ABSTRACT
Objective: The study is designed to understand the situation of full-term infants breastfeeding within 6 months of birth in Xi'an before the Covid-19 pandemic and analyze the influencing factors of exclusive breastfeeding. Methods: Five hospitals in Xi'an province have been selected as research centers. Full-term infants who met the inclusion and exclusion criteria were recruited from these centers between January 1 and February 28, 2019. The feeding situation at 10 days, 42 days, 3 months, and 6 months after birth were investigated. A self-designed breastfeeding questionnaire was used for investigation and follow-up. SPSS 22.0 was applied for statistical analysis of the data. Results: The exclusive breastfeeding rate of full-term infants on days 10 and 42 and at months three and six after birth was 61.38%, 54.78%, 48.83%, and 38.78%, respectively, with a decreasing trend over time. During breastfeeding within 48 h after delivery, 1,653 cases (91.83%) of puerpera had different grades of pain, including 1,325 cases (80.16%) of mild discomfort, 321 cases (19.42%) of moderate pain, and seven cases (0.42%) of severe pain. Within 24-48 h postpartum, 1,607 (89.27%) mothers faced problems related to postpartum breastfeeding. Among them, 694 (43,19%) neonates could not be fed effectively; 665 (41.38%) mothers had wound pain and had inconvenience to turn over; 598 (37.21%) neonates were difficult to wake up; 439 (27.32%) mothers had incorrect feeding posture; 181 (11.26%) mothers experienced other problems. The Cox risk regression model showed that weight gain during pregnancy was higher than the recommended standard. Living in suburban counties was a risk factor of exclusive breastfeeding for full-term infants. Participation in breastfeeding courses during pregnancy, feeding more than eight times daily after delivery, were the protective factors of exclusive breastfeeding for full-term infants. Conclusion: The body weight gain of parturients should be controlled within a reasonable range during pregnancy. Parturients were encouraged by medical staff to participate in breastfeeding courses or watch the breastfeeding process during pregnancy to increase their self-confidence and improve the rate of exclusive breastfeeding for full-term infants. In addition, it is necessary to strengthen the publicity of breastfeeding in suburban areas to promote breastfeeding.
ABSTRACT
Background Since December 2019, COVID-19 has emerged in Wuhan, China and spread globally. As of now, there is still no explicit therapeutic regimen and the use of corticosteroid is also controversial. We aimed to explore the effectiveness of corticosteroid and provide evidence for the rational use of corticosteroid in different patients with COVID-19.Methods In this multi-centered, retrospective study, we extracted the clinical data of 649 cases with COVID-19 with definite outcome (discharged or dead) from 14 hospitals in Hubei province, and evaluated the clinical characteristics, treatment regimens, and their association with outcomes.Results Ninety-five of 649 patients had died. Older male patients with comorbidities had an increased risk of death and more obvious abnormalities in clinical indicators. Corticosteroid, γ-globulin treatment and invasive ventilation were more frequently used in non-survivors. Survivors with corticosteroid treatment had a prolonged hospitalization. The median time duration for temperature restore for non-survivors after corticosteroid treatment was longer than that of both survivors. The lymphocyte count on admission was lower in the patients treated with corticosteroids compared to those without corticosteroid treatment. Lymphocyte count recovered significantly after corticosteroid treatment in survivors, but not in non-survivors.Conclusions The responses to corticosteroid treatment were different in COVID-19 patients with different outcomes. The surviving patients with relatively lower lymphocyte count were more likely to be given corticosteroids. For non-survivors, the lymphocyte count was too low and the effect of corticosteroids was poor. Survivors under corticosteroid treatment had a prolonged hospitalization, but had a recovery of lymphocytes. The recovery of lymphocyte count and temperature after corticosteroid treatment may be used as predictors of prognosis of patients with COVID-19.