母婴同室新生儿感染因素分析

目的：把母婴同室的新生儿感染率控制到最低限度。方法：采用回顾性分析方法,对近两年我院母婴同室新生儿感染情况与过去母婴分室新生儿感染的情况进行对比,分析新生儿感染因素。结果：母婴同室新生儿感染发生率４．４％,比母婴分室新生感染率１０．２８％明显降低。晶龄大于３ｄ的新生儿母婴同室的感染率明显低于母婴分室的感染率,晶龄３ｄ内的新生儿母婴同室与母婴分室无明显差异。结论：母婴同室实行的各项措施比较有效地控制     

Study on Pulmonary Surfactant of Sudden Death of Infant

Objective To find the pathogenesis of sudden infant death syndrome (S IDS) from changes of pulmonurry surfactant. Methods By means of thin-layer ckromatography technique, surfactant in whole lung specimens of 10 infants with SIDS and 10 control infants without SIDS (dead of nonrespiratory diseases ) were examined qualitatively and quantitatively. Results Eleven components in pulmonary surfactant were examined qualitatively, including lysophosphatidylcholine , sphingomyelin , phosphatidylcholine , phosphatidylserine , phosphatidylinositol , phos phatidylethanolamine , phosphatidylglycerol , diphosphatidylylycerol , phosphatidic acid, cholesterol and neutral lipids. Quantitative examination showed that the amount of surfactant of whole lung specimens in sudden death group [-(8.9±1.0) rng/g wet lung weight] was significantly less than that in control group [-(12. 6±1.4) mg/g uet lung weight, P＜0. 01]. Qualitative variance showed that the percentages of phosphatidylcholine (49. 4 % ± 2. 0 % ) and phosphatidylylycerol ( 2. 6 % ± 0. 7 % ) decreased markedly in sudden death group compared with those in control group (61.5 % ± 3. 0 % and 4.3 % ±1. 5%, P ＜ 0. 01 ). Conclusion Before death there is serions defect on metabolism of pulmonary surfactant in sudden death infants, with the amount decreasing and the ratio of its components being disturbed, which is one of the important pathogenies of SIDS.     

单胎初产臀位围产儿预后相关因素分析

目的 探讨臀位新生儿窒息、围产儿死亡的相关因素。方法 回顾分析４７７例单胎初产臀位新生儿Ａpgar评分与孕周、体重、先露类型、分娩方式的关系。结果 臀位早产儿、过期儿、体重〈２kg及阴道分娩的臀位新生儿容易发生窒息（Ｐ〈０．００５,Ｐ〈０．０１）。体重≥２０００g４组间Ａpgar评分较无显著性差异（Ｐ〉０．０５）。结论 臀位选择 在３７～４１＾＋６孕周,估计新生儿体重≥２０００g时分娩较合适;及早发现足先露、     

囊肿切除治疗婴儿先天性胆总管囊肿

目的探讨囊肿切除、胆道重建治疗婴儿胆总管囊肿的疗效.方法1984年6月～1999年6月共有15例婴儿先天性胆总管囊肿患儿在我科接受了囊肿切除、胆道重建手术治疗,并对这些患儿进行了随访,随访资料包括症状、体征、B超.钡餐及肝功能检查.结果随访资料完整者12例,除1例术后3个月死于肝功能衰竭外,其余11例成活的患儿生长发育均正常;2例未行套叠瓣的患儿偶有上腹疼痛,但腹痛可自行缓解,钡餐检查见钡剂返流;全组病例肝功均正常,未见胆道结石、消化道溃疡、食道下端静脉曲张.结论囊肿切除、胆道重建治疗婴儿先天性胆总管囊肿可取得满意的疗效.     

新生儿缺氧缺血性脑病血浆及脑脊液一氧化氮水平的变化

目的 :了解新生儿缺氧缺血性脑病 (HIE)时血浆和脑脊液 (CSF)中 NO水平的动态变化。方法 :采用硝酸根还原酶法 ,对 35例 HIE患儿 (轻度 10例、中度 13例、重度 12例 )分别于急性期、恢复期进行了血浆和 CSF NO水平测定。结果 :HIE急性期血浆 NO水平除轻度组外 ,中、重度组明显高于对照组 ,重度组又明显高于轻、中度组 ;恢复期轻、中、重度组血浆 NO水平均降至正常 ,与对照组比较差异无显著性。CSF中 NO水平增加的幅度与血浆成正比。结论 :血浆和 CSF中 NO水平与 HIE的脑损伤程度密切相关     

A comparison of perinatal mortality between ethnic Chinese and ethnic whites: Why the Chinese rate was lower

Objectives. To confirm the observation that has been occasionally reported in the literature that perinatal mortality rate is lower in ethnic Chinese than in ethnic whites, and to assess the reasons for this lower perinatal mortality rate.

Methods. Secondary‐analysis based on published data.

Results. This exercise demonstrates that the perinatal mortality rate was lower in ethnic Chinese than in ethnic whites. The birth weight distribution in ethnic Chinese was more favourable with reduced births at two extremes of the distribution, and the exposure to risk factors for perinatal death by their mothers was also lower.

Conclusion: Perinatal mortality rate is lower in ethnic Chinese than in ethnic whites, and the lower perinatal mortality rate in ethnic Chinese is probably caused by their favourable birth weight distribution and lower exposure to risk factors of perinatal death by their mothers.     

Two Types of Health Care Systems and Their Influence on the Introduction of Perinatal Care: An Epidemiological Twin Model in Berlin from 1950 to 1990

Objectives: When perinatal medicine emerged as a new medical discipline in the 1960s, Berlin was as one of the world's leading centers. During that time, the city was separated into two parts, each fostering its own health care system. After the destruction of the Berlin Wall, it was possible to speak with the citizens of East Berlin and to access their database systems. This created the singular opportunity to objectively compare the development of perinatal care in both parts of Berlin. Methods: Rates of maternal, perinatal, and infant mortality as well as the rate of preterm deliveries were evaluated over time and between East and West Berlin. The timing of introduction of 20 specific perinatal interventions was evaluated across 18 hospitals with more than 500 deliveries (11 in West Berlin and 7 in East Berlin). Interviews were conducted with 100 gynecologists, 100 midwives, and 100 women who had recently delivered their first child from each side of the city regarding their opinions of the importance of these interventions for the quality of perinatal medicine and how they would distribute a budget to improve maternity care. Results: Maternal, perinatal, and infant mortality decreased in both parts of Berlin until 1990 (p<0.0001), without significant differences between East and West Berlin, though the preterm delivery rate was slightly lower in East Berlin compared with West Berlin (p<0.06). Some new clinical techniques and treatments—such as cardiotocography, ultrasound, tocolytic therapy, and peridural anesthesia—were introduced earlier in West Berlin. In contrast, certain public health measures—such as maternal transport, screening programs for diabetes, and support of breastfeeding—were introduced much earlier in East Berlin. There were significant differences between the beliefs of gynecologists, midwives, and mothers in East and West Berlin. In general, citizens of East Berlin were more enthusiastic about technological medical advances, whereas citizens of West Berlin were more supportive of public health and alternative methods. In addition, there were significant differences between female and male physicians in their beliefs about how to improve health care, regardless of whether they resided in East or West Berlin. Conclusions: The results of this study may serve as a basis for reflection on how different social circumstances and health care policies can influence the improvement of maternal and child health care.     

Birth Outcomes of Immigrant Women in the United States,France, and Belgium

Objectives: To compare maternal characteristics and birth outcomes of Mexico-born and native-born mothers in the United States and those of North African mothers living in France and Belgium to French and Belgian nationals. Methods: We examined information from single live birth certificates for 285,371 Mexico-born and 3,131,632 U.S.-born mothers (including 2,537,264 U.S.-born White mothers) in the United States, 4,623 North African and 103,345 Belgian mothers in Belgium, and a French national random sample consisting of 632 North African and 11,185 French mothers. The outcomes were mean birthweight, low birthweight, and preterm births. Differences between native/nationals and foreign-born mothers in each country were assessed in bivariate and multivariate analyses controlling for maternal risk factors. Results: The adjusted odds for low birthweight were lower for immigrants than native/nationals by 32% in the United States, by 32% in Belgium, and by 30% in France. The adjusted odds for preterm births were lower for immigrants compared with native/nationals by 11% in the United States and by 23% in Belgium. In France, the odds for preterm births were comparable for immigrants and naturalized mothers. Infants of immigrant mothers also had higher mean birthweights in all three countries. Conclusion: Despite their disadvantaged status, Mexico-born and North African-born women residing in the United States, France, and Belgium show good birth outcomes. These cannot be explained solely by traditional risk factors. Protective factors and selective migration may offer further clues.     

婴儿生长发育影响因素的多元回归分析

目的：探讨４２日龄婴儿生长发育的影响因素。方法：采用多元回归的方法分析了８４对母婴的营养状况等对４２日龄婴儿身高、体重、头围的影响。结果：母亲年龄,胎盘重量,产妇血碱性磷酸酶活性和２５－ＯＨＤ浓度,脐血钙、镁浓度和碱性磷酸酶活性,婴儿喂养方式,有无佝偻病症状,乳母肉类食物摄取量,婴儿出生身长进入身长回归方程;产妇血钙、血磷和钙磷乘积,职业,脐血磷和出生体重进入体重回归方程;脐血碱性磷酸酶活性和２５－ＯＨＤ２,胎盘重量,婴儿喂养方式和出生头围进入头围回归方程。结论：４２日龄时婴儿的生长发育不仅受婴儿的喂养方式、有无佝偻病症状的影响,而且还与胎儿期母体的营养状况有关。