极/超低出生体重儿生后早期腹部局部组织氧饱和度变化趋势的前瞻性研究

目的 探讨极/超低出生体重儿（very/extremely low birth weight infant,VLBWI/ELBWI）出生后的腹部局部组织氧饱和度（abdominal regional oxygen saturation,A-rSO₂）变化趋势。 方法 选取2019年9月至2021年5月在新生儿重症监护室住院的VLBWI/ELBWI作为研究对象。利用近红外光谱技术,从出生后第1天开始每天监测A-rSO₂,共监测4周。并根据出生胎龄分为较低胎龄组（<29周组）及较高胎龄组（≥29周组）,对两组VLBWI/ELBWI生后4周内的A-rSO₂进行比较分析。 结果 共纳入VLBWI/ELBWI 63例,其中<29周组30例,≥29周组33例。63例VLBWI/ELBWI生后2周内A-rSO₂呈现波动变化：生后第1天为最低值（47.9%）,后逐渐升高,第4天达最高峰（67.4%）,第5~9天逐渐下降,然后再次上升,至出生2周后趋于稳定。≥29周组出生后第1周及第2周A-rSO2均高于<29周组,差异有统计学意义（P<0.05）。出生第3周及第4周两组A-rSO₂均值比较差异无统计学意义（P>0.05）。 结论 VLBWI/ELBWI的A-rSO₂在出生后最初2周随日龄增加存在波动变化,2周后趋于稳定;生后2周内的A-rSO₂与胎龄相关。     

Renal function and volume of infants born with a very low birth‐weight: a preliminary cross‐sectional study

Aim: The aim of our study was to compare the function and volumes of kidneys of very low birth‐weight (VLBW) and of extremely low birth‐weight (ELBW) infants at pre‐school ages. Patients and methods: We did a revision of the neonatal records of infants born in our hospital that weighed ≤1500 g at birth. The children were divided into two groups according to their weight at birth: ELBW (<1000 g) and VLBW (1000–1500 g). At the age of 5.7 ± 1.4 years, the children underwent clinical, laboratory and ultrasound renal assessments. Results: Sixty‐nine children fulfilled the requirements for the study. The rate of neonatal treatment with aminoglycosides was higher in ELBW preterms. Renal function parameters, i.e. estimated glomerular filtration rate and albuminuria, did not differ between the two groups of children. Urinary α1‐microglobulin excretion was significantly higher and kidneys were significantly smaller in the ELBW group than in the VLBW group. Conclusion: No impairment or differences in renal parameters were found in pre‐school children born ELBW compared with those born with VLBW, except for differences in kidney volume, renal cortical thickness and urinary α1‐microglobulin excretion. Thus, patients born with ELBW would require a longer follow‐up period.     

Placental histopathology in the extremely low birth weight infants

Our objective was to evaluate the placental histopathology (PH) in extremely low birth weight infants (ELBW, birth weight < 1000 g) and to determine if placental histopathological findings are associated with neonatal mortality in them. The PH of all ELBW infants (gestational age 23-30 weeks) born during a 3-year study period was prospectively evaluated and compared with term infants (gestational age > or = 37 weeks). Additionally PH of ELBW infants who expired within 28 days of life was compared with those who survived beyond 28 days. Student's t test, chi(2) test and Pearson's correlation coefficient tests were utilized for data analysis. The occurrences of placental infection (chorioamnionitis, HCA), umbilical cord inflammation (funisitis, vasculitis, and subacute necrotizing funisitis, analyzed collectively as HFV), and abruption were higher in ELBW (n = 105) compared to term infants (n = 61, p = 0.001, 0.0002, and 0.0002, respectively). Placental findings did not differ between the surviving (n = 71) and nonsurviving (n = 51) ELBW infants. Birth weight and gestational age were higher in the surviving group (p = 0.003 and 0.001, respectively). Placental abruption was found more commonly in the presence of HCA and HFV in ELBW infants as opposed to maternal hypertension in term infants. All ELBW placentas with HFV had concomitant findings of HCA whereas only 42% of ELBW placentas with HCA had findings of HFV compared to 24% in term infants (p = 0.09). There was a weak inverse correlation between HCA and birth weight in all (r = - 0.3, p = 0.01) but not in ELBW infants (r = 0.2, p = 0.07). We conclude that placental and umbilical cord inflammation and placental abruption are more commonly present in ELBW compared to term infants. However, these findings do not contribute to neonatal mortality in ELBW infants. Forty-two percent of placental (maternal) inflammation cases have concomitant cord (fetal) inflammation in ELBW infants. Finally HCA correlates inversely with birth weight in neonates.     

Rapid increase of blood pressure in extremely low birth weight infants after a single dose of dexamethasone

Blood pressure was retrospectively studied in all 22 extremely low birth weight infants (ELBW) (birth weight median 720 g, range 450–1020 g) who were admitted between July 1989 and October 1991 and received dexamethasone on days 2–25 (median 10) because of bronchopulmonary dysplasia or since lung function had not improved after installation of bovine surfactant. The average blood pressure during the 4 h before dexamethasone increased significantly (median individual increase 8 mmHg,P=0.0005) until 8–12 h thereafter. In addition to the lung disease, ten infants showed severe arterial hypotension with prolonged capillary refilling time (>3s) and oliguria and needed continuous infusion of epinephrine to increase blood pressure and urinary flow after treatment with colloids, dopamine and dobutamine had proved ineffective. Epinephrine infusion could be stopped in eight infants 8h after dexamethasone administration. In ELBW infants blood pressure rose 8–12 h after a single dose of 0.25 mg/kg dexamethasone. In ELBW infants suffering from arterial hypotension who do not respond to infusion of colloids and catecholamines, dexamethasone may represent a new therapeutic tool.     

深度水解蛋白配方奶喂养对极低/超低出生体重儿生长发育的影响

目的探讨深度水解蛋白配方奶喂养对极低出生体重(VLBW)和超低出生体重(ELBW)婴儿生长发育的影响。方法选取VLBW和ELBW婴儿375例作为研究对象,根据随机数字表法将其分为观察组(n=187)和对照组(n=188)。观察组给予深度水解蛋白配方奶喂养,当喂养达10 mL/次后,改用标准早产儿配方奶喂养。对照组给予标准早产儿配方奶喂养。两组持续喂养4周,比较两组喂养不耐受发生率、达全肠道喂养时间、胎便排净时间、自主排便次数、生长发育情况、喂养后第4天和第10天胃动素水平以及感染发生情况。结果观察组喂养不耐受率低于对照组(P0.05);观察组达全肠道喂养时间和胎便排净时间均短于对照组(P0.05);观察组平均每日自主排便次数多于对照组(P0.05);观察组婴儿体重、头围和身长均大于对照组(分别是1 793±317 g vs 1 621±138 g、30.5±1.1 cm vs 30.0±1.6 cm和43.9±1.2 cm vs 42.1±2.0 cm;均P0.05);观察组婴儿喂养第4天和第10天胃动素水平均高于对照组(P0.05);观察组婴儿感染率低于对照组(P0.05)。结论深度水解蛋白配方奶可提高胃动素水平,增加胃肠道喂养耐受性,促进VLBW和ELBW婴儿早期生长发育,降低感染发生率。     

极低/超低出生体重儿迟发型败血症发生情况及其危险因素分析

目的探讨新生儿重症监护病房(NICU)极低/超低出生体重儿迟发型败血症(LOS)的发生情况及危险因素。方法收集2011年1月至2013年12月入住NICU的极低或超低出生体重儿的临床资料,根据是否合并LOS分为两组:LOS组和无LOS组。回顾性分析LOS的发生率、病死率、常见病原菌及危险因素。结果纳入的226例极低/超低出生体重儿中,117例(51.8%)发生了LOS,其中45例为确诊LOS,72例为临床诊断LOS。LOS组患儿病死率为13.7%(16/117),明显高于无LOS组(5/109,4.6%),差异有统计学意义(P0.05)。共培养出51株病原菌,其中32株(63%)为革兰阴性细菌,16株(31%)为革兰阳性细菌,3株(6%)为真菌。多因素logistic回归分析显示,胎龄、小于胎龄儿、肠外营养持续时间、经外周静脉穿刺中心静脉置管(PICC)、机械通气是极低/超低出生体重儿LOS发生的独立影响因素(OR分别为:0.84、1.59、1.34、3.11、4.55,均P0.05)。结论极低/超低出生体重儿LOS的发生率及病死率较高。LOS常见病原菌为革兰阴性细菌。胎龄低、肠外营养持续时间长、小于胎龄儿、PICC或机械通气的极低/超低出生体重儿LOS的发生危险可能增加。     

Maternal somatostatin levels and their correlation with infant birth weight

Samples of blood were obtained from 52 primiparous breast-feeding women 4 days post partum. Thirty-six of the mothers were still breast-feeding 3–4 months later and had further blood samples taken. Somatostatin levels were analyzed by radioimmunoassay. A highly significant rank correlation (P = 0.0001) between average somatostatin levels on the two occasions was established, although somatostatin levels recorded 3–4 months post partum were significantly higher than those found 4 days post partum (P < 0.01). Furthermore, somatostatin levels obtained 4 days and 3–4 months post partum were inversely related to the birth weight of their children (P = 0.006 and P = 0.03). The significant negative correlation between somatostatin levels recorded 4 days post partum and birth weight of the infants persisted only when non-smokers were investigated. A strong positive correlation between infant birth weight and weight of placenta was found (P = 0.0001) and a negative correlation (P = 0.04) between somatostatin levels and placental weight. A stepwise regression was performed to explain the importance of somatostatin levels in birth weight. Somatostatin levels and smoking had an almost equal influence on the variation in birth weight (0%). It is suggested that low maternal somatostatin levels are related to an efficient storage of nutrients in the fetoplacental unit, thereby leading to a high birth weight.     

Clinical determinants and utility of early postnatal maximum weight loss in fluid management of extremely low birth weight infants

Background

The early postnatal physiological body weight loss process is poorly understood in preterm infants. It is complicated by clinical conditions which adversely affect the body fluid balance during 1st two weeks of life. A lack of physiological weight loss potentially could result in significant morbidities. Body weight is utilized in determining daily fluid volume intakes. Extremely low birth weight infants (birth weight < 1000 g, ELBW) have the highest morbidity and mortality among all neonates.

Aim/objective

The objective was to evaluate the early postnatal weight changes and its clinical determinants in ELBW infants. We examined the maximum weight loss from birth weight (MWL) in ELBW infants and tested its association with clinical variables which could potentially implicate the body fluid balance during the first two weeks of life.

Study design

Prospectively entered data in the computerized radiology, biochemical and hematological records, and daily case notes were retrospectively extracted during a 3-year study period. The infants' and maternal demographic, clinical course and outcome variables relevant to body fluid balance during the first two weeks of life were correlated with MWL. Pearson's correlation coefficient and Pearson's partial correlation tests were utilized for data analysis.

Results

Data are presented as mean ± SD. MWL in the entire cohort (n = 102) was 14.2 ± 5.4%. Day of life of MWL was 5.5 ± 2.1 and that of birth weight regained 14.5 ± 4.2 days. MWL correlated negatively with gestational age, antenatal steroid receipt (ANS) and pregnancy associated hypertension and positively with total days on oxygen, fluid intake, urinary output and the day of life when birth weight was regained. All these correlations were lost after controlling for GA except for the day of life when birth weight was regained. MWL did not correlate with RDS or its severity, hypotension, PIE, IVH, PDA and length of stay. Over 91% infants had MWL within 3.1-25%. Male, Caucasian and ELBW infants unexposed to ANS tended to have weight loss in excess of 25%.

Conclusion

MWL is governed by maturation and is not affected by concurrent clinical factors including fluid intakes during the 1st two weeks of life in ELBW infants. MWL within the estimated range of 14.5 + 4.2% of birth weight does not promote morbidities. Male, Caucasian and ELBW infants unexposed to ANS are susceptible to excessively high weight losses in early postnatal period.     

Parental and perinatal factors affecting childhood anthropometry of very-low-birth-weight premature infants: a population-based survey

Background: The perinatal–neonatal course of very-low-birth-weight (VLBW) infants might affect their childhood growth. We evaluated the effect of parental anthropometry and perinatal and neonatal morbidity of VLBW neonates on their childhood growth.
Methods: We obtained parental anthropometry, height and weight at age 6–10.5 years of 334 children born as VLBW infants. Parental, perinatal and neonatal data of these children were tested for association with childhood anthropometry.
Results: (1) Maternal and paternal weight standard deviation score (SDS) and discharge weight (DW) SDS were associated with childhood weight SDS (R²= 0.111, p < 0.00001); (2) Maternal and paternal height SDS, corrected gestational age (GA) at discharge, maternal assisted reproduction and SGA status were associated with childhood height SDS (R²= 0.208, p < 0.00001); (3) paternal weight SDS, DW SDS and surfactant therapy were associated with childhood body mass index (BMI) SDS (R²= 0.096, p < 0.00001). 31.1% of VLBW infants had DW SDS < −1.88, and are to be considered small for gestational age ('SGA'). One quarter of these infants did not catch up by age 6–10.5 years.
Conclusion: Childhood anthropometry of VLBW infants depends on parental anthropometry, postnatal respiratory morbidity and growth parameters at birth and at discharge. Almost one-third of VLBW premature infants had growth restriction at discharge from neonatal intensive care unit (NICU), a quarter of whom did not catch up by age 6–10.5 years.     

Recovery of metabolic acidosis in term infants with postasphyxial hypoxic-ischemic encephalopathy

Aims: To describe the base deficit (BD) values and the rate of postnatal recovery of the BD of infants with hypoxic ischemic encephalopathy due to intrapartum asphyxia; and to explore the relationships between the rate of recovery of BD, severe adverse outcome and different time patterns (acute total vs prolonged partial) of asphyxia. Methods: Clinical and laboratory data were collected from the neonatal period (n = 244) and outcome data to a minimal age of 1 y (n = 218). Rates of recovery of BD were described in four 60 min blocks of time. The values of rate of recovery were compared between the outcome groups, ignoring correlation structure within subjects and with adjustment by the generalized estimating equations method. Results: The BD normalized within 4 h of birth in all but 9 of 244 infants. The rates of recovery of BD in infants with good and severe adverse outcome respectively were 0.11 [95% confidence interval (95% CI) 0.07, 0.14] and 0.09 (95% CI 0.07, 0.12) mmol l ^-1 min ^-1 over the first 4 h after birth. The rates of recovery were similar with or without buffer therapy, and after acute near-total and prolonged partial asphyxia.

Conclusion: The BD in the great majority of infants with severe intrapartum asphyxia normalizes within 4 h of birth. The BD recovery rate of infants with adverse outcomes was similar to those with relatively good outcome. The different time patterns of asphyxial episode were not associated with differential recovery profiles.     

POSTNATAL DEVELOPMENT OF RENAL HYDROGEN ION EXCRETION CAPACITY IN RELATION TO AGE AND PROTEIN INTAKE

ABSTRACT. Svenningsen, N. W. and Lindquist, B. (Department of Paediatrics, University Hospital, Lund, Sweden). Postnatal development of renal hydrogen ion excretion capacity in relation to age and protein intake. Acta Paediatr Scand, 63: 721, 1974.—The cumulative and maximum renal hydrogen ion excretion capacity after induced acidosis has been studied in six term and twenty preterm infants at 1–3 and 44 weeks of postnatal age corresponding to for preterm babies 34–36 and 37–39 and for term babies 41–43 and 44–46 weeks of gestational age. The maximum net hydrogen ion (H⁺_NAE) excretion capacity is lower in preterm than in term infants at 1–3 weeks of postnatal life. However, when approaching full gestation there is a considerable increase of the H+_NAE excretion capacity of pretem infants almost equal to that found in term infants at 1–3 weeks of age. High dietary protein intake lasting for in average two to three weeks in preterm infants does not change the maximum renal H⁺ excretion during induced acidosis, but significantly enhances the initial increment of excretion rate of titratable acid (H⁺_TA) in comparison to preterm infants fed low protein diets. The findings of the present investigation suggest that the development of renal hydrogen ion excretion capacity in preterm infants during the first weeks of life is related primarily to gestational age. This development may, however, to a certain degree respond to increased excretory needs imposed by dietary load.     

Impact of fluconazole prophylaxis on incidence and outcome of invasive candidiasis in a neonatal intensive care unit

OBJECTIVES: We assessed the impact of intravenous fluconazole prophylaxis (FP) in extremely low birth weight (ELBW [<1000 g]) infants on the incidence of and outcome from invasive candidiasis (IC) in all infants admitted to a neonatal intensive care unit (NICU). STUDY DESIGN: Beginning April 1, 2002, FP was given to ELBW infants aged < 5 days admitted to the NICU of Woman's Hospital of Texas. Infants in NICU in whom IC developed during the first 2 years of FP (FP period) were compared with those with IC during 2000-2001. RESULTS: During 2000-2001 and the FP period, the incidence of IC in ELBW infants decreased from 7% (15 of 206) to 2% (5 of 240) (P=.01), and the IC-related mortality rate decreased from 12% (4 of 33) to 0 (0 of 40) (P=.04); the incidence of IC increased from 0.1% (4 of 2806) to 0.2% (8 of 3372) in infants of birth weight > or = 1000 g (P=.06), and no IC-related deaths occurred. During the FP period, IC developed in older infants (24 vs 12 days; P=.12) who had similar risk factors for IC. CONCLUSION: Invasive candidiasis occurred in our NICU in spite of FP and shifted to bigger, more mature infants who had a better outcome.     

超低和极低出生体重儿神经发育结局及影响因素分析

目的 评估超低/极低出生体重儿 （ELBWI和VLBWI） 在纠正年龄 （CA） 18月时神经发育结局,探讨影响神经发育结局的因素。方法 收集2013年1月至2014年6月入住新生儿重症监护病房并存活出院的ELBWI和VLBWI病例,在CA40周、1、3、6、12、18月定期随访,评估神经发育结局。按神经发育状况分为神经发育正常组和神经发育异常组,比较两组临床资料的差异,分析ELBWI和VLBWI神经发育的危险因素。结果 共338例ELBWI和VLBWI纳入研究,15例在住院期间死亡。CA18月时,145例 （44.9%） 存活且随访资料完整,75例 （23.2%） 死亡,失访103例 （31.9%）。CA18月时,145例患儿中神经发育损伤71例 （49.0%）,3例 （2.1%） 脑性瘫痪;未发现单眼或双眼失明的视觉损伤及需要助听器的听觉损伤。Logistic回归分析发现BPD和败血症是ELBWI和VLBWI神经发育异常的独立危险因素 （OR=3.530,P < 0.001;OR=2.528,P=0.035）,BPD发生程度越重,神经发育异常的发生率越高。结论 败血症、BPD （尤其是重度BPD） 是ELBWI和VLBWI神经发育异常的危险因素。     

营养与早产儿神经发育结局

随着围产医学和新生儿医学发展,极低和超低出生体质量(VLBW/ELBW)早产儿存活率普遍提高,但这些早产儿可进一步发生神经系统发育不良。除与神经系统发育有关的疾病如脑损伤外,在大脑迅速生长和发育的时期,营养同样是影响神经系统发育及不良预后的重要因素。VLBW/ELBW早产儿发生生长发育迟缓的风险增高,主要与出生后营养摄入不足有关。目前的证据显示,VLBW/ELBW早产儿出生后生长发育迟缓与神经系统发育损害有关。此外某些特殊营养素,如长链多不饱和脂肪酸与早产儿神经发育有相关关系。     

The corrected blood urea nitrogen predicts the developmental quotient of extremely low-birth-weight infants at the corrected age of 36 months

BACKGROUND: Currently, there are no nutritional indices to predict cognitive function in extremely low-birth-weight (ELBW) infants. OBJECTIVE: To assess the neonatal blood urea nitrogen (BUN) values in ELBW infants according to their cognitive function at the corrected age of 36 months. METHODS: This was a retrospective study that assessed the neonatal factors affecting the developmental outcome in two groups "developmental quotient (DQ)> or =80" and "DQ<80", the groups were divided based on the DQ at the corrected age of 36 months. Between 1996 and 1999, 178 ELBW infants born at <28 weeks of gestation were admitted to our neonatal intensive care unit (NICU), of these, 32 died. Of the surviving 146 infants, 37 infants without any exclusion criteria (that would affect the cognitive function and BUN) except the nutritional factor, were assessed. Area under the curve (AUC) of corrected BUN (CBUN: BUN x 0.5/serum creatinine) from 28 to 84 days of life was used as an index of protein intake. RESULTS: No significant differences were observed between the two groups with regard to the gestational age, birth weight, Z score of birth weight, and sex. However, compared to 15 infants with DQ<80, 22 infants with DQ> or =80 had significantly shorter duration of artificial ventilation and O(2) supplementation, a higher Apgar score at 5 min, and a higher AUC of CBUN. On multiple regression analysis, DQ> or =80 was observed to be significantly correlated with the AUC of CBUN (Odd's ratio 1.03, 95% confidence interval: 1.002-1.06). CONCLUSION: The CBUN level would provide an estimate of adequate protein intake and the subsequent development of an ELBW infant.     

湖南省极低/超低出生体重儿抗生素使用多中心调查报告

目的 对湖南省新生儿病房极低出生体重（VLBW）和超低出生体重（ELBW）患儿住院期间抗生素使用情况进行调查，为规范湖南省新生儿病房住院早产儿抗生素的合理应用提供临床数据。方法 对湖南省24家三级医疗机构新生儿病房上报的2017年1~12月住院VLBW/ELBW患儿抗生素使用情况进行调查。结果 24家医疗机构2017年全年住院VLBW/ELBW患儿共1 442例，抗生素中位使用时间为17 d（范围：0~86 d），抗生素使用时间占住院时间的53.0%。各医疗机构抗生素使用时间占住院时间的百分比差异较大，最高达91.4%，最低为14.6%，2/3（16家）的单位超过50.0%。血及脑脊液细菌培养阳性共113例，细菌培养阳性率为7.84%，各机构细菌培养阳性率不同（0%~14.9%）。败血症常见致病菌中肺炎克雷伯杆菌检出29例（25.7%），大肠杆菌12例（10.6%），金黄色葡萄球菌3例（2.7%）。使用最多的抗生素为第三代头孢菌素类抗生素，占全部抗生素使用的41.00%；其次为青霉素类抗生素（32.10%），再次为碳青霉烯类抗生素（13.15%）。抗生素使用时间占比与出生体重Z值、出生体重与出院体重Z值的差值呈负相关（分别r_s=-0.095、-0.151，均P < 0.01），与病死/放弃率呈正相关（r_s=0.196，P < 0.01）。结论 湖南省新生儿病房住院VLBW/ELBW患儿抗生素使用时间较长，不同医疗机构抗生素使用情况差别大。第三代头孢菌素及碳青霉烯类抗生素使用比例较高。     

Management of extremely low-birth-weight infants

Better health care of women during pregnancy and delivery, improvement in neonatal intensive therapy and technology have led to a decrease in neonatal mortality and morbidity and to lower limits of birth weight and gestational age for survival. This paper refers to the management protocol used in the Department of Perinatal Pathology of the Provincial Maternity Hospital of Milan for extremely low-birth-weight (ELBW) infants (birth weight < 1000 g). In this hospital, all newborn infants presenting evidence of life, irrespective of birth weight and gestational age, are resuscitated and transferred to the Neonatal Intensive Care Unit (NICU) for clinical management. After the introduction of this protocol the mortality rate of ELBW infants dropped from 71.4% in 1977–78 to 48% in 1987–88. In a group of 72 ELBW infants with a mean birth weight of 850 g and a mean gestational age of 27 weeks, 80% presented a normal outcome, 12% presented a mild neurological impairment and 8% were affected by severe cerebral palsy at the age of two years. The intact survival of a newborn infant of 450 g at birth is also reported.     

Association between fluid intake and weight loss during the first ten days of life and risk of bronchopulmonary dysplasia in extremely low birth weight infants

OBJECTIVE: To demonstrate the association between fluid intake and weight loss during the first 10 days of life and the risk of bronchopulmonary dysplasia (BPD) in extremely low birth weight (ELBW) infants. STUDY DESIGN: A retrospective analysis of data from a cohort of ELBW infants enrolled in the Neonatal Research; 1,382 infants with birth weight between 401 and 1,000 g were randomized. The daily fluid intake and weight loss during the first 10 days of life were compared between the infants who survived without BPD and those who either died or developed BPD. Demographic and clinical neonatal variables were also compared. Multivariate logistic regression was used to analyze the effect of fluid intake and weight loss on death or BPD, controlling for demographic and clinical factors that are significantly associated with BPD by univariate analysis. RESULTS: 585 infants survived without BPD and 797 infants either died or developed BPD. Univariate analysis showed that the daily fluid intakes were higher (day 2-10) and weight loss less (day 6-9) in the group of infants who either died or developed BPD. In addition, lower birth weight, lower gestational age, male gender, lower 1 and 5-minute Apgar Scores, higher oxygen requirement at 24 hours of age, longer duration of assisted ventilation, use of postnatal steroids for BPD and presence of severe intraventricular hemorrhage, proven necrotizing enterocolitis, patent ductus arteriosus, and late onset sepsis, were associated with higher incidence of death or BPD. The adjusted risk of higher fluid intake and less weight loss during the first 10 days of life remained significantly related to death or BPD. CONCLUSION: In this cohort of ELBW infants treated during the post surfactant era, higher fluid intake and less weight loss during the first 10 days of life were associated with an increased risk of BPD. The finding suggests that careful attention to fluid balance might be an important means to reduce the incidence of BPD.     

多种油脂肪乳在超低出生体重儿中应用的疗效分析

目的 分析多种油脂肪乳(SMOF)在超低出生体重(ELBW)儿中应用的疗效.方法 回顾性选取2018年1月1日至2020年7月30日收治的ELBW儿49例为研究对象,入院时日龄≤14 d,接受胃肠外营养时间>14 d.根据应用的脂肪乳剂种类,分为SMOF组(n=26)和中长链脂肪乳(MCT/LCT)组(n=23),比较...     

The association of early postnatal weight loss with outcome in extremely low birth weight infants

Background

To compare outcomes of extremely low birth weight (ELBW) infants having different weight losses in the first 3 days of life.