胎膜早破与足月新生儿呼吸窘迫综合征的相关分析

目的 明确胎膜早破(PROM)与足月新生儿呼吸窘迫综合征(RDS)的相关性.方法 采用病例对照研究的方法,选择2008年1月-2010年12月出生后在本院新生儿重症监护中心住院、胎龄在37周以上、诊断为RDS的患儿205例为病例组,同期入院、主要诊断为新生儿黄疸(除外感染因素所致者)的410例足月新生儿为对照组.对所有纳入对象的临床资料进行回顾性分析,记录相关信息,包括有无PROM、患儿性别、分娩方式、出生体质量、羊水污染等,探讨PROM与足月儿RDS的关系.结果 1.RDS组RPOM所占比例(30.2％,62/205例)明显高于对照组(15.5％,63/410例),差异有统计学意义(x2=12.276,P＜0.001).2.经单因素分析,PROM、选择性剖宫产、男性、小于胎龄儿、羊水量少、妊娠期血糖偏高及糖尿病、羊水Ⅲ度污染、宫内窘迫、出生时窒息等因素均与足月儿RDS具有相关性(Pa＜0.05),均为RDS的危险因素,而孕母年龄≥35岁、脐带绕颈、胎盘早剥与RDS均无相关性(Pa＞0.05).3.经Logistic回归分析:PROM、选择性剖宫产、男性、妊娠期血糖异常及糖尿病、出生时窒息等与足月儿RDS密切相关.结论 PROM与足月儿RDS密切相关,是足月儿RDS的高危因素之一.     

新生儿早期脑血流变化规律的研究

目的 探讨新生儿早期脑血流随日龄的动态变化.方法 选择本院新生儿科住院的早产适于胎龄儿和健康足月儿,应用经颅多普勒超声测定不同胎龄新生儿生后7 d内每天大脑中动脉(MAC)血流速度及阻力指数(RI)和搏动指数(PI).结果 早产适于胎龄儿组65例,足月儿组49例.足月儿组脑血流速度较早产儿组明显增快(P<0.05);各组2～7 d各时间段大脑中动脉收缩期峰值流速(Vs)、平均血流速度(Vm)、舒张期末血流速度(Vd)均较第1天增快(P<0.05);早产适于胎龄儿组3～7 d各时间段Vs、4～7 d各时间段Vm与第2天比较均增快(P<0.05);足月儿组4～7 d各时间段Vs和Vm均较第2天增快(P<0.05);早产适于胎龄儿与足月儿Vs、Vm 4～7 d各时间段呈逐渐增加趋势,但差异无统计学意义;Vd增加较缓慢,2～7 d各时间段差异不明显;新生儿早期RI、PI亦呈渐增趋势,生后第1天较高,2～7 d内RI、PI短时期降低之后砌、PI又逐渐升高.结论 新生儿早期脑血流速度随日龄增大逐渐增快,生后前3 d波动较大,然后缓慢增加,逐渐趋于稳定.     

新生儿败血症血清降钙素原的动态改变

目的：探讨新生儿败血症患儿血中降钙素原(procalcitonin PCT)的改变。方法：以放免方法检测24例新生儿败血症患儿血中PCT的改变,同时检测20例缺血缺氧性脑病(HIE)以及16例正常足月儿作为正常对照。结果：新生儿败血症患儿在急性期PCT较正常对照组明显升高［(112.23±10.13) μg/L vs (8.65±2.14) μg/L］, (P0.05);而HIE组患儿PCT与正常对照组比较无明显的差别。结论：新生儿败血症患儿在急性期血中PCT明显增高,对败血症的早期诊断有一定的价值。     

新生儿早发型败血症89例临床特点与病原菌分析

目的 探讨新生儿早发型败血症的临床特征.方法 将我院新生儿科10年来收治的新生儿早发型败血症89例分为早产儿组和足月儿组,对其临床特点和实验室检查结果进行回顾性分析.结果 新生儿早发型败血症病原菌中革兰阴性菌与革兰阳性菌分别为52.8%和47.1%.其中早产儿组以革兰阴性菌为主,占72.7%;足月儿组革兰阴性菌与革兰阳性菌大致相同.两组病原菌构成差异有显著性(P＜0.05).早产儿组多脏器功能障碍综合征、弥散性血管内凝血及病死率高于足月儿,差异有显著性(P＜0.05).结论 早产儿早发型败血症较足月儿病情严重,病死率高.两者的病原菌构成有差异,根据其感染特点、胎龄迅速准确判断病原菌,合理使用抗生素,是减少伤残和病死率的关键.     

新生儿早发型败血症89例临床特点与病原菌分析

目的 探讨新生儿早发型败血症的临床特征.方法 将我院新生儿科10年来收治的新生儿早发型败血症89例分为早产儿组和足月儿组,对其临床特点和实验室检查结果进行回顾性分析.结果 新生儿早发型败血症病原菌中革兰阴性菌与革兰阳性菌分别为52.8%和47.1%.其中早产儿组以革兰阴性菌为主,占72.7%;足月儿组革兰阴性菌与革兰阳性菌大致相同.两组病原菌构成差异有显著性(P＜0.05).早产儿组多脏器功能障碍综合征、弥散性血管内凝血及病死率高于足月儿,差异有显著性(P＜0.05).结论 早产儿早发型败血症较足月儿病情严重,病死率高.两者的病原菌构成有差异,根据其感染特点、胎龄迅速准确判断病原菌,合理使用抗生素,是减少伤残和病死率的关键.     

NICU新生儿败血症心肌损害与出生状况的相关性研究

目的研究新生儿败血症心肌损害的发生与其出生时状况的相关关系,以改善新生儿败血症的预后。方法采用前瞻性临床观察研究方法,对郑州大学第三附属医院NICU2005-11-15—2006-05-31收治的112例败血症新生儿心肌损害的发生与其出生时胎龄、体重、性别、产式及有无窒息史等状况的关系进行了相关性分析。结果112例患儿中发生心肌损害者57例(50.9%)。23例早产儿心肌损害的发生率为78.3%,显著高于足月儿(43.4%),早产与新生儿败血症心肌损害的发生有显著的正相关性(r=0.288,P<0.05);28例低出生体重儿心肌损害的发生率为67.9%,显著高于正常出生体重儿(45.2%),低出生体重与新生儿败血症心肌损害的发生有显著的正相关性(r=0.196,P<0.05);新生儿败血症合并窒息者34例,心肌损害的发生率为85.3%,显著高于无窒息者(35.9%),窒息与新生儿败血症心肌损害的发生有显著的正相关性(r=0.454,P<0.05)。而不同性别及分娩方式对患婴心肌损害的发生率无影响。结论早产、低体重、窒息是新生儿败血症发生心肌损害的3个高危因素,对于这些新生儿发生败血症时,更要关注其心肌损害的发生以降低病死率。     

早产儿真菌性败血症临床特点及血浆1,3-β-D葡聚糖检测意义

目的 探讨早产儿真菌性败血症临床特点及血浆1,3-β-D葡聚糖检测的意义.方法 对2009年3月至2011年2月本院新生儿重症监护病房收治临床怀疑真菌感染的早产儿,应用MB -80微生物动态快速检测系统及GKT-5M真菌1,3-β-D葡聚糖检测试剂盒定量检测血浆1,3-β-d葡聚糖水平,同时进行血常规、C反应蛋白和血培养检测.确诊真菌性败血症的患儿为病例组,未确诊者为对照组.分析早产儿真菌性败血症的临床特点,比较两组血浆1,3-β-D葡聚糖水平.结果 30例疑诊患儿,病例组14例.病例组中,71.4％ (10/14)的真菌性败血症早产儿为极低出生体重儿,血培养均为假丝酵母菌（念珠菌）.临床表现除出现感染症状外,85.7％ (12/14)的患儿血小板计数明显下降.42.9％( 6/14)的真菌性败血症早产儿合并真菌性脑膜炎.病例组血浆1,3-β-D葡聚糖水平为181.1（129.6～1009.3）pg/ml,明显高于对照组5.0(5.0 ～8.8) pg/ml,差异有统计学意义(P＜0.05).6例合并真菌性脑膜炎患儿血浆1,3-β-D葡聚糖水平为1565.5(183.6～3549.3) pg/ml,8例未合并真菌性脑膜炎患儿的血浆1,3-β-D葡聚糖水平为159.0(48.0～183.7) pg/ml,差异有统计学意义(P＜0.05).病例组治疗后血浆1,3-β-D葡聚糖较治疗前显著下降,差异有统计学意义(P＜0.05).结论 早产儿真菌性败血症多见于极低出生体重儿,以念珠菌血症多见,多数患儿血小板计数明显下降,易合并真菌性脑膜炎.血浆1,3-β-D葡聚糖对早产儿真菌性败血症的早期诊断、治疗及预后判断有一定意义.     

缺氧缺血性脑病新生儿血清超敏C反应蛋白与血小板参数的变化及其临床意义

目的探讨超敏C反应蛋白(hs-CRP)、血小板参数在新生儿HIE中的变化及其意义。方法利用全自动生化分析仪测定35例HIE和16例正常新生儿血清hs-CRP水平,同时采集所有新生儿足跟外周血进行血小板参数测定,并与血清酶学检测指标CK、CK-MB、LDH、-αHBDH、ALT、AST结果进行对照研究。结果1.HIE新生儿急性期血清hs-CRP水平明显高于对照组(P<0.05);恢复期下降与正常对照组差异无显著性(P>0.05)。2.HIE新生儿急性期PLT明显低于对照组(P<0.01),平均血小板体积(MPV)及血小板体积分布宽度(PDW)明显高于对照组(P<0.01);恢复期PLT、MPV、PDW与正常对照组之间无明显差异(P>0.05)。3.HIE新生儿急性期CK、CK-MB、LDH、-αHBDH、AST、ALT均较正常新生儿显著升高(P<0.01,0.05);恢复期血清酶(CK、CK-MB、-αHBDH、ALT)降低明显(P<0.05);LDH、AST降低不明显(P>0.05),但与正常对照组比较差异仍显著(P<0.01,0.05)。结论hs-CRP与血小板参数的动态变化具有协同性,且与HIE的病程相平行,能较敏感地反映HIE患儿病情轻重程度及转化趋势,与血清酶学改变一起可作为了解HIE的疗效及病情监测的指标之一。     

胎膜早破对超早产儿早期预后的影响

目的 探讨胎膜早破（PROM）对超早产儿早期预后的影响,为超早产儿管理、产前咨询提供依据。方法 收集2017~2019年单胎超早产儿179例为研究对象,按是否存在PROM分为PROM组（69例）和非PROM组（110例）,对孕母情况及患儿早期预后指标进行统计分析。结果 PROM组早发型败血症和坏死性小肠结肠炎发生率高于非PROM组（P < 0.05）,肺表面活性物质使用率及血流动力学显著的动脉导管未闭发生率低于非PROM组（P < 0.05）。多因素logistic回归分析显示绒毛膜羊膜炎是早发型败血症、坏死性小肠结肠炎的独立危险因素（分别OR=11.062、9.437,P < 0.05）,PROM是使用肺表面活性物质的独立保护因素（OR=0.363,P < 0.05）。结论 PROM增加了超早产儿早发型败血症及坏死性小肠结肠炎的发生率,未增加其他不良结局发生率。对有超早产风险的PROM孕妇,建议积极保胎、预防绒毛膜羊膜炎以延长孕周、降低感染发生率,从而改善超早产儿结局。     

新生儿重症监护室五年死亡病例分析

目的 了解新生儿重症监护室5年新生儿死亡原因及变迁,探讨预防措施,降低病死率.方法 对新生儿重症监护室2004年1月至2008年12月5年间死亡的69例病例进行回顾性分析.结果 (1)男女比例1.7:1,早产儿占34.8%,胎龄≤32周的早产儿占早产儿死亡病例的70.8%;(2)以早期新生儿死亡为主,占59.4%,住院3 d内死亡占69.6%;(3)早产儿前三位死亡原因为呼吸窘迫综合征、败血症、硬肿症,占早产儿死亡数的70.8%;足月儿前三位死亡原因为败血症、重度窒息、肺炎,占足月儿死亡数的77.1%;(4)呼吸窘迫综合征病死率逐年下降,败血症、重度窒息病死率无下降趋势.结论 要降低我省新生儿的病死率,必须加强围生期保健,减少早产儿的出生,深入推广新生儿新法复苏,积极控制感染.     

胎膜早破对孕母感染及早产儿结局的影响

目的探讨胎膜早破(PROM)对孕母感染及早产儿结局的影响。方法以441例早产儿及其母亲(387例)为研究对象,根据孕母是否胎膜早破分为对照组(无PROM,104例),PROM时间72 h组(90例)及≥72 h组(193例)。比较各组母、婴的临床特点及并发症差异。结果破膜时间≥72 h组孕母的年龄、脐血管炎发生率以及抗生素应用高于对照组和破膜时间72 h组(P0.05);中-重度绒毛膜羊膜炎的发生率高于对照组(P0.05),但与72 h组的差异无统计学意义(P0.05)。破膜时间≥72 h组早产儿肺炎、颅内出血的发生率高于对照组和破膜时间72 h组(P0.01);先天性感染的发生率、住院天数高于对照组(P0.05),但与72 h组的差异无统计学意义(P0.05)。多因素回归分析显示,破膜时间≥72 h是早产儿发生肺炎(P0.05)及颅内出血(P0.05)的独立危险因素。结论破膜时间≥72 h使孕母胎盘炎症发生风险增加,而且与早产儿肺炎、颅内出血发生相关。     

Autonomic cardiac control of very preterm newborns: a prolonged dysfunction

BACKGROUND: Autonomic nervous system (ANS) activity is fundamental to infant health. ANS activity of preterm newborns seems to be reduced at term equivalent age, but follow-up of ANS activity has rarely been performed in that population during the weeks after birth. The aim of the study was to perform such a follow-up in preterm newborns of different gestational ages, up to their term equivalent ages. METHODS: Prolonged electrocardiographic recordings were prospectively performed in a group of 39 premature newborns, each week, up to term equivalent age before discharge. Control values were obtained from a group of 19 full-term newborns, recorded at the first week of their life. ANS indices were calculated from recordings during quiet sleep periods by spectral-domain analysis (Fourier transform): Ptot (total power), VLF (very low-frequencies), LF (low-frequencies), HF (high-frequencies), LF/HF ratio, LFnu (normalized low-frequencies) and HFnu (normalized high-frequencies) values. RESULTS: Ptot, VLF, LF and HF were significantly lower in the preterm group at birth compared to the control group, while LFnu, HFnu and LF/HF ratio were not significantly different. The results were similar when comparing the control group to any ANS values at a given post-natal corrected age of preterm newborns. Furthermore, preterm newborns did not demonstrate any significant increase in ANS values from birth to theoretical term. CONCLUSION: The finding of substantial reduced ANS activity and failure of maturation in preterm infants up to term equivalent age needs confirming by other research groups, and mechanisms and implications for infant health explored.     

Umbilical vein plasma concentrations of asymmetrical dimethylarginine are increased in male but not female neonates delivered preterm: a pilot study

BACKGROUND: Infants born term have substantially elevated plasma concentrations of the endogenous nitric oxide synthase antagonist asymmetrical dimethylarginine (ADMA) that normalize with growth. The plasma levels of ADMA in preterm newborns are unknown. SUBJECTS AND METHODS: Plasma concentrations of ADMA, symmetrical dimethylarginine (SDMA) and L-arginine were analyzed from venous umbilical cord blood samples of 19 preterm and 21 term infants by high performance liquid chromatography. RESULTS: Male preterm newborns (n=11) had higher ADMA (median [95% confidence interval (CI)]: 1.90 [1.73-2.10] micromol/l) than females born preterm (n=8; 1.57 [1.24-1.69] micromol/l; p<0.005). In term born males (n=10) and females (n=11) ADMA was significantly lower than in preterm male infants (all p<0.005), and without sex differences. SDMA and L-arginine concentrations were comparable between all groups. ADMA correlated inversely with body weight in male preterm newborns (r=-0.67; p<0.03). CONCLUSION: Male neonates delivered preterm have significantly higher umbilical cord venous plasma concentrations of ADMA compared to female neonates and infants born term. The sex difference and the time course of elevated ADMA may play a role in development and warrant further investigation.     

足月儿与早产儿排尿方式的比较研究

目的 探讨足月儿与早产儿出生后排尿方式的不同.方法 选取2010年3月至5月人住郑州大学第一附属医院新生儿室的出生后3～7d足月儿12例与早产儿14例作为研究对象,足月儿孕(38.3±1.1)周,体重(3.1±0.4)kg,早产儿孕(32.5±1.6)周,体重(1.7±0.4)kg.观察新生儿在12 h内(上午9点至晚上9点)的自由排尿情况,记录每次排尿量、残余尿量、排尿时的意识状态(清醒/睡眠)、排尿次数及排尿时间等参数,同时记录饮奶量、液体输入量及摄入时间,液体摄人量按标准进行.每次排尿量等于排尿后尿垫重量减去排尿前尿垫重量,残余尿量由超声检测仪测得.共观察记录了220例次.结果 每次排尿量、残余尿量、排尿次数、排尿时意识清醒状态百分比在足月儿分别为(19.8±10.9)ml、(1.55±1.01)ml、(7.2±1.9)次、(43.5±26.8)%,而在早产儿则分别为(11.1±7.5)ml、(1.82±0.88)ml、(9.6±2.5)次、(24.7±19.1)%.二组数据相比,早产儿的每次排尿量及排尿时意识清醒状态百分比小于足月儿,残余尿量及排尿次数大于足月儿,均具有统计学差异(P＜0.05).结论 足月儿与早产儿排尿方式明显不同,提示足月儿膀胱功能的发育优于早产儿,早产儿膀胱功能及其受控制的神经系统发育较足月儿明显延迟.

Abstract：

Objective To study the voiding patterns of term and preterm newborns.Methods Between March 2010 and May 2010,26 hospitalized newborns aged 3 to 7 days at this center were recruited in this study.In these patients,12 were term newborns,with an average gestational age of (38.3 ± 1.1 ) weeks,weight of (3.1 ± 0.4) kg,14 were preterm newborns with an average gestational age of (32.5 ± 1.6) weeks,and weight of (1.7 ± 0.4) kg.The voiding volumes (VV),post-void residual volumes (PRV),state of consciousness at voiding,voiding time (VT),voiding frequency (VF)in 12 hours as well as the volume of milk and liquid fed in the same time frame were recorded and analyzed retrospectively.Results In the term newborns,the VV and consciousness voiding rate were significantly higher compared with the preterm newborns [VV and consciousness voiding rate,( 19.8 ±10.9) ml (43.5 ± 26.8%) vs (11.1 ± 7.5) ml (24.7 ± 19.1 %),P＜0.05].However,the PRV and VF were significant lower in term newborns [PRV and VF,(1.55 ± 1.01 ) ml (7.2 ± 1.9) times vs (1.82 ± 0.88) ml (9.6 ± 2.5) times,P＜0.05].Conclusions Incomplete voiding pattern exists in term and preterm newborns.The better urodynamic parameters of the term newborns indicate the term newborns have better mature bladder function than preterm newborns.     

Development of sleep–wakefulness rhythm in premature babies

The aims of this study were: (1) to investigate the evolution of the sleep pattern in preterm newborns during their first month of life; (2) to assess the influence of light–dark on the sleep pattern; and (3) to compare this pattern with that of full–term newborns. The population consisted of 60 healthy, preterm newborns and 63 full–term newborns, divided into four age groups, 1 week apart, throughout the first month of life. Preterm newborns were further divided into five groups according to conceptional (corrected) age. An observer took note every 30 min, for 24 h, of sleep or wakefulness in every case. The average sleeping time in preterm groups according to postnatal age remained unchanged during the first month of life: 17.57 honday 1 and 17.15h on day 28. When the preterm infants were re–grouped according to conceptional age, average daily sleep was 17.86 h at 32 weeks and 15.22 h at 37 weeks. The full–term newborns had an average daily sleep of 14.78 h on day 1 and 11.94 h on day 28, with a decrease throughout week 4 of life ( p < 0.001). The decrease in daily sleeping time in the full–term groups, took place at the expense of the daylight span, where there was a decrease througout the first month of life ( p < 0.01). There were no differences in preterm newborns during the light and dark phases. A progressive synchronization of sleep to the light–dark was seen in the control group. Therefore, the sleeping pattern could be taken as an indication of the degree of biological immaturity of preterm newborns.     

早期新生儿腹胀临床分析

目的 腹胀是新生儿患者常见症状,严重时可危及生命,因此应尽快明确腹胀原因,避免严重后果。该文旨在探讨早期新生儿腹胀的临床特点,为临床医生对腹胀的病因诊断和鉴别诊断提供帮助。方法 回顾性分析2011年1月至2012年12月有腹胀主诉和临床表现的201例早期新生儿临床特点,其中早产儿65例,足月儿136例。结果 先天畸形（包括先天性巨结肠、肛门闭锁、肠旋转不良、肠闭锁、肠重复畸形、后尿道瓣膜）为早期新生儿腹胀的主要病因,分别为早产组44.6%、足月组61.8%。就单病种而言,败血症为早产组第1位及足月组第2位病因,分别为35.4%和21.3%;先天性巨结肠为足月组第1位及早产组第2位病因,分别为33.8%和13.8%。呕吐为腹胀的主要伴随症状,在足月组占64.0%,早产组占44.6%。早产组以肠胀气可见液平为第1位X线表现,占47.7%,足月组占30.1%。足月组以肠胀气为第1位X线表现,占57.3%,早产组占40%。对因及对症治疗后,早产组86.2%、足月组88.2%的患儿以治愈或好转为转归,组间差异无统计学意义。结论 先天畸形为腹胀早期新生儿主要病因;就单病因而言,败血症和先天性巨结肠分别为早期早产儿和早期足月儿的第1位病因;呕吐是早期新生儿腹胀的主要伴随症状;早期早产儿X线表现较足月儿严重;两组患儿转归均较好。     

尿视黄醇结合蛋白和N-乙酰-β葡萄糖苷酶对早产儿肾功能的评价意义

目的 分析尿视黄醇结合蛋白(RBP)、尿N-乙酰-β葡萄糖苷酶(NAG)对评价早产儿肾功能的临床意义.方法 受选新生儿89例,分为早产儿窒息组(18例)、早产儿非窒息组(25例)和足月儿对照组(46例).观察所选对象生后48h内晨尿的RBP和NAG水平,分别与尿肌酐(Cr)相比(以RBP/Cr和NAG/Cr表示);观察血肌酐和血尿素氮,以及非窒息早产儿在生后0~48h,~96h,~168h的RBP/Cr、NAG/Cr变化情况.结果 早产儿窒息组的尿RBP/Cr水平[(0.951±0.629)g/mol]高于非窒息组[(0.389±0.281)g/mol]和足月儿对照组[(0.119±0.081)g/mol],3组间比较差异有统计学意义(P<0.05);非窒息组高于足月儿对照组(P<0.05).早产儿窒息组和非窒息组的尿NAG/Cr比值均高于足月儿对照组,差异有统计学意义(P<0.05),但前两者比较差异无统计学意义(P>0.05).3组间的血肌酐和尿素氮比较差异无统计学意义(P>0.05).早产儿非窒息组尿RBP/Cr与胎龄和日龄均无线性相关(P>0.05),而NAG/Cr与胎龄呈线性负相关(r=-0.625,P<0.05),与日龄呈正相关(P<0.05).结论 尿RBP/Cr和NAG/Cr比值有助于评估早产儿肾功能,前者对窒息损害较后者敏感,后者受胎龄影响更大.

Abstract：

Objective To investigate the clinical value of urinary retinol binding protein(RBP) and N-acetyl-β-glucosaminidase(NAG) for evaluating renal function in preterm neonate.Methods 89 neonates in our NICU were selected,divided into three groups:the asphyxial preterm group (18 cases),the no-asphxial preterm group (25 cases),and the control group (46 term infants without asphyxia).All objects were detected the urinary RBP,NAG and creatinine(Cr).The levels of RBP/Cr and NAG/Cr and blood urea nitrogen(BUN),Cr were observed within 48h after birth after birth.The fluctuations of urinary RBP/Cr and NAG/Cr in no-asphxial preterm group also were observed in 0~48h,~96h,~168h after birth respectively.Results The urinary RBP/Cr levels in asphyxial preterm group [(0.951±0.629)g/mol] were higher than those in no-asphxial preterm group[(0.389±0.281)g/mol] and the control group[(0.119±0.081)g/mol](P<0.05).The urinary RBP/Cr levels in no-asphxial preterm group were also significantly higher than those in the control group(P<0.05).The levels of urinary NAG/Cr in the asphyxial and no-asphxial preterm groups were both higher than those in the control group(P<0.05),but there was no difference betwteen the former two groups(P>0.05).The levels of serum Cr and BUN were no significant difference in the three groups(P>0.05).The urinary RBP/Cr level had non-linear correlation with either postnatal or gestational age in no-asphyxial preterm group.While the urinary NAG/Cr levels negative correlated with the gestational age(r=-0.625,P<0.05).And the correlation between the urinary NAG/Cr and postnatal age was postive(P<0.05).Conclusion The determination of urinary NAG/Cr and RBP/Cr provides a sensitive and reliable method to evaluate the renal function of neonates,especially in preterm infants.The RBP/Cr is affected by asphyxia more than NAG/Cr,which is rather correlated with gestational age.     

Prevalence of head deformities in preterm infants at term equivalent age

Introduction

Due to a rising number of head deformities in healthy newborns, there has been an increasing interest in nonsynostotic head deformities in children over recent years. Although preterm infants are more likely to have anomalous head shapes than term newborns, there is limited data available on early prevalence of head deformities in preterm infants.

Aims

The purposes of the present study were to acquire quantitative data on head shape of preterm infants at Term Equivalent Age (TEA), to determine the prevalence of symmetrical and asymmetrical head deformities and to identify possible risk factors.

Methods

In a cross-sectional study design, Cranial Vault Asymmetry Index (CVAI) and Cranial Index (CI) calculated from routine head-scans with a non-invasive laser shape digitizer were recorded and categorized in type and severity of deformation for three different groups of gestational age. Perinatal and postnatal patient data was tested for possible associations.

Results

Scans of 195 infants were included in the study. CVAI at TEA was higher in very preterm (4.1%) compared to term and late preterm infants. Prevalence of deformational plagiocephaly was 38% in very preterm infants. CI was lower in very (71.4%) and late (77.2%) preterm infants compared to term infants (80.0%). Compared to term babies (11%), a large number of very (73%) and late (28%) preterm infants exhibited dolichocephaly at TEA.

Discussion

Prevalence of symmetrical and asymmetrical head deformities in preterm infants is high at TEA. Interventions are required to prevent head deformities in preterm infants during the initial hospital stay.     

北京地区25家医院晚期早产儿住院期间母乳喂养对感染相关性疾病发生的影响

目的 了解北京地区晚期早产儿住院期间感染性疾病的发生率,分析感染性疾病发生的危险因素,探讨母乳喂养对感染性疾病发生的影响。方法 收集北京地区25家医院新生儿病房在2015年10月23日至2017年10月30日住院的晚期早产儿资料。根据喂养方式分为母乳喂养组和配方奶喂养组,比较两组一般情况、感染性疾病的发生率,并应用多因素logistic回归分析感染性疾病发生的危险因素。结果 纳入1 576例晚期早产儿,其中母乳喂养组153例,配方奶喂养组1 423例。发生感染性疾病共计484例（30.71%）,其中母乳喂养组感染性疾病发生率显著低于配方奶喂养组（22.88% vs 31.55%,P=0.033）。多因素logistic回归分析显示,母乳喂养是感染性疾病发生的独立保护性因素（OR=0.534,P=0.004）,而男婴、胎膜早破、妊娠糖尿病、窒息是发生感染性疾病的危险因素（分别OR=1.328、5.386、1.535、2.353,均P < 0.05）。结论 母乳喂养可降低晚期早产儿住院期间感染性疾病的发生,是晚期早产儿感染性疾病的保护因素,应积极提倡晚期早产儿住院期间实施母乳喂养。