Cross-sectional study on the sleep status and risk factors for sleep problems in infants and young children in Jilin Province北大核心CSCD

目的 了解吉林省婴幼儿睡眠状况及睡眠问题发生的危险因素。 方法 选取吉林省8个地级市和1个自治州的1 080例0~3岁的健康婴幼儿作为研究对象。采用自制调查问卷收集研究对象的一般资料,采用简明婴幼儿睡眠问卷了解婴幼儿睡眠情况,并应用多因素logistic回归分析探讨睡眠问题发生的危险因素。 结果 婴幼儿睡眠问题的总检出率为38.24%（413/1 080）。4~11月龄、12~24月龄、25~36月龄组睡眠总时长均高于推荐睡眠总时长（P<0.05）。多因素logistic回归分析显示,足月出生、主要监护人文化程度较高、白天活动强度较大是婴幼儿睡眠问题的保护因素（P<0.05）,而服用维生素D频次较低、夜间喂养频繁和母亲打鼾是睡眠问题发生的危险因素（P<0.05）。 结论 吉林省4月龄以上婴幼儿睡眠总时长均高于推荐睡眠总时长,但睡眠问题发生率较高。睡眠问题的发生与多种因素有关;加强对早产儿的随访,对主要监护人进行婴幼儿睡眠知识宣教,坚持规律地补充维生素D,有利于减少婴幼儿睡眠问题的发生。     

Intestinal and pharyngeal microbiota in early neonates: an analysis based on high-throughput sequencing北大核心CSCD

目的 初步探讨早期新生儿肠道和咽部微生物群的分布特点及相关性。 方法 选取上海市浦东新区妇幼保健院2021年9月—2022年1月出生的混合喂养的足月健康新生儿为研究对象。采用16S rRNA基因测序技术分析新生儿出生当天及出生后5~7 d的粪便和咽拭子样本,分析比较早期新生儿肠道和咽部微生物群的组成及功能差异。 结果 多样性分析表明,早期新生儿咽部微生物群的多样性高于肠道,但差异无统计学意义（P>0.05）。门水平上,出生当天肠道变形菌门相对丰度高于咽部（P<0.05）;出生后5~7 d肠道放线菌门和变形菌门相对丰度高于咽部、厚壁菌门相对丰度低于咽部（P<0.05）。属水平上,出生当天肠道和咽部的优势菌属组成差异无统计学意义（P>0.05）;出生后5~7 d肠道和咽部的链球菌属、葡萄球菌属、罗氏菌属、双歧杆菌属及埃希菌-志贺菌属等共生菌差异有统计学意义（P<0.05）。直系同源序列聚类数据库分析显示,咽部菌群更多地集中在染色质结构和动力学及细胞骨架上,而肠道菌群在RNA加工修饰、能量生成和转换、氨基酸转运代谢、碳水化合物转运代谢、辅酶转运和代谢等方面表现丰富（P<0.05）。京都基因和基因组百科全书分析显示,与咽部菌群相比,肠道菌群对细胞运动、细胞进程和信号转导、内分泌系统、排泄系统、免疫系统、代谢性疾病、神经系统和转录功能参数的预测程度更高（P<0.05）。 结论 新生儿出生时肠道和咽部的微生物群组成及多样性无显著差异,随着出生时间的推移,两个生态位的微生物群组成开始出现分化,并逐渐显现出各自不同的功能。     

Clinical characteristics and risk factors for early-onset necrotizing enterocolitis in preterm infants with very/extremely low birth weight北大核心CSCD

Objective To investigate the clinical characteristics and risk factors for early-onset necrotizing enterocolitis (NEC) in preterm infants with very/extremely low birth weight (VLBW/ELBW). Methods A retrospective analysis was performed on the medical data of 194 VLBW/ELBW preterm infants with NEC who were admitted to Children's Hospital Affiliated to Zhengzhou University from January 2014 to December 2021. These infants were divided into early-onset group (onset in the first two weeks of life; n=62) and late-onset group (onset two weeks after birth; n=132) based on their onset time. The two groups were compared in terms of perinatal conditions, clinical characteristics, laboratory examination results, and clinical outcomes. Sixty-two non-NEC infants with similar gestational age and birth weight who were hospitalized at the same period as these NEC preterm infants were selected as the control group. The risk factors for the development of early-onset NEC were identified using multivariate logistic regression analysis. Results Compared with the late-onset group, the early-onset group had significantly higher proportions of infants with 1-minute Apgar score ≤3, stage III NEC, surgical intervention, grade ≥3 intraventricular hemorrhage, apnea, and fever or hypothermia (P<0.05). The multivariate logistic regression analysis showed that feeding intolerance, blood culture-positive early-onset sepsis, severe anemia, and hemodynamically significant patent ductus arteriosus were independent risk factors for the development of early-onset NEC in VLBW/ELBW preterm infants (P<0.05). Conclusions VLBW/ELBW preterm infants with early-onset NEC have more severe conditions compared with those with late-onset NEC. Neonates with feeding intolerance, blood culture-positive early-onset sepsis, severe anemia, or hemodynamically significant patent ductus arteriosus have a higher risk of early-onset NEC. © 2023 Xiangya Hospital of CSU. All rights reserved.     

Association of Haemophilus influenzae infection with environmental and climatic factors in Suzhou,China北大核心CSCD

Objective To investigate the epidemiological characteristics of respiratory Haemophilus influenzae (HI) infection in children in Suzhou, China and its association with climatic factors and air pollutants. Methods The data on air pollutants and climatic factors in Suzhou from January 2016 to December 2019 were collected. Respiratory secretions were collected from 7 940 children with acute respiratory infection who were hospitalized during this period, and bacterial culture results were analyzed for the detection of HI. A stepwise regression analysis was used to investigate the association of HI detection rate with air pollutants (PM2.5, PM10, NO2, SO2, CO, and O3) and climatic factors (monthly mean temperature, monthly mean humidity, monthly total rainfall, monthly total sunshine duration, and monthly mean wind speed). Results In 2016-2019, the 4-year overall detection rate of HI was 9.26% (735/7 940) among the children in Suzhou. The children aged <1 year and 1-<3 years had a significantly higher HI detection rate than those aged ≥3 years (P <0.01). The detection rate of HI in spring was significantly higher than that in the other three seasons, and the detection rate of HI in autumn was significantly lower than that in the other three seasons (P<0.001). The multiple linear regression analysis showed that PM10 and monthly mean wind speed were independent risk factors for the detection rate of HI: the detection rate of HI was increased by 0.86% for every 10 µg/m3 increase in the concentration of PM10 and was increased by 5.64% for every 1 m/s increase in monthly mean wind speed. Air pollutants and climatic factors had a lag effect on the detection rate of HI. Conclusions HI is an important pathogen for acute respiratory infection in children in Suzhou and is prevalent in spring. PM10 and monthly mean wind speed are independent risk factors for the detection rate of HI. © 2022 Xiangya Hospital of CSU. All rights reserved.     

Association between early parenteral nutrition and the development of bronchopulmonary dysplasia in preterm infants北大核心CSCD

目的分析生后1周未能肠内营养的胎龄<32周早产儿肠外营养素摄入情况与支气管肺发育不良(bronchopulmonary dysplasia,BPD)发生的关系。方法回顾性收集2017年10月—2022年8月出生并于生后24 h内转入苏州大学附属儿童医院新生儿重症监护病房、胎龄<32周、生后第1周营养摄入完全依靠肠外营养的早产儿作为研究对象,包括79例BPD患儿和73例非BPD患儿。比较两组早产儿住院期间的临床资料。结果BPD组生后体重下降超过10%、宫外生长发育迟缓、胃肠外营养相关性胆汁淤积的患儿比例较非BPD组高(P<0.05),出生体重恢复时间、达完全肠内营养时间、出院时纠正胎龄均大于非BPD组(P<0.05),而纠正胎龄36周时体格发育Z评分低于非BPD组(P<0.05)。BPD组生后1周内液体摄入量高于非BPD组(P<0.05),而热卡摄入量低于非BPD组(P<0.05);BPD组生后1周内氨基酸、葡萄糖、脂质的起始剂量及其摄入总量均低于非BPD组(P<0.05);BPD组生后第3天的糖脂比高于非BPD组,生后第7天的热氮比和糖脂比均高于非BPD组(P<0.05)。结论BPD患儿生后1周内氨基酸和脂质的摄入量及其所提供的热卡占总热量的比例低于非BPD患儿,提示早期肠外营养素摄入与BPD的发生可能有关。     

Birth weight curves of singleton neonates with a gestational age of 24-42 weeks and their regional differences in 11 cities of China: an analysis of 93 720 cases北大核心CSCD

目的 研制胎龄24~42周单胎新生儿出生体重曲线,并探讨其地区差异特征。 方法 在中国11市（海口、广州、深圳、柳州、桂林、泉州、重庆、成都、长沙、宁波、连云港）选择年分娩量7 000例以上的11家妇幼保健院,纳入其2017年1月1日至2020年12月31日分娩的全部活产单胎新生儿进行出生体重曲线研制。 结果 纳入了11市合计93 720例胎龄24~42周单胎新生儿进行研究。建立了中国11市合计及各市单胎儿出生体重3rd~97th百分位数参考值,并绘制了出生体重百分位曲线图。深圳市和泉州市单胎儿出生体重曲线水平与中国11市合计单胎儿水平基本相同;海口市、广州市、桂林市、柳州市单胎儿出生体重曲线水平略低于中国11市合计单胎儿水平;重庆市、成都市、长沙市单胎儿出生体重曲线水平略高于中国11市合计单胎儿水平;宁波市和连云港市单胎儿出生体重曲线高于中国11市合计单胎儿水平。中国11市合计单胎儿出生体重曲线与中国协作网2011~2014年单胎儿出生体重曲线非常接近。 结论 制定了中国11市合计及各市单胎新生儿出生体重3rd~97th百分位数参考值,可作为该区域新生儿宫内生长评价的参考标准。部分地区新生儿宫内生长水平与全国水平有差异。 引用格式：中国当代儿科杂志,2022,24（5）：482-491     

Subjective pubertal timing and health-compromising behaviours among Swiss adolescent girls reporting an on-time objective pubertal timing

Aim: The aim of this research is to assess the associations between subjective pubertal timing (SPT) and onset of health‐compromising behaviours among girls reporting an on‐time objective pubertal timing (OPT). Methods: Data were drawn from the Swiss SMASH 2002 survey, a self‐administered questionnaire study conducted among a nationally representative sample of 7548 adolescents aged 16–20 years. From the 3658 girls in the initial sample, we selected only those (n = 1003) who provided information about SPT and who reported the average age at menarche, namely 13, considering this as an on‐time OPT. Bivariate and logistic analyses were conducted to compare the early, on‐time and late SPT groups in terms of onset of health‐compromising behaviours. Results: A perception of pubertal precocity was associated with sexual intercourse before age 16 [adjusted odds ratio (AOR): 2.10 (1.30–3.37)] and early use of illegal drugs other than cannabis [AOR: 2.55 (1.30–5.02)]. Conversely, girls perceiving their puberty as late were less likely to report intercourse before age 16 [AOR: 0.30 (0.12–0.75)]. Conclusion: Faced with an adolescent girl perceiving her puberty as early, the practitioner should investigate the existence of health‐compromising behaviours even if her puberty is or was objectively on‐time.     

Perceived pubertal timing, pubertal status and the prevalence of alcohol drinking and cigarette smoking in early and late adolescence: a population based study of 8950 Norwegian boys and girls

Aim: To study whether perceived pubertal timing is related to the prevalence of alcohol drinking and cigarette smoking among adolescent boys and girls. Methods: The Young‐HUNT study (95–97), conducted in Nord‐Trøndelag County in Norway, comprises information from 8950 students, aged 13–19 years. Odds ratios (OR) with 95% confidence intervals (CI) related to alcohol drinking and cigarette smoking were estimated by logistic regression analyses. Results: Boys and girls who perceived themselves as early matured were more likely to report more risky drinking than those who perceived themselves as being on time, both in middle school and high school. A nearly identical pattern was found for smoking. However, boys in middle school, who perceived themselves as late, were more likely to smoke than those who were on time. Conclusion: In both genders, perceived early maturation was associated with increased risk behaviour involvement. Perceptions of being early in combination with high pubertal status yielded the highest prevalence of alcohol and tobacco use.     

Height,weight, body mass index and pubertal development reference values for children of Turkish origin in the Netherlands

The aim of this study was to provide growth and sexual maturation reference data for Turkish children living in The Netherlands. We also compared these references with the reference data of children of Dutch origin and with Turkish reference data collected in Turkey and elsewhere in Europe. Cross-sectional growth and demographic data were collected from 2,904 children of Turkish origin and 14,500 children of Dutch origin living in the Netherlands in the age range 0–20 years. Growth references for length, height, weight for height, body mass index (BMI) and head circumference were constructed with the LMS method. Reference curves for sexual maturation and menarche were estimated by a generalised additive model. Predictive variables for height and BMI were assessed by univariate and multivariate regression analyses. Young Turkish adults were 10 cm shorter than their Dutch contemporaries. Mean height was 174.0 cm for males and 160.7 cm for females. Height differences in comparison with Dutch children started at 3 years. Height SDS was predominantly associated with target height. The height of Turkish children living in the Netherlands was similar to Turkish children in Germany and to children from high socio-economic classes in Istanbul. Compared to Dutch children, maturation stages started 0.5–0.7 years later for both sexes. In girls, median age at menarche was 12.8 years, 5 months earlier than in Dutch girls. BMI of Turkish children was higher than that of Dutch children at all ages. BMI SDS was associated with birth weight and the duration of stay of the mother in the Netherlands. Conclusion:Turkish children are considerably shorter and more overweight than Dutch children. Separate growth charts for Turkish children in The Netherlands are useful for growth monitoring.Abbreviations BMI body mass index - SD standard deviation - SES socio-economic status - TH target height     

促性腺激素释放激素类似物对特发性中枢性性早熟女童体重指数影响的长期观察

目的：动态研究促性腺激素释放激素类似物（GnRHa）治疗对特发性中枢性性早熟（ICPP）女童体重指数（BMI）的影响。方法：对2003年1月至2006年1月确诊为ICPP 的134例女童进行随访研究,其中57例给予GnRHa治疗（疗程1.69±0.43年）,测量治疗前、治疗结束时及近成年身高时的身高、体重、骨龄及BMI等,并与未治疗组（77例）比较。结果：（1）GnRHa治疗组在治疗结束时的预测终身高标准差分值（SDS）较治疗前明显升高（P0.05）,且近成年身高SDS明显高于靶身高SDS（P0.05）;近成年身高时的BMI SDS比治疗前和未治疗组明显降低（P<0.01）,但治疗前、治疗结束时及近成年身高时BMI平均值都在±1SD内,处于正常范围。结论：GnRHa对改善ICPP女童终身高有显著疗效;GnRHa治疗后的BMI改变处于正常范围。     

中国不同出生胎龄新生儿体重身长比、体质指数和重量指数的参照标准及生长曲线

目的:制定中国出生胎龄24~42周新生儿体重身长比、体质指数和重量指数的参照标准及生长曲线,为新生儿出生时身体比例及营养状况评价提供参考依据。方法:横断面研究,于2015年6月至2018年11月在北京、哈尔滨、西安、上海、南京、武汉、广州、福州、昆明等13个城市调查出生胎龄24~42周单胎活产新生儿24375名,排除了影响参照标准建立的母亲和新生儿因素。采用基于位置、尺度、形状的广义可加模型构建出生胎龄24~42周男、女新生儿体重身长比、体质指数和重量指数的百分位数(P 3、P 10、P 25、P 50、P 75、P 90、P 97)参照值及生长曲线。将研制的参照标准与我国1988年数值、INTERGROWTH项目及美国相关参照值进行比较。结果:24375名新生儿中早产儿12264名(男7042名、女5222名),足月儿12111名(男6155名、女5956名)。研制出出生胎龄24~42周男、女新生儿体重身长比、体质指数和重量指数百分位数生长参照值及生长曲线。男新生儿体重身长比在不同出生胎龄P 10、P 50、P 90上比女新生儿高0~0.2 kg/m,男新生儿体质指数在不同出生胎龄P 10、P 50、P 90上比女新生儿高0.1~0.3 kg/m²。体重身长比和体质指数曲线在高百分位数上、重量指数曲线在高、低百分位数上与我国1988年数值均有较大差异,如体重身长比、体质指数、重量指数与我国1988年数值在P 90上的差值范围分别为-1.09~0.40 kg/m、-1.19~0.92 kg/m²、-0.64~0.81 kg/m³。体重身长比曲线与INTERGROWTH项目参照值有较好的一致性,在P 50上的差值范围-0.17~0.20 kg/m,出生胎龄≤32周时在P 90上低0.02~0.40 kg/m、在P 10上高0.13~0.41 kg/m。体质指数曲线与美国参照值差异较为明显,在P 50上的差值范围-0.47~0.17 kg/m²,出生胎龄≥37周时在P 90上低0.53~1.10 kg/m²但≤28周时高0.17~0.45 kg/m²。结论:建立中国出生胎龄24~42周新生儿不同性别的体重身长比、体质指数和重量指数的标准化参照值,可供临床及相关科研工作参照使用。     

Turner syndrome and metabolic derangements: another example of fetal programming

Background and aim

Turner syndrome (TS) patients have an increased risk of weight gain and metabolic syndrome. To date, it is unknown what factors are involved in this metabolic process, even though it is recognized that TS patients are frequently born small-for-gestational age. The aim of this study was to evaluate the correlation between lipid and glucose profiles with being overweight and birth weight and length in TS patients.

Study design

This was a cross-sectional study.

Subjects and outcome measures

Serum glucose, insulin (HOMA-IR), total cholesterol, and triglycerides were measured in 64 patients with TS. Data regarding birth weight and length and current body mass index (BMI) were also evaluated.

Results

Total cholesterol showed a significant negative correlation with birth weight and a positive correlation with BMI; triglycerides showed significant negative correlation with birth weight and length and a positive correlation with BMI; and HOMA-IR showed a significant negative correlation with birth weight and length. Low birth weight and a high BMI were predictive for 28% of total cholesterol and triglycerides; and low birth weight for 22% of HOMA-IR.

Conclusions

Lipid profile was correlated with a high current BMI and low birth weight and length in TS patients and glucose profile only with low birth weight. Thus far, growth retardation may play a role in metabolic derangements in this group of patients, being considered another example of fetal programming.     

Relationship between gestational age,birth weight and deciduous tooth eruption

BackgroundTeething is a normal part of child growth and development. Growth parameters and feeding pattern may be determinants of the timing of teeth eruption in healthy infant. Primary tooth eruption may be affected by gestational age, postnatal nutrition, degree of prematurity as well as severity of neonatal illness.ObjectivesThe aim of this study was to evaluate the relation between gestational age, weight and neonatal illness to the time of eruption of the first deciduous tooth.Materials and methodsThis study was a follow up prospective study carried out at the Bab El Sharia University hospital from October 2010 to October 2012. The study included 250 newborn from the obstetric department, from the NICU and from the outpatient clinics at the hospital. The babies were stratified according to gestational age to preterm (<37 weeks): 72 cases and full term (>37 weeks): 178 cases. The babies were followed from birth till the eruption of the first deciduous tooth.ResultsThere was a negative linear correlation between the time of the first deciduous tooth eruption and birth weight. The eruption of the first deciduous tooth was delayed in babies admitted to NICU specially if there was major interference such as intubation, mechanical ventilation.ConclusionDelayed tooth eruption was related to lower birth weight and prematurity. The delayed eruption in preterm babies may be related to premature birth and not to a delay in dental development.