliated Hospital of Inner Mongolia Medical University and diagnosed with BPD from January 2016 to December 2020 as the observation group, while 56 cases of non-BPD premature infants of the same nationality and time period were selected as the control group.Using PCR method to detect the genotype and allele distribution of the VEGF gene rs2010963, rs3025039 and rs699947 locus.Combining clinical data to analyze whether the above gene loci were related to the onset of premature infants with Mongolian BPD in our area.Results:Through genetic testing, it was found that CC, CA and AA genotypes can be detected at the rs699947 site of VEGF gene in premature infants in both the observation group and the control group.The frequencies of the three genotypes in the observation group were 16.0%, 24.0%, and 60.0%, respectively; the frequency of the C allele was 28.0%, the frequency of the A allele was 72.0%, and the frequency of the three genotypes in the control group was 32.1.%, 32.1% and 35.7%, respectively.The frequency of C allele was 48.2%, the frequency of G allele was 51.8%, and the allele and genotype frequencies of this locus between the observation group and the control group were significant differences from those of the control group( P<0.05). Conclusion:The polymorphism of VEGF gene rs699947 locus is associated with the occurrence and development of BPD in Mongolian premature infants, and allele A may be a susceptible factor.