喂养方式对6个月内婴儿体格发育的影响研究

【目的】了解不同喂养方式对0~6月龄婴儿体格发育的影响作用。【方法】采用分层随机抽样的方法,在陕西彬县、长武两县随机抽取健康单胎新生儿及其家庭,进行问卷调查和体格检查,以体格测量方法评价婴儿营养状况。【结果】1 249例婴儿及其家庭参加调查,婴儿母乳喂养率为97.28%,4个月内纯母乳喂养率为65.49%;4个月内纯母乳喂养婴儿体重、身长、上臂围在1、3、6月龄时均显著高于混合喂养和人工喂养婴儿(P<0.05);纯母乳喂养婴儿各种疾病患病率在1、3、6月龄时均显著低于非纯母乳喂养婴儿(P<0.05)。【结论】母乳是婴儿最适宜的食品,能完全满足4~6月内婴儿的生长发育需求。普及科学喂养知识,提倡母乳喂养,将有助于提高当地婴儿的体格发育水平。     

新生儿败血症早期临床诊断

目的:探讨诊断新生儿败血症早期的临床首发症状及实验室依据,以益早期诊治。方法:对我院新生儿科2001年1月~2004年12月收治的416例败血症患儿进行回顾性分析,分为足月儿组及早产儿组,分别对其发病时间、感染途径、临床首发症状及实验室检查等方面进行对比。结果:两组均以生后7日后发生率高;感染途径足月儿以皮肤、脐部为主,早产儿以呼吸道为主;临床表现上足月儿组首发症状依次为发热、纳少、皮肤黄疸、反应差。而早产儿组以体温波动、纳少、皮肤黄疸、腹胀及呼吸暂停为首发症状;早期的实验室检查以中性粒细胞与C反应蛋白(简称CRP)增高、血小板减少、以及血糖的变化对临床早期诊治较有意义。结论:新生儿临床败血症应注意早期反复发热或体温波动、纳少、皮肤黄疸、反应差等隐匿的中毒症状,并且结合入院周围血象、CRP、血糖及感染途径进行综合分析,对早期的诊治有指导意义。     

不同胎龄婴幼儿智能发育状况的追踪研究

目的 通过追踪记录不同胎龄(26⁺¹~42⁺⁶周)婴幼儿的智能发育指标并进行比较分析,发现不同胎龄婴幼儿的智能发育规律。方法 选取2012-2014年间于佛山市妇幼保健院儿童保健科随访至2岁或以上的婴幼儿3 438例,根据胎龄把随访婴幼儿分为5组,使用《0~6岁儿童神经心理发育量表》对各组婴幼儿分别进行3、6、9、12、18、24月龄的神经心理发育测试,计算各组的发育商均值并比较分析。结果 极早产儿组的发育商于随访期间低于其他组别婴幼儿(P<0.05)。晚期早产儿组的发育商于18月龄及以后与各胎龄足月儿、过期产儿组比较,差异无统计学意义(P>0.05)。各胎龄足月儿、过期产儿组于6月龄及以后发育商比较,差异无统计学意义(P>0.05)。结论 极早产儿仍为智能发育障碍的主要人群,需积极采取相关手段提高其生命质量。     

Infant motor development and equipment use in the home

Forty-three mother-infant dyads were recruited to determine the relationship between both total equipment use and the use of individual pieces of equipment and infant motor development. At 8 months of age, total and individual equipment use was determined by parental survey and infant motor development was assessed using the Alberta Infant Motor Scale. Statistically significant correlations were found for the relationships between total equipment use and infant motor development (r = -0.50, P = 0.001) and individual pieces of equipment [exersaucer (r = -0.58, P = 0.001), highchair (r = -0.32, P = 0.04), and infant seat (r = -0.32, P = 0.03)] and infant motor development. These findings suggest that infants who have high equipment use tend to score lower on infant motor development or that infants who have low equipment use tend to score higher on infant motor development. Limitations of this cross-sectional study make it difficult to determine causality between these constructs. If equipment use is found to be causally related to infant motor development and predictive of later motor development in a future prospective study, parental education emphasizing the moderate use of equipment within the home environment might be warranted.     

‘The best thing for the baby’: Mothers’ concepts and experiences related to promoting their infants’ health and development

Mothers and pregnant women in contemporary western societies are at the centre of a web of expert and lay discourses concerning the ways they should promote and protect the health and development of their foetuses and infants. This article reports the findings from an Australian study involving interviews with 60 mothers. The findings explore in detail four topics discussed in the interviews related to pregnancy and caring for young infants: disciplining the pregnant body; promoting infants’ health; immunisation; and promoting infants’ development. Itis concluded that the mothers were highly aware of their responsibilities in protecting their foetuses and infants from harm and promoting their health and development. They conceptualised the infant body as highly vulnerable and requiring protection from contamination. They therefore generally supported the idea of vaccination as a way of protecting their babies’ immature immune systems, but were also often ambivalent about it. The mothers were aware of the judgemental attitudes of others, including other mothers, towards their caring efforts and attempted to conform to the ideal of the ‘good mother’. The emotional dimensions of caring for infants and protecting their health are discussed in relation to the voluntary participation of mothers in conforming to societal expectations.     

Addition of Supplementary Foods and Infant Growth (2 to 24 Months)

Objective: To determine the effect of adding supplementary foods on infant growth 2 to 8 and 12 to 24 months.

Methods: Length (cm/month) and weight (kg/month) of white infants (n = 94) were measured five to nine times from 2 to 24 months of age. Mothers reported birth weights, infants’ ages at first introduction of supplementary food, illnesses and information sources about infant feeding. Simple linear regression equations were used to compute slopes for each child (unit changes in length and in weight by age). Stepwise linear regression was used to determine the effect on weight and length slopes by the introduction of supplementary foods (e.g., an infant’s age when cereal, fruit, juice, vegetables and a meat cluster were first added) to the diet. Breast feeding (months duration or ever fed), illness scores and gender were covariates in the regression models.

Results: A significant model (F = 10.09, p = .002) for weight gain (2 to 8 months) showed that gender explained 10% of the variance; for length slope, the model was non-significant and gender explained 3% of the variance. Females had a slower weight gain compared to that of males. None of the covariates or supplementary foods were retained in the models. Weight prior to 12 months was the best predictor (p = .0001, 54% of the variance) of weight gain 12 to 24 months.

Conclusions: Unit changes in weight or length for an infant’s age were not statistically associated with the timing of when supplementary foods were first added to the diet 2 to 8 or 12 to 24 months. Weight prior to 12 months was a significant predictor of weight gain 12 to 24 months.     

婴儿一日摄入母乳量的测定——24、48和72小时称奶量结果的相关分析

<正> 为研究婴儿营养,了解母乳喂养婴儿营养素摄入情况,需测出婴儿一日摄入的母乳量。目前常用的测量方法是称重法,即称量每次婴儿吃奶前后体重,两次结果之差表示为婴儿摄入的母乳量。此法的优点是简单可行,易于操作,缺点是给母亲喂奶带来麻烦,影响母亲哺乳。一般认为称量的时间长些则可能反映婴儿摄入奶量的实际情况,但限于人力,时间等因     

晚期早产儿和足月儿早期运动发育对照研究

目的研究晚期早产儿(在校正月龄后)和同龄足月儿早期运动发育水平的差异,为早期实施针对性的运动干预方案提供依据。方法选取2013年6月-2014年5月在本院出生并在门诊随访的晚期早产儿46例作为观察组,随机选择同时期在本院出生的健康足月儿50例为对照组。在两组婴儿(14.0±1.0)周龄运用Alberta婴儿运动量表(Alberta Infant Motor Scale,AIMS)进行运动发育评估,比较两组原始得分、百分位≥50%的比例和运动发育异常率。结果晚期早产儿AIMS原始得分低于足月儿组,但两组差异无统计学意义(P0.05);两组AIMS得分相对应的百分位≥50%的比例,晚期早产儿显著低于足月儿(P0.01)。晚期早产儿和足月儿运动发育异常的比例两组比较差异有统计学意义(P0.05)。结论晚期早产儿的早期运动发育趋势在校正胎龄后还常落后于正常足月出生同龄婴儿,应尽早实施早期干预,促进早产儿的良好发育。     

NICU婴儿培养箱集中管理策略

婴儿培养箱的使用和管理存在诸多的问题,其中清洁消毒的问题尤为突出.通过对NICU婴儿培养箱的集中管理,探索出一条针对临床行之有效的策略.临床工程的介入,使婴儿培养箱在维修、维护、保养、清洁、培训等方面更加合理.科学的管理可优质服务于患儿,取得真正满意的效果.     

1560例2岁以下门诊小儿血红蛋白值的观察

<正> 儿童期的缺铁性贫血是多发病之一,尤以3岁以下发病率最高,不仅影响小儿体格发育,甚至影响智能发育。WHO公布6月至6岁小儿血红蛋白值(下称Hb)<11g为贫血诊断标准。经全国性会议讨论认为此标准也适用于我国。笔者就我院2岁以下门诊就诊小儿的Hb值作为观察内容,以了解我区贫血的发生情况。 一、资料来源及方法 资料选自我院门诊就诊的小儿。1983年5月至11月止,收集2岁以下小儿为观察对象(包括新生儿在内)共1560例,病例选择以上呼吸道感染起病,病程在1至2天内者或健康体检者。对有腹泻,呕吐及     

新生儿败血症早产儿与足月儿的临床特点分析

目的 探讨早产儿与足月儿新生儿败血症的临床特点,为临床诊治提供依据。方法 回顾性分析97例早产儿与43例足月儿败血症的临床资料。结果 早产儿晚发型败血症的比例高于足月儿(P<0.01),足月儿早发型败血症的比例高于早产儿(P<0.01)。胎膜早破、剖宫产、PICC置管、脐静脉置管和静脉营养在早产儿败血症中的比例高于足月儿(P均<0.01)。母亲围生期感染、羊水污染、顺产在足月儿败血症中的比例高于早产儿(P均<0.01)。早产儿败血症易表现为反应差、喂养不耐受、腹胀、呼吸暂停、呼吸困难、需机械通气治疗(P均<0.05或<0.01),易合并感染性休克和坏死性小肠结肠炎(P<0.01或<0.05),检测白细胞总数和血小板明显降低(P均< 0.01)。结论 早产儿与足月儿败血症在临床表现和实验室检查方面存在一定差异,早产儿败血症常累及多个系统的变化,应引起重视。     

Differing Postneonatal Mortality Rates of African-American and White Infants in Chicago: An Ecologic Study

Objectives: This study sought to determine whether neighborhood impoverishment explains the racial disparity in urban postneonatal mortality rates. Methods: Stratified and multivariate logistic regression analyses were performed on the vital records of all African-Americans and whites born in Chicago by means of a linked 1992–1995 computerized birth–death file with appended 1990 U.S. census income and 1995 Chicago Department of Public Health data. Four community-level variables (low median family income, high rates of unemployment, homicide, and lead poisoning) were analyzed. Communities with one or more ecologic risk factors were classified as impoverished. Results: The postneonatal mortality rate of African-Americans (N = 104,656) was 7.5/1000 compared to 2.7/1000 for whites (N = 52,954); relative risk (95% confidence interval) equaled 2.8 (2.3–3.3). Seventy-nine percent of African-American infants compared to 9% of white infants resided in impoverished neighborhoods; p < 0.01. In impoverished neighborhoods, the adjusted odds ratio (controlling for infant and maternal individual-level risk factors) of postneonatal mortality for African-American infants equaled 1.5 (0.5–4.2). In nonimpoverished neighborhoods, the adjusted odds ratio of postneonatal mortality for African-American infants equaled 1.8 (1.1–2.9). Conclusions: We conclude that urban African-American infants who reside in nonimpoverished neighborhoods are at high risk for postneonatal mortality.     

早产儿足跟干血片促甲状腺激素水平的检测及分析

目的 了解早产儿足跟干血片促甲状腺激素(thyrotropin, TSH)水平, 探讨早产儿合适的筛查时机和切值, 为临床提供更好的诊断标准。方法 从 2011年收集的10万余份标本中选出早产儿标本4 606份, 以不同胎龄、采血时间和体重分组, 足月儿为对照组。采用时间分辨荧光免疫法测其干血片TSH值, 分析TSH水平分布及组间比对。结果 早产儿足跟干血片TSH整体水平低于足月儿, 极早早产儿和极低体重儿中存在明显的个体差异, 分布不均衡 ;早产儿在延迟2周采血后, 其TSH水平有所下降, 一般早产儿为整体均衡下降, 而极早早产儿和极低体重儿在百分位数居中的水平变化不大, 但在百分位数末端高值处则有升高;一般早产儿的TSH切值与足月儿基本一致, 而极早早产儿和极低体重儿的则有明显下降, 且在延迟2周采血后亦有明显下降。结论 制定TSH筛查切值应考虑不同胎龄、体重和采血时间的影响。     

婴儿啼哭声音的生理和病理因素分析

婴儿啼哭具有重要的意义。除了传递生理及病理信息外,还可以提高抚育者的关注度改善抚育行为。对于早期建立与抚育者的关系、参与婴儿护理及早期的语言学习等具有不可或缺的作用。自上世纪中叶开始,不断有研究者试图将婴儿啼哭的分析应用于临床,在婴儿啼哭中寻找病理相关信息并取得了可喜的成绩,自闭症、婴儿猝死综合征和声带运动受损患儿的哭声分析有望成为早期简便筛查工具之一。而婴儿哭声在肠绞痛、疼痛评价等方面已应用于临床。本文总结了婴儿啼哭声音的影响因素及在相关疾病中的表现特点,以期为其临床应用提供参考。     

Biochemical Differences Between Preterm And Term Milk

As determined by 24-hour milk collections made during the first four weeks of lactation, preterm milk had a higher protein and sodium concentration and a lower calcium and phosphate content than term milk.     

研究婴儿操对儿童早期发展的影响

目的 研究婴儿操对儿童早期发展的影响.方法 将在儿保门诊进行健康体检的42天足月婴儿随机分为实验组和对照组.实验组由儿保医师指导家长每日在家中进行训练,并定期追踪随访;对照组仅给予常规的儿童系统保健管理服务.两组婴幼儿定期进行体格发育、营养状况及神经发育评估,并于生后6个月、12个月、18个月用婴幼儿智力发育测验量表进行智力测试.结果 实验组体格发育主要指标高于对照组,6个月、12个月、18个月身长的χ2值分别为:7.198、6.667、6.053,体重的χ2值分别为:7.888、7.392、6.380,P值均小于0.05; 6个月时实验组智力发育指数较对照组高2.71分(P＜0.05),实验组心理运动发育指数比对照组高3.32分(P＜0.01);12个月时实验组智力发育指数较对照组高3.90分(P＜0.01),心理运动发育指数比对照组高3.62分(P＜0.01);18个月时智力发育指数较对照组高5.82分(P＜0.01),心理运动发育指数比对照组高3.84分(P＜0.01);差异有显著性,表明脑的发育与外界环境刺激密切相关.结论 婴儿操有利于婴幼儿体格和智能发展.     

Effects of an At‐Home Video Course on Maternal Learning,Infant Care and Infant Health

Although pre‐natal education is widely available, there is a lack of in‐depth post‐natal education for the first year despite an increased need for such support, and what is offered is untested as to its effects on maternal behavior and infant care. 251 volunteer expectant mothers were randomly assigned to intervention and control groups; two subsamples of high‐risk (young mothers and mothers of pre‐term infants) were also identified in each group. The intervention groups received a year‐long, eight‐hour video and book course produced by My Baby U. for home use. Designed to enable new parents to become more knowledgeable, observant and responsive to their infants’ cues, the course follows seven families Interacting with a number of well‐known infant researchers. Course‐participating and non‐participating mothers were compared at three time points on their knowledge of infant development and their infant‐related behavior. Infant health information gathered via pediatric records was also compared for the groups. Analyses of the data demonstrated that intervention group mothers significantly increased their knowledge of infant development compared to the nonintervention group, were more pro‐active with regard to Infant medical care, and that their Infants had significantly fewer severe illnesses during the year.     

早产儿医院感染危险因素研究

目的探讨早产儿医院感染特点及危险因素。方法追踪观察2003年7月-2004年6月在儿科住院的早产儿医院感染发生情况;采用因素分析方法分析医院感染危险因素。结果早产儿医院感染率为16.03%;医院感染与胎龄、体重、喂养方式、疾病严重程度、住院时间、抗菌药物及激素的应用、侵袭性操作等有明显关系;感染的病原菌主要是真菌,其次是革兰阳性球菌;感染部位主要是呼吸道,其次是皮肤软组织、口腔黏膜、胃肠道。结论早产儿医院感染率高,应重点监控,其主要危险因素为胎龄小、低体重、病情重、非母乳喂养、住院时间长、使用广谱抗菌药物和激素、侵袭性操作等。     

Effects of an At-Home Video Course on Maternal Learning, Infant Care and Infant Health

Although pre-natal education is widely available, there is a lack of in-depth post-natal education for the first year despite an increased need for such support, and what is offered is untested as to its effects on maternal behavior and infant care. 251 volunteer expectant mothers were randomly assigned to intervention and control groups; two subsamples of high-risk (young mothers and mothers of pre-term infants) were also identified in each group. The intervention groups received a year-long, eight-hour video and book course produced by My Baby U. for home use. Designed to enable new parents to become more knowledgeable, observant and responsive to their infants' cues, the course follows seven families Interacting with a number of well-known infant researchers. Course-participating and non-participating mothers were compared at three time points on their knowledge of infant development and their infant-related behavior. Infant health information gathered via pediatric records was also compared for the groups. Analyses of the data demonstrated that intervention group mothers significantly increased their knowledge of infant development compared to the nonintervention group, were more pro-active with regard to Infant medical care, and that their Infants had significantly fewer severe illnesses during the year.     

妊高征与小于胎龄儿的相关性研究

目的:探讨妊高征与小于胎龄儿(SGA)之间的联系。方法:选取2000年1月~2004年10月在本院出生的单胎活产SGA病例共834例(男443例,女391例)作为病例组。以胎儿性别及出生孕周进行频数匹配,按1∶3的比例,采用完全随机抽样方法选取出生体重在10%~90%分位的适于胎龄儿2 502例(男1 329例,女1 173例)为对照组,比较病例组及对照组新生儿母亲孕期患妊高征的比例。结果:①病例组母亲患轻度、中度及重度妊高征比例分别是对照组的2.52(95%C I,1.35~4.69)、4.21(2.03~8.70)和5.15(3.10~8.54)倍;②分层分析表明,男性及女性病例组母亲妊高征的患病比例分别是对照组的4.45(2.72~7.27)和3.51(2.14~5.75)倍,男性及女性病例组母亲妊高征的患病优势比无显著差异,早产和足月病例组母亲患妊高征的比例分别为对照组的9.96(4.50~22.02)和3.21(2.15~4.78)倍,早产病例组母亲妊高征的患病优势比显著高于足月病例组;③校正性别、足月与否及母亲年龄的多因素分析结果与单因素分析结果类似。结论:妊高征可显著增加SGA发病的危险性。