Improving exclusive breast feeding in the first 24 h of life using Plan-Do-Study-Act cycle in a tertiary care hospital

BackgroundBreast milk is the most ideal form of nutrition for neonates, but the rate of early initiation of breast feeding is as low as 41.6% in India. We aimed to improve the proportion of new-borns on exclusive breast feeds in first 24 h after birth in our hospital from a baseline rate of 33% to more than 90% by 6 weeks using concepts of quality improvement (QI) initiative.MethodsWe implemented this QI initiative using Plan-Do-Study-Act (PDSA) cycles and the project was conducted from 07 May 2017 to 17 Jun 2017. All singleton term neonates with birth weight above 2.5 kg were included. Neonates requiring any form of resuscitation at birth, respiratory distress requiring any form of respiratory support, and neonates requiring observation in NICU for any other reason were excluded. We ran PDSA cycles (including educating residents and nurses on breast feeding, initiating skin to skin contact and breast feeding in first hour of birth, demonstrating all mothers face to face about attachment and positioning and restriction on issue of formula milk) to improve breast feeding exclusivity.ResultsA total of 199 neonates were enrolled, over a span of 6 weeks. We could achieve sustained exclusive breast feeding in first 24 h of life in more than 90% of the enrolled neonates by adhering to the QI initiative.ConclusionThis QI project using PDSA methodology has significantly improved the rates of exclusive breast feeding in first 24 h of life in normal neonates roomed in with their mothers.     

Hypoglycaemia in high-risk neonates on exclusive breastfeeding

BackgroundNeonates at risk of hypoglycemia are often roomed in with mothers, but there is paucity of literature on the occurrence of hypoglycemia in these exclusively breastfed high-risk neonates. The primary objective was to estimate the incidence of hypoglycaemia in high-risk neonates on exclusive breastfeeding. The secondary objectives were to study the time of presentation, symptoms of hypoglycaemia, and the various maternal and neonatal risk factors.MethodsThis prospective observational study was carried out in a tertiary care teaching hospital of eastern India between January 2017 and June 2018. All neonates roomed in with mothers with high-risk factors such as low birth weight, preterm, small for gestational age, large for gestational age and infants of diabetic mothers were included. All included neonates were exclusive breastfed and underwent blood glucose monitoring at 2, 6, 12, 24, 48 and 72 h of life using glucometer strips and also whenever clinical features suggested hypoglycaemia. Hypoglycemia was defined as the blood glucose level ≤46 mg/dL.ResultsOf a total of 250 neonates studied, 52 (20.8%) developed hypoglycaemia in first 72 h. Hypoglycaemia was detected in most at 2 h with the second peak at 48 h of age. Only 8 (3.2%) neonates had symptomatic hypoglycaemia with jitteriness being the commonest symptom, followed by lethargy and poor feeding.ConclusionThere is a need to closely monitor the blood glucose levels for at least first 48 h in high-risk neonates roomed in with mothers on exclusive breastfeeding.     

新生儿惊厥176例临床分析

目的讨探新生儿惊厥的病因、临床表现特点,以有效控制惊厥的发作,早期干预减少后遗症。方法对我院新生儿科的176例新生儿惊厥患儿的临床资料进行回顾性分析。结果显示以缺氧缺血性脑病和颅内出血多见,发病时间多在生后3 d内;其次为低血钙和低血糖,发病时间多在生后1周;而感染多发生于1周后。结论早期发生惊厥者主要与围产期窒息有关,本组缺氧缺血性脑病占首位,其次是颅内出血,常在出生12~24 h发病,出生1周后发病者应考虑感染和电解质紊乱。因此强调加强围产期保健,提高产科技术,建立高危新生儿监护的重要性,早期干预,有助于降低发病率、病死率及后遗症。     

不同烧伤面积患者早期钙离子浓度的影响因素与临床意义

目的 分析不同烧伤面积患者早期钙离子浓度的影响因素与临床意义。方法 选取2019年1月—2022年6月南通大学附属医院烧伤整形外科收治的符合入选标准的住院患者116例作为研究对象，对其病例资料进行回顾性分析。结果 两组患者的性别、年龄、吸入性损伤及入院时间比较，差异均无统计学意义（P>0.05）。发生低钙血症患者三度创面的比例高于未发生低钙血症患者，发生低钙血症患者入院时白蛋白浓度低于未发生低钙血症患者，烧伤面积大于未发生低钙血症患者（P <0.05）。患者三度创面、大面积烧伤（烧伤面积> 50%）、低蛋白血症等因素间钙离子浓度比较，差异均有统计学意义（P <0.05）；患者性别、年龄、吸入性损伤、延迟复苏（入院时间> 6 h）等因素间钙离子浓度比较，差异均无统计学意义（P>0.05）。多因素逐步线性回归分析结果显示，大面积烧伤、低蛋白血症及年龄是影响患者入院时钙离子浓度的独立危险因素（P <0.05），且大面积烧伤与低蛋白血症是影响钙离子浓度的主要因素。患者三度创面、大面积烧伤、低蛋白血症、低钙血症等因素间创面愈合时间比较，差异均有统计学意义...     

甲状腺切除术后甲状旁腺功能减退的主要影响因素分析

目的 探讨甲状腺切除术后低钙血症及甲状旁腺功能减退(hypoparathyroidism,HPP)的危险因素和防治措施.方法 回顾性分析第二军医大学长海医院2016年1月1日至6月30日收治的449例因各类甲状腺疾病而行甲状腺切除术患者的临床资料,其中男性95例、女性354例,平均年龄(48.99±12.81)岁.运用EmpowerStats与R软件,采用平滑曲线拟合、阈值效应分析、单因素分析及多因素分析,筛选术后发生低钙血症及HPP的危险因素.结果 449例患者中,出现甲状旁腺激素(parathyroid hormone,PTH)低于正常值者共27例(6.01％),低钙血症43例(9.58％);暂时性HPP 23例(5.12％),其中1例可能发展为永久性HPP.术后PTH较术前每下降1％,术后低钙血症发生风险增加4％(P＜0.000 1).甲状腺癌患者术后出现HPP风险最高,其次为结节性甲状腺肿、甲状腺功能亢进,6种甲状腺疾病术后HPP发生率差异有统计学意义(P＜0.05).手术切除范围越大,HPP发生率越高,双侧次全切以上的手术加中央区淋巴结清扫是术后发生HPP的危险因素(P＜0.05).结论 甲状腺疾病病理类型、手术方式及难度是影响术后甲状旁腺功能的重要因素,术后PTH水平的变化对低钙血症及HPP的发生有重要的预测作用.     

Methicillin-resistant Staphylococcus aureus development in intensive care patients: A case-control study

Objectives:To determine the factors associated with the development of methicillin-resistant Staphylococcus aureus (MRSA), hospital stay and mortality, and early versus late MRSA infection.Methods:Cases (n=44) were intensive care unit (ICU) patients admitted to King Fahd Specialist Hospital, Al-Qassim, Saudi Arabia between 2015 and 2019 who developed MRSA during their hospital stay. Controls (n=48) were patients from the same place and period who did not develop MRSA. Data were abstracted from hospital records.Results:Admission with sepsis (case: 46% vs. control: 2%, p<0.001) and having at least one comorbid condition (case: 95% vs. control: 46%, p<0.001) were significantly associated with the development of MRSA. Age (mean ± SD: case: 65±18, control: 64±18, p=0.7) and gender (% male, case: 52%, control: 56%, p=0.70) were not associated with the development of MRSA. Approximately 73% of all MRSA cases developed within the first 2 weeks of admission. Among the early cases, 44% died during their ICU stay; the corresponding percentage among the late cases was 42% (p=0.69). There was no difference between early and late MRSA cases in terms of non-sepsis admissions (50% vs. 67%, p=0.32) or comorbid status (at least one: 97% vs. 92%, p=0.17).Conclusion:Sepsis and comorbid conditions were significant risk factors for MRSA development among hospital patients.     

Pretransplant mortality predictors in living and deceased donor liver transplantation

BackgroundAlthough there were some reports predicting postoperative morbidity and mortality in patients undergoing liver transplantation, most of them studied deceased-donor liver transplantation (DDLT). In this context, we performed this study to predict early mortality after liver transplantation from preoperative variables in both living-donor liver transplantation (LDLT) and DDLT.MethodsWe retrospectively reviewed the medical charts of 159 patients undergoing liver transplantation (LDLT, n = 103; DDLT, n = 56). Then, we identified the factors that independently predicted 30-day mortality using multivariable logistic regression models.ResultsThe 30-day mortality and 1-year mortality for DDLT versus LDLT were 30% versus 6% and 39% versus 11%, respectively. In multivariate logistic regression analysis, pretransplant hepatic encephalopathy (odds ratio, 5.594; 95% confidence interval, 1.110–28.194; p = 0.037) in patients with DDLT and serum creatinine (odds ratio, 4.883; 95% confidence interval, 1.296–18.399; p = 0.019) in patients with LDLT were the independent risk factors for a composite of 30-day mortality.ConclusionIn conclusion, hepatic encephalopathy in DDLT and serum creatinine level in LDLT were the significant pretransplant variables that were related with early death after LT.     

Cranial ultrasonographic findings in healthy full-term neonates: A retrospective review

BackgroundUltrasonography is a non-invasive diagnostic technique, and it has been used to detect intracranial lesions in neonates for a long time. Correspondingly, screening tests using cranial ultrasonography have been applied for early detection of intracranial lesions in full-term neonates during the past decade.MethodsWe retrospectively reviewed the findings of cranial ultrasonographic screening tests in healthy full-term neonates between September 2004 and August 2009. The ultrasonographic findings were divided into the following categories: (a) nonsignificant (NS) group, including normal and normal variations, (b) minor anomaly group, including tiny cystic lesions, mild hemorrhage, or mild ventricular anomaly, and (c) major anomaly group, including significant anomaly of any intracranial pathology. The participants with major anomalies were further reviewed, and the following medical records of all enrolled patients were reviewed until they were 24 months of age.ResultsThere were a total of 3186 neonates who received cranial ultrasonographic screening examination during the 5-year period, and most of them (2982 cases, 93.6%) were assigned to the NS group. The most common normal variation was the presence of cavum septum pellucidum (1979 cases, 62.1%). Minor anomalies were found in 202 (6.3%) neonates, including 119 (3.7%) neonates with tiny cysts, and 59 (1.9%) neonates with mild intraventricular hemorrhage. Major anomalies were found in two (0.06%) neonates, including obstructive hydrocephalus and agenesis of the corpus callosum. Two other infants (0.06%) initially presented with minor anomaly or normal variation, but they were diagnosed as Moyamoya disease and neonatal seizure some months later.ConclusionThe incidence of minor and major anomalies detected by cranial ultrasonographic screening examinations in healthy full-term neonates is 6.3% and 0.06%, respectively. Thus, cranial ultrasonographic screening testing may play a role in the early diagnosis of intracranial anomalies of otherwise healthy neonates. However, this examination cannot exclude or detect all cranial abnormalities, including many potential neurologic diseases of neonates, so continuing clinical diligence is still important for all infants.     

胎龄小于32周的极/超低出生体质量儿支气管肺发育不良及严重程度危险因素分析

目的 研究影响胎龄小于32周的极/超低出生体质量儿支气管肺发育不良及其严重程度的危险因素,为新生儿临床工作提供帮助.方法 选取2019年1月至2021年1月于安徽医科大学第一附属医院新生儿科住院超过28天的130例胎龄小于32周的极/超低出生体质量儿,根据支气管肺发育不良诊断标准分为支气管肺发育不良(BPD)组54例和非支气管肺发育不良(nB-PD)组76例;其中54例BPD早产儿,根据BPD诊断标准分为轻度BPD组43例、中重度BPD组11例.分析该130例患儿的围产期因素,其中孕母因素包括是否使用产前激素、生产方式、是否多胎、是否为初产妇、产妇年龄、是否合并相关疾病如重度子痫前期、绒毛膜羊膜炎、阴道流液、产前发热、胎膜早破;新生儿因素包括胎龄、出生体质量、Apgar评分、性别、首选通气方式、机械通气时间及是否使用INSURE技术.对各组间有统计学差异的因素,采用logistic回归分析探究影响患儿BPD及其严重程度的危险因素.结果 logistic分析提示,胎龄越小(OR=0.110,95％CI:0.007～0.638)、机械通气时间越长(OR=2.178,95％CI:1.046～4.534)、用氧时间越长(OR=1.635,95％CI:1.148～2.327)和未采用INSURE技术(OR=0.006,95％CI:0.000～0.972)是患儿发生BPD的危险因素.机械通气时间越长(OR=1.567,95％CI:1.228～1.720)、用氧时间越长(OR=1.358,95％CI:1.009～1.828)是患儿BPD严重程度的危险因素.结论 胎龄小、未采用INSURE技术、机械通气时间及用氧时间长是患儿发生BPD的危险因素;机械通气时间和用氧时间越长是患儿BPD严重程度的危险因素.因此,对于胎龄小于32周的极/超低出生体质量儿,应首选INSURE技术及无创通气,减少机械通气及用氧时间.     

新生儿病房肺炎克雷伯菌医院感染的危险因素及防控分析

目的 调查分析新生儿病房肺炎克雷伯菌医院感染的危险因素,为预防和控制新生儿医院感染提供依据。方法 调查2012年2~9月发生医院感染新生儿的出生胎龄、体质量、入院诊断,采样监测病区物品表面、医务人员手及咽试子,分析感染的危险因素。结果 832例新生儿中,发生医院感染21例,感染率为2.52%。主要感染部位为血流感染,占71.43%;以早产儿为主,占47.62%;胎龄<37周、出生体质量≤1500 g是新生儿发生医院感染的危险因素(P<0.05);在婴儿床、备用医疗用品及洗澡间的婴儿用品表面均检出与患儿感染一致的病原菌。结论 改善医疗环境,严格卫生消毒,对胎龄小、出生体质量低等高危患儿采取必要的预防干预措施,能有效降低医院感染的发生。     

Transarterial treatment of acute gastrointestinal bleeding: Prediction of treatment failure by clinical and angiographic parameters

BackgroundAcute gastrointestinal bleeding (GIB) is a life-threatening abdominal emergency and can be treated by transarterial embolization (TAE). Rehemorrhage and poor outcome are associated with several clinical factors. This study investigated the clinical and angiographic parameters associated with treatment failure for patients with acute GIB undergoing TAE.MethodsSixty-seven patients who had angiographic evidence of contrast extravasation and who received subsequent TAE were included in this study. Treatment failure was defined as continuous or recurrent bleeding that required surgery within 7 days after the bleeding episode and/or death within 1 month. Univariate and multivariate logistic regression was applied to analyze the clinical and angiographic parameters affecting treatment failure.ResultsPatients were divided into two groups: success (n = 35, 52.3%) and failure (n = 32, 47.7%). In the failure group, 22 patients (68.9%) re-bled and then received surgery. With the aid of angiographic localization, 68.2% (15 of 22 patients) survived after surgery. The other 10 patients who did not receive surgery died within 30 days. Several clinical and angiographic parameters analyzed by multivariate analysis were associated with treatment failure (p < 0.05), including presence of coagulopathy [odds ratio (OR), 14.7], number of supplying arteries >1 (OR, 13.2), and a distance of >5 cm (OR, 6.3) during TAE.ConclusionAngiographic parameters associated with treatment failure in patients undergoing TAE are established when the number of supplying arteries is >1, and a distance of >5 cm. Patients with these risk factors should be watched carefully for recurrence in the post-procedural period.     

沙库巴曲缬沙坦联合卡维地洛治疗不同病因老年人慢性心力衰竭的有效性和安全性分析

目的探讨沙库巴曲缬沙坦联合卡维地洛治疗不同病因老年人慢性心力衰竭的疗效。方法选取2019年3月—2021年2月常州市第四人民医院收治的89例慢性心力衰竭患者,依据病因将其分为冠状动脉粥样硬化性心脏病(以下简称冠心病)组(45例)、高血压心脏病组(16例)和扩张型心肌病组(28例)。所有患者采用沙库巴曲缬沙坦联合卡维地洛连续治疗3个月。对比3组患者心功能指标、临床疗效、血清学指标及治疗期间不良反应。结果治疗前,3组患者左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、左心室射血分数(LVEF)及心脏指数比较,差异无统计学意义(P>0.05);治疗后3组患者LVEDD、LVESD均低于治疗前(P <0.05),LVEF及心脏指数则均高于治疗前(P <0.05);治疗后3组患者LVEDD、LVESD、LVEF及心脏指数比较,差异无统计学意义(P>0.05)。3组患者临床疗效、总有效率比较,差异无统计学意义(P>0.05)。3组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论沙库巴曲缬沙坦联合卡维地洛可用于治疗老年人慢性心力衰...     

A review of umbilical venous catheter-related complications at a tertiary neonatal unit in Singapore

INTRODUCTIONUmbilical venous catheters (UVCs), commonly inserted in neonates for vascular access, are not without complications.METHODSA single-centre retrospective cohort study that reviewed complications related to UVC insertion in neonates was conducted in a tertiary neonatal unit in Singapore from January 2016 to July 2017. Ideal UVC position was defined as catheter tip within 0.5 cm above or below the diaphragm. Catheter-related sepsis was defined as clinical or biochemical abnormalities suggesting any new-onset or worsening sepsis 72 hours before or after removal of UVCs, with or without positive culture. Catheter-associated bloodstream infection (CABSI) was defined as positive microbiological growth in one or more blood cultures obtained from a symptomatic infant up to two days after UVC placement or within 48 hours of catheter removal.RESULTS108 patients had UVC insertions. Mean gestational age and birth weight were 30.4 ± 4.0 weeks and 1,536.2 g ± 788.9 g, respectively. Mean UVC duration was 6.6 days. The UVC was in an ideal position in 27 (25.0%), deep in 13 (12.0%) and short in 35 (32.4%) neonates. One-third of the UVCs (n = 33) were malpositioned. Catheter-related sepsis was observed in 16 (14.8%) neonates, with 5 (4.6%) having CABSI. The most common organism was coagulase-negative Staphylococcus. Other complications include peritoneal extravasation in 3 (2.8%) patients, with two requiring surgical intervention. Venous thrombosis occurred in 2 (1.9%) neonates and was managed conservatively.CONCLUSIONAlthough complication rates were in line with international norms, UVCs were associated with serious complications and should be judiciously used.     

Impact of a quality improvement program: Early initiation of breastfeeding after cesarean section in a tertiary care hospital,in Eastern India

BackgroundEarly initiation of breastfeeding (EIBF) within 1 h of birth is crucial in preventing newborn deaths and plays a vital role in early infant nutrition. Promoting and supporting breastfeeding is an integral part of midwifery. The objective of the study was to improve the EIBF rate in neonates born through a Cesarean Section (CS) from 0% to 50% within six months through a quality improvement (QI) process and to assess the maternal experience of EIBF in operation theatre (OT).MethodsSix Plan-Do-Study-Act (PDSA) cycles were conducted to test the change ideas proposed by the team members for a month to improve EIBF. Participants of the study were the stable term newborns delivered by CS under spinal anesthesia.ResultsThe EIBF rate improved from 0% to 88% after the sixth PDSA cycle. The effect was sustained for six months. Mothers of 51 neonates (98%) who received EIBF reported that their newborns were breastfed successfully, and it was not physically tiring to feed immediately in the OT.ConclusionsA quality improvement (QI) initiative was able to improve and sustain the improved EIBF rate after CS. Early skin-to-skin contact to be initiated with EIBF for better neonatal outcomes.     

新生儿低钙血症高危因素的探讨

目的探讨影响早期新生儿血钙的高危因素。方法选择正常新生儿50例为对照组,住院新生几476例,分别于生后24h,3d．5d、7d抽取股静脉血,用日本产全自动生化分析仪查血清总钙和游离钙、血清钠,血糖,心肌酶。用U检验分析实验纽与对照纽低钙发生率的差异;用多因素回归分析分析性别．孕周,出生体重,赝内出血,窒息或宫内窘迫、肌酸磷酸激酶（CPK）、组织损伤、低血钠、低血糖对血钙的影响。统计学方法：采用SPSS13．0软件包,Logistic回归分析。结果实验纽低钙发生率为26．05％（124／476）,对照纽低钙发生率为0,U=4．11,P〈0．01。Logistie回归分析结果：出生体重、血糖．孕周,窒息、及CPK入选方程,B分别0．074,～0．492,-0．040,0.600,0．001。EXP（B）：0．485,0．612,0．961,1．822,1．001。P〈O．05,提示出生体重越轻．血糖越低．孕周越小、窒息发生及CPK越高出现新生儿低钙的危险性越大。结论病理儿易出现低钙,低出生体重、低血糖．早产、窒息．CPK增高为低钙的高危因素。性别、组织损伤,颅内出血．低钠与低钙无关。     

白血病化疗后并发的急性肿瘤溶解综合征

目的：探讨急性白血病(AL)患者在化疗后发生急性肿瘤溶解综合征(ATLS)的临床特征、促发因素、高危因素及诊断防治的经验教训。方法：对AL在常规化疗前和化疗中常规进行各项血生化指标检查。结果：所有病例均有不同项目和不同程度的血生化指标异常,主要表现为高钾血症、高尿酸血症、高磷血症和低钙血症以及肾功能异常。9例发生了ATLS,其中1例死于急性肾衰,5例死于高血钾所致的心律失常。3例经早期诊断和及时处理病情好转。结论：早期诊断、及时给予羟基脲及别嘌呤醇和碱化尿液可防治ATLS。     

新生儿肺出血31例诊治体会

目的探讨影响新生儿肺出血的病因分布,采取合理的治疗措施提高抢救成功率。方法回顾31例新生儿肺出血患儿的病史、病因分布、临床检查及治疗结果等特点,分析它们在肺出血病理生理中的影响。结果引起新生儿肺出血的主要因素:非感染因素有早产、低体温、窒息、吸入性肺炎、寒冷损伤、硬肿症等;感染因素包括败血症、肺部感染等。加强呼吸支持治疗使部分患儿抢救成功(3/9)。结论预防非感染因素如早产、低体温、窒息、吸入性肺炎、寒冷损伤等,感染因素败血症、肺部感染等,可预防新生儿肺出血的发生。新生儿肺出血发生后应积极给予呼吸支持,降低病死率。     

新生儿先天性肾脏和泌尿道畸形的超声筛查及随访

目的 探讨新生儿先天性肾脏和泌尿道畸形(congenital anomalies of the kidney and urinary tract,CAKUT)的发病情况,评价出生后早期行泌尿系超声筛查的价值。方法 对2016年1月至2018年12月于清华大学附属北京清华长庚医院出生和就诊的新生儿行泌尿系超声筛查并随访,同时对母孕产期资料进行分析,筛选与CAKUT发病相关的危险因素。结果 (1)本次筛查的2 655例新生儿中,CAKUT阳性82例(男60例,女22例),阳性率为3.1%(82/2 655), 其中肾积水66例,重复肾6例,多发性肾囊肿2例,肾囊性发育不良2例,髓质海绵肾1例,小肾脏3例,孤立肾1例,马蹄肾1例。(2)66例肾积水患儿中有4例失访;8例目前随访尚不足6个月,肾积水无明显变化,继续随访观察中;54例完成随访1年,1年内恢复正常32例,减轻3例,加重7例,无变化12例,其中1例因反复泌感、肾功能下降接受手术治疗。(3)CAKUT高危因素以孕晚期胎儿泌尿系超声异常最多,胎儿泌尿系超声异常的高危新生儿有44例,生后筛查发现CAKUT病例35例,发生率为79.5%(35/44)。(4)本次筛查的2 655例新生儿中,有2 611例新生儿产前泌尿系超声检查是正常的,这些产前泌尿系超声检查正常的新生儿中,有47例出生后泌尿系B超筛查符合CAKUT诊断,发生率为1.8%(47/2 611)。结论 新生儿最常见的CAKUT为肾积水,多数预后良好,但应定期随访;对新生儿尤其是母孕期胎儿泌尿系超声异常的高危新生儿行泌尿系统超声筛查,对于早期发现CA KUT有重要的临床意义。     

Luteal phase support with decapeptyl improves pregnancy outcomes in intracytoplasmic sperm injection with higher basal follicle-stimulating hormone or lower mature oocytes

BackgroundThe role of midluteal phase gonadotropin-releasing hormone (GnRH) agonist had been an issue of debate. The aim of this retrospective study was to evaluate the effect of a mid-luteal phase GnRH agonist as an additional luteal phase support (LPS) in patients receiving intracytoplasmic sperm injection (ICSI). Additionally, we elucidate which subgroup would gain the most benefit from GnRH agonist as LPS.MethodsThe medical records were retrieved from January 2009 to January 2012 and a total of 348 patients receiving ICSI were included in this retrospective study. Among them, 240 patients met the inclusion criteria of patients aged ≤38 years, previous assisted reproductive technology (ART) cycles ≤ 2. There were 147 patients in the decapeptyl group who received GnRH agonist decapeptyl 6 days after ICSI as additional LPS and 93 patients in the control group. Subgroupings were done according to advanced age, the number of previous ART cycles, high basal follicle-stimulating hormone (FSH) level, and patients who had fewer mature oocytes retrieved. Live birth rates, clinical pregnancy rate (CPR), and implantation rate were the primary outcomes.ResultsLPS with decapeptyl led to a higher implantation rate (24.5% vs. 17.0%, p = 0.023), a higher CPR (49.0%, n = 72 vs. 33.3%, n = 31, p = 0.023) and a higher live birth rate (41.5%, n = 61 vs. 28.0%, n = 26, p = 0.039). In the subgroup analysis, decapeptyl improved the CPR of those patients with basal FSH >8 mIU/mL (50.0%, n = 15 vs. 8.3%, n = 1, p = 0.031) and also improved CPR (42.3%, n = 11 vs. 0%, n = 0, p = 0.017) and live birth rate (30.8%, n = 8 vs. 0%, n = 0, p = 0.035) of patients whose number of mature oocytes was three or fewer.ConclusionThis study demonstrated that administration of decapeptyl as additional luteal support can enhance ICSI clinical outcomes. Those patients with higher basal FSH level or fewer number of mature oocytes may obtain particularly significant benefit.