Early rehabilitation intervention reduces the incidence of extrauterine growth retardation in preterm infants / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the effect of early rehabilitation intervention on the incidences of extrauterine growth retardation (EUGR) and early diseases in preterm infants.</p><p><b>METHODS</b>The appropriate-for-gestational-age preterm infants with a gestational age of <34 weeks and a birth weight of 1 000 to <2 000 g who were admitted to the neonatal intensive care unit (NICU) within 24 hours after birth were enrolled in a prospective randomized controlled trial. These infants were randomly divided into rehabilitation intervention group and control group. The infants in the rehabilitation intervention group were given early rehabilitation after their vital signs became stable, including oral sensory and muscle strength training and pressure touching of the head, chest, abdomen, extremities, hands, and feet. The primary outcome measures were the time to independent oral feeding, length of hospital stay, and incidence rate of EUGR. The secondary outcome measures were the incidence rates of related diseases in preterm infants, such as apnea, feeding intolerance, and sepsis.</p><p><b>RESULTS</b>A total of 97 preterm infants who met the inclusion criteria and had complete data were enrolled, with 48 in the control group and 49 in the rehabilitation intervention group. The rehabilitation intervention group had a shorter time to independent oral feeding than the control group (P<0.05). Compared with the control group, the rehabilitation intervention group had a shorter length of hospital stay and a lower corrected gestational age at discharge (P<0.05), as well as a lower incidence rate of EUGR (P<0.05). The rehabilitation intervention group ONCLUSIONS: Early rehabilitation intervention for preterm infants in the NICU may reduce the incidence rates of apnea, feeding intolerance, and EUGR and help them to achieve independent oral feeding early.</p>

A 5-year retrospective clinical study of perinatal cytomegalovirus infection / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the incidence, clinical features, and treatment of perinatal cytomegalovirus (CMV) infection, as well as the factors affecting the therapeutic effect of ganciclovir.</p><p><b>METHODS</b>The clinical data of 237 infants who were hospitalized and diagnosed with perinatal CMV infection from 2008 to 2012 were retrospectively analyzed.</p><p><b>RESULTS</b>The clinical features of infants with perinatal CMV infection and the proportion of such infants in all hospitalized infants showed no significant differences across the five years. In most infants, two or more systems were involved, and CMV hepatitis plus CMV pneumonia was most common (43.1%). The results of pathogen detection showed that the percentage of the infants with positive blood CMV-IgM and blood/urine CMV-DNA was 3.8%, while 90.3% of all infants had positive blood CMV-IgM alone and 5.9% had positive blood/urine CMV-DNA alone. A total of 197 infants were treated with ganciclovir, and the cure rate was 88.3%. An abnormal history of pregnancy (OR=6.191, 95% CI: 1.597-24.002) and liver involvement before medication (OR=3.705, 95% CI: 1.537-8.931) were the independent risk factors affecting the therapeutic effect of ganciclovir in infants with perinatal CMV infection.</p><p><b>CONCLUSIONS</b>The epidemiological characteristics of perinatal CMV infection have remained generally stable for the last 5 years. CMV often involves several organs or systems, especially the liver and lung. Ganciclovir has a significant efficacy in the treatment of perinatal CMV infection, and an abnormal history of pregnancy and liver involvement before medication can increase the risk of ganciclovir resistance in infants with perinatal CMV infection.</p>

Risk factors for extrauterine growth restriction in preterm infants with gestational age less than 34 weeks / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the correlated factors contributed to extrauterine growth restriction (EUGR) in preterm infants with the gestational age less than 34 weeks.</p><p><b>METHODS</b>A total of 694 preterm infants with the gestational ages less than 34 weeks were enrolled. They were classified into EUGR and non-EUGR groups by weight on discharge. The perinatal data, growth data, nutritional information and morbidities during hospitalization were compared between the two groups.</p><p><b>RESULTS</b>EUGR on discharge occurred in 284 (40.9%) out of the 694 infants. The incidence of EUGR in intrauterine growth restriction (IUGR) infants was significantly higher than in non-IUGR infants (P<0.01). The very low birth weight (VLBW) infants had a higher incidence of EUGR than non-VLBW infants (P<0.01). The incidence of EUGR increased with the decreases of gestational age at birth and birth weight (P<0.01). Compared with the non-EUGR group, the fasting time, the duration of parenteral nutrition, the time beginning to feed and the age to achieve full enteral feeds were significantly greater in the EUGR group (P<0.01). The cumulative protein deficit and cumulative caloric deficit in the first week of life in the EUGR group were higher than in the non-EUGR group (P<0.05). The incidences of respiratory distress syndrome, apnea, necrotizing enterocolitis and septicemia in the EUGR group were higher than in the non-EUGR group (P<0.05). The logistic regression analysis showed that birth weight, gestational age at birth and IUGR were the independent risk factors for EUGR.</p><p><b>CONCLUSIONS</b>The incidence of EUGR in infants with gestational age less than 34 weeks is high, especially in IUGR or VLBW infants. Early and aggressive nutritional strategy and prevention of apnea and septicemia may facilitate to reduce the occurrence of EUGR.</p>