Objective:To investigate the dynamic trajectory,predictors,and underlying adaptation mechanisms of family resilience(FR)among Chinese families with preterm infants(PIs)from birth to six months.Methods:Guided by Ecolog...Objective:To investigate the dynamic trajectory,predictors,and underlying adaptation mechanisms of family resilience(FR)among Chinese families with preterm infants(PIs)from birth to six months.Methods:Guided by Ecological Systems Theory,a convergent parallel mixed-methods study was conducted in the Neonatal Intensive Care Unit(NICU)of a tertiary hospital in Fujian Province,China,from June 2023 to June 2024.Quantitative data were collected from 202 caregivers selected by convenience sampling at four time points:at birth(T0),42 days postpartum(T1),3 months postpartum(T2),and 6 months postpartum(T3).Generalized Estimating Equations(GEE)was used to analyze scale score differences across time points and explore factors influencing FR.Qualitative data were collected through semi-structured interviews with 14 caregivers recruited by maximum variation purposive sampling and analyzed using Colaizzi’s phenomenological approach.After conducting separate data analyses,the findings were integrated through side-by-side comparison and joint display.Results:Quantitative results revealed a non-linear,“V”-shaped trajectory of FR,significantly influenced by educational level,conception via assisted reproduction,farming occupation,coping style,psychological resilience,family functioning,and social support.Qualitative findings identified four themes:initial uncertainty and emotional distress,post-discharge anxiety,gradual adaptation,and eventual stabilization.Integrated mixed-methods findings revealed that the initial confusion phase demands a comprehensive response to family needs(T0);the post-discharge bottleneck requires addressing the care capability-needs gap(T1);the role adaptation phase is pivotal for enhancing internal family resources(T2);and the family-work transition necessitates enhanced work-family facilitation(T3).Conclusions:This study systematically identifies the unique“V”-shaped trajectory of FR in Chinese families with PIs and its key influencing factors,and accurately analyzes their dynamic experiences and adaptation across four stages.These findings provide an empirical basis for stage-specific targeted interventions,strongly support the practical advancement of the family-centered care model,and deliver critical guidance for enhancing FR.展开更多
Background There have been numerous intervention studies focusing on the development of preterm infants,but there has been limited investigation into the home environment as a determinant of developmental outcomes in ...Background There have been numerous intervention studies focusing on the development of preterm infants,but there has been limited investigation into the home environment as a determinant of developmental outcomes in preterm infants.The aspects and extent to which the home environment affects the early(18 months corrected age)neuropsychological development of preterm infants are still unclear.Aims This study aimed to analyse the effect of the home environment on the neuropsychiatric development of preterm infants at 18 months corrected age after discharge from the neonatal intensive care unit(NICU).It also sought to provide a basis for promoting neuropsychiatric development among preterm infants by improving the home environment.Methods In this retrospective cross-sectional study,275 preterm infants born between January 2019 and January 2022 were followed up for systematic management after discharge from the NICU at Shanghai Children's Hospital.The Home Nurture Environment Questionnaire was used to assess the home environment of the infants and analyse its impact on the developmental quotient(evaluated by the Gesell Developmental Scale)and the rate of developmental delays at 18 months corrected age.Results A total of 41.454%of the infants were extremely preterm.The developmental quotient scores at 18 months corrected age were in the middle of the scale.The language domain had the highest rate of developmental delay(46.182%),followed by the adaptive domain(37.091%).Multiple logistic regression analyses showed that compared with infants in supportive home environments,infants with moderate/unsupportive home environments had significantly elevated risks of development delay:2.162-fold for global(odds ratio(OR)2.162,95% confidence interval(Cl)1.274 to 3.665,p=0.004),2.193-fold for fine motor(OR 2.193,95%CI 1.161 to 4.140,p=0.016),2.249-fold for language(0R 2.249,95%CI 1.336 to 3.786,p=0.002)and 2.042-fold for personal-social(OR 2.042,95%CI 1.149 to 3.628,p=0.015).Conclusions A supportive home environment is a crucial protective factor for the neuropsychological development of preterm infants.It is associated with higher developmental quotient scores and protects against neuropsychiatric delays.Incorporating evaluation and continuous improvement of the home environment into the management framework for preterm infants to promote optimal neurodevelopment is essential.展开更多
Objective:To study the effects of prolonging small feeding volumes early in life on the incidence of necrotizing enterocolitis(NEC)in very low birth weight(VLBW)preterm infants.Methods:A total of 128 VLBW infants who ...Objective:To study the effects of prolonging small feeding volumes early in life on the incidence of necrotizing enterocolitis(NEC)in very low birth weight(VLBW)preterm infants.Methods:A total of 128 VLBW infants who could not be breastfed were assigned into the experimental group(63 cases)and the control group(65 cases)using a random number table.The experiment group was fed 12 mL/(kg·d)on day 1 which was increased to 24 mL/(kg·d)for the first 10 study days.The control group was fed 12 mL/(kg·d)for the first 14e48 hours.Then,the feeding volume increased by 24-36 mL/(kg·d)up to 140e160 mL/(kg·d)and maintained until the 10th day after birth.The incidence of feeding intolerance and NEC,duration of hospitalization,time to full enteral feedings,incidence of intrahepatic cholestasis,and the levels of gastrin and motilin in serum were assessed.Results:The incidence of feeding intolerance was significantly lower in the experimental group compared with the control group(15.87% vs.33.84%).There was a significant reduction in the incidence of NEC between the experimental and control groups(7.9% vs.16% in the control group).Conclusion:A protocol that prolongs small feeding volumes early in life can reduce the incidence and severity of NEC,but still warrants further study.展开更多
BACKGROUND Premature infant formula is based on milk and contains energy,vitamins,etc.Breast milk is rich in minerals,such as phosphorus and calcium,and proteins.Both can be used for nutritional support in preterm inf...BACKGROUND Premature infant formula is based on milk and contains energy,vitamins,etc.Breast milk is rich in minerals,such as phosphorus and calcium,and proteins.Both can be used for nutritional support in preterm infants with low-birth-weight.However,their effects on the difference in infant growth rate and postpartum depression are still unclear.AIM To explore the effect of early micro-breastfeeding on the growth rate of preterm infants with low-birth-weight and maternal postpartum depression.METHODS Data of 68 preterm infants with low-birth-weight and their mothers admitted to the Department of Neonatology,Suzhou Ninth Hospital Affiliated to Soochow University,between January 2022 and December 2024,were retrospectively collected.The infants were divided into two groups according to the different enteral feeding methods in the early stage:Control group(n=32 cases,premature infant formula feeding)and observation group(n=36 cases,micro-breastfeeding,i.e.,exclusive breastfeeding,no mixed feeding).The baseline data;feeding status;gastrointestinal adverse reactions such as vomiting,gastric retention,and abdominal distension;growth rate(body weight,body length,and head circumference);and adverse events(infection,cholestasis,hyperbilirubinemia,and necrotizing enterocolitis)were compared between the two groups.Moreover,the maternal postpartum depression status of the two groups based of infants based on the Edinburgh postpartum depression scale(EPDS)was compared.RESULTS No significant difference in baseline data was found between the two groups(P>0.05).The onset time of weight gain(6.49±0.53 days vs 7.09±0.61 days,P<0.001),time for complete meconium excretion(6.28±0.92 days vs 8.31±1.17 days,P<0.001),time for recovery to birth weight(8.81±1.40 days vs 10.95±1.64 days,P<0.001),and time to reach full enteral feeding(12.29±2.08 days vs 15.48±2.27 days,P<0.001)were compared between the observation and control groups.The incidence of vomiting,abdominal distension,and gastric retention was significantly lower in the observation group than in the control group,and the difference was significant(P<0.05).The rates of the weight growth(15.88±1.57 g/day vs 14.84±1.51 g/day,P=0.007),head circumference(0.63±0.08 cm/week vs 0.59±0.05 cm/week,P=0.018),and length(0.80±0.12 cm/week vs 0.73±0.14 cm/week,P=0.029)were compared between the observation and control groups.On hospital admission of preterm infants with low-birthweight,the mothers of the two groups did not show a significant difference in the EPDS scores for postpartum depression(P>0.05).Preterm infants with low-birth-weight were hospitalized for 2 weeks,and the EPDS score for maternal postpartum depression was significantly lower in the observation group than in the control group(8.38±1.47 vs 9.49±2.35,P=0.021).CONCLUSION Compared with preterm infant formula feeding,early micro-breastfeeding can more effectively promote the growth rate of preterm infants with low-birth-weight and reduce the gastrointestinal feeding intolerance and related complications,thereby alleviating mothers’concerns about their children and reducing the risk of postpartum depression.展开更多
BACKGROUND There have been few reports on level 3 difficult removal of peripherally inserted central catheter(PICC)in neonates.Here,we reported a case of an extremely preterm infant who underwent level 3 difficult rem...BACKGROUND There have been few reports on level 3 difficult removal of peripherally inserted central catheter(PICC)in neonates.Here,we reported a case of an extremely preterm infant who underwent level 3 difficult removal of a PICC.CASE SUMMARY Female baby A,weighing 1070 g at 27^(+1) wk of gestational age,was diagnosed with extremely preterm infant and neonatal respiratory distress syndrome.She underwent PICC insertion twice.The first PICC insertion went well;the second PICC was inserted in the right lower extremity,however,phlebitis occurred on the second day after the placement.On the third day of catheterization,phlebitis was aggravated,while the right leg circumference increased by 2.5 cm.On the fourth day of catheterization,more red swelling was found in the popliteal part,covering an area of about 1.5 cm×4 cm,which was diagnosed as phlebitis level 3;thus,we decided to remove the PICC.During tube removal,the catheter rebounded and could not be pulled out(several conventional methods were performed).Finally,we successfully removed the PICC using a new approach termed“AFGP”.On the 36th day of admission,the baby fully recovered and was discharged.CONCLUSION The“AFGP”bundle approach was effective for an extremely preterm infant,who underwent level 3 difficult removal of a PICC.展开更多
With the continuous progress of medical care, the survival rate of preterm infants is increasing year by year, and adequate nutrition is crucial for the growth and development of preterm infants. Enteral nutrition (EN...With the continuous progress of medical care, the survival rate of preterm infants is increasing year by year, and adequate nutrition is crucial for the growth and development of preterm infants. Enteral nutrition (EN) is a nutritional support method that provides metabolically required nutrients and various other nutrients through the gastrointestinal tract, which is the best way to supply nutrition to preterm infants. A reasonable EN strategies can help improve the quality of survival, and long-term prognosis of preterm infants. This article summarizes and discusses the literature reports on EN for preterm infants at home and abroad in recent years, and reviews the research progress of EN strategies for preterm infants, personalized feeding programs, and related clinical problems affecting the establishment of EN, to provide reference for clinical work. EN for preterm infants requires the comprehensive use of a variety of research strategies and continuous exploration and innovation to provide better nutritional support for preterm infants and promote their healthy growth.展开更多
To treat respiratory distress syndrome,surfactant is currently delivered via less invasive surfactant administration（LISA） or INtubation SURfactant Extubation（INSURE）.The aim of this study was to compare the effec...To treat respiratory distress syndrome,surfactant is currently delivered via less invasive surfactant administration（LISA） or INtubation SURfactant Extubation（INSURE）.The aim of this study was to compare the effect of the two delivery methods of surfactant on cerebral autoregulation.Near infrared spectroscopy monitoring was carried out to detect cerebral oxygen saturation（Sc O2）,and the mean arterial blood pressure（MABP） was simultaneously recorded.Of 44 preterm infants included,the surfactant was administrated to 22 via LISA and 22 via INSURE.The clinical characteristics,treatments and outcomes of the infants showed no significant differences between the two groups.The correlation coefficient of Sc O2 and MABP（rSc O2-MABP） 5 min before administration was similar in the two groups.During surfactant administration,rSc O2-MABP increased in both groups（0.44±0.10 to 0.54±0.12 in LISA,0.45±0.11 to 0.69±0.09 in INSURE）.In the first and second 5 min after instillation,rSc O2-MABP was not significantly different from baseline in the LISA group,but increased in the first 5 min after instillation（0.59±0.13,P=0.000 compared with the baseline in the same group） and recovered in the second 5 min after instillation（0.48±0.10,P=0.321） in the INSURE group.There were significant differences in the change rates of rSc O2-MABP between the two groups during and after surfactant administration.Our results suggest that cerebral autoregulation may be affected transiently by surfactant administration.The effect duration of LISA is shorter than that of INSURE（〈5 min in LISA vs.5–10 min in INSURE）.展开更多
There is uncertain result with regard to the use of inhalation or instillation steroids to prevent bronchopulmonary dysplasia in preterm infants. This meta-analysis was designed to evaluate the efficacy and safety of ...There is uncertain result with regard to the use of inhalation or instillation steroids to prevent bronchopulmonary dysplasia in preterm infants. This meta-analysis was designed to evaluate the efficacy and safety of early airway administration (within 2 days after birth) of corticosteroids and pulmonary surfactant (PS) for preventing bronchopulmonary dysplasia (BPD) in premature infants with neonatal respiratory distress syndrome (NRDS). The related studies were retrieved in PubMed, EMBASE, the Cochrane Library, Clinical Trial, CNKI, Wanfang and VIP Database from inception to August 2018. Two reviewers independently screened the studies to ensure that all patients with diagnosis of NRDS were enrolled to studies within 1 day after birth, assessed the quality of included studies by GRADEpro system and extracted the data for review. The meta-analysis was performed by RevMan 5.2 software. A subgroup analysis about inhaled corticosteroid (ICS) delivery method was made between ICS inhalation subgroup [inhalation of ICS by nebulizer or metered dose inhaler (MDI)] and ICS intratracheal instillation subgroup (PS used as a vehicle). Eight randomized controlled trials were enrolled in the meta-analysis, 5 trials of which stated the randomized method, grouping and blinded method, and the follow-up procedures were reported. GRADEpro system showed high quality of 4 trials (5 articles), and the rest 4 trials had moderate quality. Meta-analysis showed that the incidence of BPD was decreased in ICS group, the relative risk (RR) was 0.56 (95% CI: 0.42-0.76), and similar trends were found in ICS inhalation subgroup and ICS intratracheal instillation subgroup, with the corresponding RR being 0.58 (95% CI: 0.41-0.82) and 0.47 (95% CI: 0.24-0.95) respectively. ICS could also significantly reduce the mortality risk as compared with placebo control group (RR: 0.67;95% CI: 0.45-0.99), with RR of ICS inhalation subgroup and ICS intratracheal instillation subgroup being 0.81 (95% CI: 0.34-1.94) and 0.64 (95% CI: 0.41-0.99) respectively. Moreover, the percentage of infants using PS more than one time was lower in ICS group than in the placebo control group, with the RR and 95% CI being 0.55 (95% CI: 0.45-0.67), and that in ICS intratracheal instillation subgroup lower than in ICS inhalation subgroup (RR: 0.56;95% CI: 0.45-0.69, and RR: 0.35;95% CI:0.08-1.52 respectively). There was no significant difference in the incidence of infection or retinopathy of prematurity and neuro-motor system impairment between ICS group and placebo control group, with the corresponding RR being 0.95 (95% CI:0.59-1.52), 0.92 (95% CI: 0.62-1.38) and 1.13 (95% CI: 0.92-1.39), respectively. It was concluded that early administration of ICS and PS is an effective and safe option for preterm infants with NRDS in preventing BPD and reducing mortality, decreasing the additional PS usage, especially for the ICS intratracheal instillation subgroup. Furthermore, the appropriate dose and duration of ICS, combined use of inhalation or instillation of ICS with PS and the long-term safety of airway administration of corticosteroids need to be assessed in large trials.展开更多
Objective To investigate the current enteral feeding practices in hospitalized late preterm infants in the Beijing area of China. Methods A multi-center, cross-sectional study was conducted. Infants born after 34 week...Objective To investigate the current enteral feeding practices in hospitalized late preterm infants in the Beijing area of China. Methods A multi-center, cross-sectional study was conducted. Infants born after 34 weeks and before 37 weeks of gestation were enrolled from 25 hospitals in the Beijing area of China from October 2015 to October 2017. Data on enteral feeding practices were collected and analyzed. Results A total of 1,463 late preterm infants were enrolled, with a mean gestational age（GA） of 35.6（34.9, 36.1） weeks. The percentage of exclusive breastfeeding was 4.5% at the initiation of enteral feeding but increased to 14.4% at discharge. When human milk was not available, most infants（46.1%） were fed with preterm infant formula. The rate of exclusive human milk feeding in infants born at 34 weeks gestation was higher than at discharge（21.1% of infants born at 34 weeks＇ GA versus 12.1% of infants born at 35 weeks＇ GA versus 12.3% of infants born at 36 weeks＇ GA, P 〈 0.001）. Only 28.4% of late preterm infants achieved full enteral feeding at discharge, and only 19.2% achieved 120 kcal/（kg·d） by enteral feeding at discharge. Importantly, 40.5% of infants did not regain the birth weight at discharge. Conclusion Enteral feeding support of late preterm infants has not been standardized to achieve optimal growth. Moreover, the human milk feeding rate was low, and many late preterm infants did not achieve the goal of enteral feeding and failed to regain birth weight at the time of discharge. More aggressive enteral feedings protocols are needed to promote human milk feeding and optimize growth for late preterm infants.展开更多
Background: The Readiness for Hospital Discharge Scale (RHDS)-Parent Form shows satisfactory reli-ability and validity to assess the readiness of parents to take care of their children discharged from hospitals in Wes...Background: The Readiness for Hospital Discharge Scale (RHDS)-Parent Form shows satisfactory reli-ability and validity to assess the readiness of parents to take care of their children discharged from hospitals in Western countries. However, the reliability and validity of this instrument has not been evaluated in Chinese populations.Objectives: Evaluate the psychometric features of the RHDS-Parent Form among Chinese parents of preterm infants. Methods: The RHDS-Parent Form was translated into a Chinese version following an international in-strument translation guideline. A total of 168 parents with preterm infants were recruited from the neonatal intensive care units of two tertiary-level hospitals in China. The internal consistency of this measure was assessed using the Cronbach's a coefficient;confirmatory factor analysis was conducted to evaluate the construct validity;and Pearson correlation coefficient was used to report the convergent validity. Results: The Chinese version of RHDS (C-RHDS)-Parent Form included 22 items with 4 subscales, ac-counting for 56.71% of the total variance. The C-RHDS-Parent Form and its subscales showed good reliability (Cronbach's a values 0.78-0.92). This measure and its subscales showed positive correlations with the score of Quality of Discharge Teaching Scale. Conclusion: The factor structure of C-RHDS-Parent Form is partially consistent with the original English version. Future studies are needed to explore the factors within this measure before it is widely used in Chinese clinical care settings.展开更多
Preterm infants are vulnerable to brain injuries,and have a greater chance of experiencing neurodevelopmental disorders throughout development. Early screening for motor and cognitive functions is critical to assessin...Preterm infants are vulnerable to brain injuries,and have a greater chance of experiencing neurodevelopmental disorders throughout development. Early screening for motor and cognitive functions is critical to assessing the developmental trajectory in preterm infants, especially those who may have motor or cognitive deficits. The brain imaging technology functional near-infrared spectroscopy(fNIRS) is a portable and low-cost method of assessing cerebral hemodynamics, making it suitable for large-scale use even in remote and underdeveloped areas. In this article, we review peer-reviewed, scientific f NIRS studies of motor performance, speech perception, and facial recognition in preterm infants. f NIRS provides a link between hemodynamic activity and the development of brain functions in preterm infants. Research using fNIRS has shown different patterns of hemoglobin change during some behavioral tasks in early infancy. fNIRS helps to promote our understanding of the developmental mechanisms of brain function in preterm infants when performing motor or cognitive tasks in a less-restricted environment.展开更多
Background: Respiratory distress syndrome (RDS) or hyaline membrane disease (HMD) is the most common cause of neonatal morbidity and mortality in preterm infants. We aimed to determine the frequency of RDS among 3 gro...Background: Respiratory distress syndrome (RDS) or hyaline membrane disease (HMD) is the most common cause of neonatal morbidity and mortality in preterm infants. We aimed to determine the frequency of RDS among 3 groups of preterm infants and the value of some related factors. Methods: A cross-sectional, descriptive analytical investigation was carried out in the NICU ward of Akbarabadi Hospital (Tehran-Iran) during spring 2011. Newborns’ data were collected and assessed by using their hospital medical records. Seventy-three preterm infants with gestational age < 34 weeks were hospitalized in the NICU. All participants were divided into 3 groups: extremely preterm (<28 weeks), very preterm (28 to <32 weeks) and moderate preterm (32 to 34 weeks). Frequency of RDS and some related factors were compared among 3 groups. Results: RDS was observed in 65.6% of all participants;however frequency of RDS was not different between three groups. An inversely correlation was found between gestational age and mortality rate (p = 0.05). In regard to Betamethasone administration prior to birth, this interval was significantly longer in alive neonates in comparison to infants who died (p < 0.05). Conclusion: RDS was frequent in preterm neonates with gestational age < 32 weeks. Time of Betamethasone administration prior to birth can significantly influence on neonatal mortality rate.展开更多
Despite significant advances in perinatal medicine, the management of extremely preterm infants in the delivery room remains a challenge. There is an increasing evidence for improved outcomes regarding the resuscitati...Despite significant advances in perinatal medicine, the management of extremely preterm infants in the delivery room remains a challenge. There is an increasing evidence for improved outcomes regarding the resuscitation and stabilisation of extremely preterm infants but there is a lack of evidence in the periviable(gestational age 23-25 wk) preterm subgroup. Presence of an experienced team during the delivery of extremely preterm infant to improve outcome is reviewed. Adaptation from foetal to neonatal cardiorespiratory haemodynamics is dependent on establishing an optimal functional residual capacity in the extremely preterm infants, thus enabling adequate gas exchange. There is sufficient evidence for a gentle approach to stabilisation of these fragile infants in the delivery room. Evidence for antenatal steroids especially in the periviable infants, delayed cord clamping, strategies to establish optimal functional residual capacity, importance of temperature control and oxygenation in delivery room in extremely premature infants is reviewed in this article.展开更多
Purpose:To evaluate the effect of an oral stimulation program on preterm infants.Methods:Preterm infants(n=72)were randomly assigned to experimental and control groups.Controls(n=36)received routine care while the exp...Purpose:To evaluate the effect of an oral stimulation program on preterm infants.Methods:Preterm infants(n=72)were randomly assigned to experimental and control groups.Controls(n=36)received routine care while the experimental group(n=36)received oral stimulation in addition to routine care.Postmenstrual age,total intake volume,body weight,the transition time from initiation of oral feeding to full oral feeding and feeding efficiency were calculated.Results:Postmenstrual age and full oral feeding weight were significantly lower in the experimental group(p<0.05).The time from initiation of oral feeding to full oral feeding was significantly shorter in the experimental group(p<0.05)while feeding efficiency was higher in the experimental group(p<0.05)compared to controls.No significant differences existed in hospital stay length or weight gain rate.Conclusions:An early oral stimulation program is beneficial in preterm infants.展开更多
Extravasation injuries occur in up to 70% of neonates in intensive care, majority being preterm infants. Their fragile and premature anatomy makes prevention and management of extravasation extra difficult compared to...Extravasation injuries occur in up to 70% of neonates in intensive care, majority being preterm infants. Their fragile and premature anatomy makes prevention and management of extravasation extra difficult compared to those of full-term. With increasing advances of intensive care for preterm infants, the use of intravenous medication and nutrition will increase, thus lead to further potential risk of extravasation injuries, which has serious complications, such as full-thickness skin loss, tissue necrosis and acute limb compartment syndrome, with long-term functional and cosmetic sequelae. There is a current lack of evidence in the literature on the most appropriate therapeutic strategy for this vulnerable patient group. This review aims to highlight our trust regime on the management of extravasation injuries (non-chemotherapeutic) for preterm infants, including injury classification and assessment, and implementation of initial interventions.展开更多
Objective:To determine the predictive role of stress,self-efficacy,and perceived social support on readiness for discharge in mothers of preterm infants.Methods:The present cross-sectional,descriptive-analytical study...Objective:To determine the predictive role of stress,self-efficacy,and perceived social support on readiness for discharge in mothers of preterm infants.Methods:The present cross-sectional,descriptive-analytical study was conducted on 120 mothers of preterm infants admitted to hospitals affiliated to Lorestan University of Medical Sciences,Iran in 2019.Participants were selected by a convenience sampling method and based on inclusion criteria.Data collection tools included the demographic questionnaire of mothers and infants,parent perceptions of their child's hospital discharge,parental stressor scale:neonatal intensive care unit,perceived maternal parenting,and multidimensional scale of perceived social support.Data were analyzed using Pearson correlation and stepwise regression at the significance level of 0.05.Results:Infant behavior and appearance,situational belief,and family support achieved the highest mean score from parents'stress,self-efficacy,and perceived social support dimensions,respectively.There was a significant relationship between stress,self-efficacy,and perceived social support with readiness for discharge in mothers of preterm infants(P<0.001).The score of mothers'readiness for discharge decreased by 0.07 per 1-point increase in stress score,and the score of readiness for discharge in mothers of preterm infants rose by 0.35 and 0.43,respectively,for a unit increase in the scores of self-efficacy and perceived social support.Conclusions:Stress,self-efficacy,and perceived social support can be considered as predictors of readiness for discharge in mothers of preterm infants.It is suggested that nurses in neonatal intensive care units provide a better platform for the readiness for discharge in mothers of preterm infants by reducing stressors and increasing maternal self-efficacy and social support.展开更多
Breastfeeding and human milk are the normative standards for feeding and nutrition of both term and pre-term infants. Fresh mother’s own milk is recognized as the optimal choice for feeding all newborns, including pr...Breastfeeding and human milk are the normative standards for feeding and nutrition of both term and pre-term infants. Fresh mother’s own milk is recognized as the optimal choice for feeding all newborns, including preterm and very low birth weight infants. Evidence documents short and long-term metabolic, immunologic and neurodevelopmental advantages of breastfeeding when compared to formula. Moreover, benefits of breastfeeding on psychological and relational aspects have to be considered. Currently, human milk supplementation is usually performed to meet the specific nutritional requirements of preterm infants. When mother’s milk is unavailable or in short supply, donor milk represents the best alternative, although some nutritional elements are inactivated by the necessary pasteurization process. Aim of this review is to briefly summarize the main biological and nutritional factors that contribute to the beneficial effects of human milk feeding for preterm infants.展开更多
Many preterm infants suffer from neural disorders caused by early birth complications. The detection of children with neurological risk is an important challenge. The electroencephalogram is an important technique for...Many preterm infants suffer from neural disorders caused by early birth complications. The detection of children with neurological risk is an important challenge. The electroencephalogram is an important technique for establishing long-term neurological prognosis. Within this scope, the goal of this study is to propose an automatic detection of abnormal preterm babies’ electroencephalograms (EEG). A corpus of 316 neonatal EEG recordings of 100 infants born after less than 35 weeks of gestation were preprocessed and a time series of standard deviation was computed. This time series was thresholded to detect Inter Burst Intervals (IBI). Temporal features were extracted from bursts and IBI. Feature selection was carried out with classification in one step so as to select the best combination of features in terms of classification performance. Two classifiers were tested: Multiple Linear Regressions and Support Vector Machines (SVM). Performance was computed using cross validations. Methods were validated on a corpus of 100 infants with no serious brain damage. The Multiple Linear Regression method shows the best results with a sensitivity of 86.11% ± 10.01%, a specificity of 77.44% ± 7.62% and an AUC (Area under the ROC curves) of 0.82 ± 0.04. An accurate detection of abnormal EEG for preterm infants is feasible. This study is a first step towards an automatic analysis of the premature brain, making it possible to lighten the physician’s workload in the future.展开更多
<span style="font-family:Verdana;"><strong>Background:</strong></span><span "=""><span style="font-family:Verdana;"> Ea</span><span>&l...<span style="font-family:Verdana;"><strong>Background:</strong></span><span "=""><span style="font-family:Verdana;"> Ea</span><span><span style="font-family:Verdana;">rly intervention is beneficial for improving preterm infant motor and cognitive outcomes in early childhood;however, little is known about whether early intervention can influence a preterm infant’s participation. Additionally, many studies investigating the impact of early intervention for preterm infants have been conducted in large metropolitan centres, leaving preterm infants who reside i</span><span style="font-family:Verdana;">n regional areas underrepresented in the literature to date. Consequentia</span></span><span style="font-family:Verdana;">lly, it is not yet known whether there are service delivery models, such as using telehealth as an adjunct to face-to-face intervention, that might cater to the needs of preterm infants residing outside metropolitan centres. PreEMPT (Preterm infant Early intervention for Movement and Participation Trial) is a novel early physiotherapy intervention that has been designed to use a participation goal-directed intervention approach via a mixture of face-to-face clinic sessions and telehealth sessions to improve the motor and participation outcomes of preterm born infants. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> This study aims to evaluate the feasibility of PreEMPT using an assessor-blinded, randomised controlled trial to compare PreEMPT to Usual Physiotherapy Care (UPC) for preterm infants residing in a regional Australian hospital catchment area. Twenty-six preterm infants (≤34 + 6 weeks gestational age) will be recruited prior to term corrected age from the special care nursery of a regional hospital. Following informed consent and baseline assessments, infants will be randomly allocated to receive either PreEMPT, a novel participation-focused early physiotherapy intervention delivered weekly for 14 forty-five-minute sessions alternating face-to-face sessions with telehealth into the infant’s home, or UPC, two - three physiotherapy sessions in the 4-month intervention period. Outcome measures relating to infant neuromotor development, motor performance, general development, and parental mental health and well-being will be assessed at 4-, 6- and 8-months corrected age. Feasibility will be evaluated by acceptability (parental satisfaction), demand and practicality (recruitment rate and telehealth session implementation), implementation (attendance at assessment and treatment sessions), and limited efficacy testing (comparing outcomes listed above for infants in PreEMPT and UPC). </span><b><span style="font-family:Verdana;">Discussion:</span></b><span style="font-family:Verdana;"> This study will be the first of its kind to use the participation of preterm infants in meaningful life situations as the foundation for intervention delivered via alternating face-to-face clinic sessions with telehealth into the home. The feasibility of this approach will be evaluated and used to inform future iterations of research about PreEMPT’s efficacy for improving preterm infant motor and participation outcomes.</span></span>展开更多
Motor development at late preterm infants has significant importance as it composes the picture of the severe evidences of motor impairments or other developmental difficulties. Early detection is crucial as early int...Motor development at late preterm infants has significant importance as it composes the picture of the severe evidences of motor impairments or other developmental difficulties. Early detection is crucial as early intervention is the unique immediate solution option to catch up the developmental milestones. Method: Α systematic search for scientific articles of the decade 2010-2020 investigating the motor profile of late preterm infants was conducted. Results: The search identified 9 studies, many of which highlighted the risk of motor and developmental delays even at 36 months of age. Conclusions: The stability of motor and developmental delays indicates the need of further investigation at a later age and intervention to avoid possible academic difficulties.展开更多
文摘Objective:To investigate the dynamic trajectory,predictors,and underlying adaptation mechanisms of family resilience(FR)among Chinese families with preterm infants(PIs)from birth to six months.Methods:Guided by Ecological Systems Theory,a convergent parallel mixed-methods study was conducted in the Neonatal Intensive Care Unit(NICU)of a tertiary hospital in Fujian Province,China,from June 2023 to June 2024.Quantitative data were collected from 202 caregivers selected by convenience sampling at four time points:at birth(T0),42 days postpartum(T1),3 months postpartum(T2),and 6 months postpartum(T3).Generalized Estimating Equations(GEE)was used to analyze scale score differences across time points and explore factors influencing FR.Qualitative data were collected through semi-structured interviews with 14 caregivers recruited by maximum variation purposive sampling and analyzed using Colaizzi’s phenomenological approach.After conducting separate data analyses,the findings were integrated through side-by-side comparison and joint display.Results:Quantitative results revealed a non-linear,“V”-shaped trajectory of FR,significantly influenced by educational level,conception via assisted reproduction,farming occupation,coping style,psychological resilience,family functioning,and social support.Qualitative findings identified four themes:initial uncertainty and emotional distress,post-discharge anxiety,gradual adaptation,and eventual stabilization.Integrated mixed-methods findings revealed that the initial confusion phase demands a comprehensive response to family needs(T0);the post-discharge bottleneck requires addressing the care capability-needs gap(T1);the role adaptation phase is pivotal for enhancing internal family resources(T2);and the family-work transition necessitates enhanced work-family facilitation(T3).Conclusions:This study systematically identifies the unique“V”-shaped trajectory of FR in Chinese families with PIs and its key influencing factors,and accurately analyzes their dynamic experiences and adaptation across four stages.These findings provide an empirical basis for stage-specific targeted interventions,strongly support the practical advancement of the family-centered care model,and deliver critical guidance for enhancing FR.
基金funded by Shanghai Municipal Health and Wellness Commission Health Industry Clinical Research Special Project(202140299).
文摘Background There have been numerous intervention studies focusing on the development of preterm infants,but there has been limited investigation into the home environment as a determinant of developmental outcomes in preterm infants.The aspects and extent to which the home environment affects the early(18 months corrected age)neuropsychological development of preterm infants are still unclear.Aims This study aimed to analyse the effect of the home environment on the neuropsychiatric development of preterm infants at 18 months corrected age after discharge from the neonatal intensive care unit(NICU).It also sought to provide a basis for promoting neuropsychiatric development among preterm infants by improving the home environment.Methods In this retrospective cross-sectional study,275 preterm infants born between January 2019 and January 2022 were followed up for systematic management after discharge from the NICU at Shanghai Children's Hospital.The Home Nurture Environment Questionnaire was used to assess the home environment of the infants and analyse its impact on the developmental quotient(evaluated by the Gesell Developmental Scale)and the rate of developmental delays at 18 months corrected age.Results A total of 41.454%of the infants were extremely preterm.The developmental quotient scores at 18 months corrected age were in the middle of the scale.The language domain had the highest rate of developmental delay(46.182%),followed by the adaptive domain(37.091%).Multiple logistic regression analyses showed that compared with infants in supportive home environments,infants with moderate/unsupportive home environments had significantly elevated risks of development delay:2.162-fold for global(odds ratio(OR)2.162,95% confidence interval(Cl)1.274 to 3.665,p=0.004),2.193-fold for fine motor(OR 2.193,95%CI 1.161 to 4.140,p=0.016),2.249-fold for language(0R 2.249,95%CI 1.336 to 3.786,p=0.002)and 2.042-fold for personal-social(OR 2.042,95%CI 1.149 to 3.628,p=0.015).Conclusions A supportive home environment is a crucial protective factor for the neuropsychological development of preterm infants.It is associated with higher developmental quotient scores and protects against neuropsychiatric delays.Incorporating evaluation and continuous improvement of the home environment into the management framework for preterm infants to promote optimal neurodevelopment is essential.
基金The study was funded by the Zhejiang Provincial Traditional Chinese Medicine Administration of China(approval number 2011ZB083)the Quality of Nursing Practice Project of the Chinese Medical Association.
文摘Objective:To study the effects of prolonging small feeding volumes early in life on the incidence of necrotizing enterocolitis(NEC)in very low birth weight(VLBW)preterm infants.Methods:A total of 128 VLBW infants who could not be breastfed were assigned into the experimental group(63 cases)and the control group(65 cases)using a random number table.The experiment group was fed 12 mL/(kg·d)on day 1 which was increased to 24 mL/(kg·d)for the first 10 study days.The control group was fed 12 mL/(kg·d)for the first 14e48 hours.Then,the feeding volume increased by 24-36 mL/(kg·d)up to 140e160 mL/(kg·d)and maintained until the 10th day after birth.The incidence of feeding intolerance and NEC,duration of hospitalization,time to full enteral feedings,incidence of intrahepatic cholestasis,and the levels of gastrin and motilin in serum were assessed.Results:The incidence of feeding intolerance was significantly lower in the experimental group compared with the control group(15.87% vs.33.84%).There was a significant reduction in the incidence of NEC between the experimental and control groups(7.9% vs.16% in the control group).Conclusion:A protocol that prolongs small feeding volumes early in life can reduce the incidence and severity of NEC,but still warrants further study.
文摘BACKGROUND Premature infant formula is based on milk and contains energy,vitamins,etc.Breast milk is rich in minerals,such as phosphorus and calcium,and proteins.Both can be used for nutritional support in preterm infants with low-birth-weight.However,their effects on the difference in infant growth rate and postpartum depression are still unclear.AIM To explore the effect of early micro-breastfeeding on the growth rate of preterm infants with low-birth-weight and maternal postpartum depression.METHODS Data of 68 preterm infants with low-birth-weight and their mothers admitted to the Department of Neonatology,Suzhou Ninth Hospital Affiliated to Soochow University,between January 2022 and December 2024,were retrospectively collected.The infants were divided into two groups according to the different enteral feeding methods in the early stage:Control group(n=32 cases,premature infant formula feeding)and observation group(n=36 cases,micro-breastfeeding,i.e.,exclusive breastfeeding,no mixed feeding).The baseline data;feeding status;gastrointestinal adverse reactions such as vomiting,gastric retention,and abdominal distension;growth rate(body weight,body length,and head circumference);and adverse events(infection,cholestasis,hyperbilirubinemia,and necrotizing enterocolitis)were compared between the two groups.Moreover,the maternal postpartum depression status of the two groups based of infants based on the Edinburgh postpartum depression scale(EPDS)was compared.RESULTS No significant difference in baseline data was found between the two groups(P>0.05).The onset time of weight gain(6.49±0.53 days vs 7.09±0.61 days,P<0.001),time for complete meconium excretion(6.28±0.92 days vs 8.31±1.17 days,P<0.001),time for recovery to birth weight(8.81±1.40 days vs 10.95±1.64 days,P<0.001),and time to reach full enteral feeding(12.29±2.08 days vs 15.48±2.27 days,P<0.001)were compared between the observation and control groups.The incidence of vomiting,abdominal distension,and gastric retention was significantly lower in the observation group than in the control group,and the difference was significant(P<0.05).The rates of the weight growth(15.88±1.57 g/day vs 14.84±1.51 g/day,P=0.007),head circumference(0.63±0.08 cm/week vs 0.59±0.05 cm/week,P=0.018),and length(0.80±0.12 cm/week vs 0.73±0.14 cm/week,P=0.029)were compared between the observation and control groups.On hospital admission of preterm infants with low-birthweight,the mothers of the two groups did not show a significant difference in the EPDS scores for postpartum depression(P>0.05).Preterm infants with low-birth-weight were hospitalized for 2 weeks,and the EPDS score for maternal postpartum depression was significantly lower in the observation group than in the control group(8.38±1.47 vs 9.49±2.35,P=0.021).CONCLUSION Compared with preterm infant formula feeding,early micro-breastfeeding can more effectively promote the growth rate of preterm infants with low-birth-weight and reduce the gastrointestinal feeding intolerance and related complications,thereby alleviating mothers’concerns about their children and reducing the risk of postpartum depression.
基金the 2017 Scientific Research Project of Sichuan Health and Family Planning Commission,No.18PJ215.
文摘BACKGROUND There have been few reports on level 3 difficult removal of peripherally inserted central catheter(PICC)in neonates.Here,we reported a case of an extremely preterm infant who underwent level 3 difficult removal of a PICC.CASE SUMMARY Female baby A,weighing 1070 g at 27^(+1) wk of gestational age,was diagnosed with extremely preterm infant and neonatal respiratory distress syndrome.She underwent PICC insertion twice.The first PICC insertion went well;the second PICC was inserted in the right lower extremity,however,phlebitis occurred on the second day after the placement.On the third day of catheterization,phlebitis was aggravated,while the right leg circumference increased by 2.5 cm.On the fourth day of catheterization,more red swelling was found in the popliteal part,covering an area of about 1.5 cm×4 cm,which was diagnosed as phlebitis level 3;thus,we decided to remove the PICC.During tube removal,the catheter rebounded and could not be pulled out(several conventional methods were performed).Finally,we successfully removed the PICC using a new approach termed“AFGP”.On the 36th day of admission,the baby fully recovered and was discharged.CONCLUSION The“AFGP”bundle approach was effective for an extremely preterm infant,who underwent level 3 difficult removal of a PICC.
文摘With the continuous progress of medical care, the survival rate of preterm infants is increasing year by year, and adequate nutrition is crucial for the growth and development of preterm infants. Enteral nutrition (EN) is a nutritional support method that provides metabolically required nutrients and various other nutrients through the gastrointestinal tract, which is the best way to supply nutrition to preterm infants. A reasonable EN strategies can help improve the quality of survival, and long-term prognosis of preterm infants. This article summarizes and discusses the literature reports on EN for preterm infants at home and abroad in recent years, and reviews the research progress of EN strategies for preterm infants, personalized feeding programs, and related clinical problems affecting the establishment of EN, to provide reference for clinical work. EN for preterm infants requires the comprehensive use of a variety of research strategies and continuous exploration and innovation to provide better nutritional support for preterm infants and promote their healthy growth.
基金supported by a grant from the Medical and Health Science and Technology Project of Guangzhou(No.20151A011027)
文摘To treat respiratory distress syndrome,surfactant is currently delivered via less invasive surfactant administration（LISA） or INtubation SURfactant Extubation（INSURE）.The aim of this study was to compare the effect of the two delivery methods of surfactant on cerebral autoregulation.Near infrared spectroscopy monitoring was carried out to detect cerebral oxygen saturation（Sc O2）,and the mean arterial blood pressure（MABP） was simultaneously recorded.Of 44 preterm infants included,the surfactant was administrated to 22 via LISA and 22 via INSURE.The clinical characteristics,treatments and outcomes of the infants showed no significant differences between the two groups.The correlation coefficient of Sc O2 and MABP（rSc O2-MABP） 5 min before administration was similar in the two groups.During surfactant administration,rSc O2-MABP increased in both groups（0.44±0.10 to 0.54±0.12 in LISA,0.45±0.11 to 0.69±0.09 in INSURE）.In the first and second 5 min after instillation,rSc O2-MABP was not significantly different from baseline in the LISA group,but increased in the first 5 min after instillation（0.59±0.13,P=0.000 compared with the baseline in the same group） and recovered in the second 5 min after instillation（0.48±0.10,P=0.321） in the INSURE group.There were significant differences in the change rates of rSc O2-MABP between the two groups during and after surfactant administration.Our results suggest that cerebral autoregulation may be affected transiently by surfactant administration.The effect duration of LISA is shorter than that of INSURE（〈5 min in LISA vs.5–10 min in INSURE）.
文摘There is uncertain result with regard to the use of inhalation or instillation steroids to prevent bronchopulmonary dysplasia in preterm infants. This meta-analysis was designed to evaluate the efficacy and safety of early airway administration (within 2 days after birth) of corticosteroids and pulmonary surfactant (PS) for preventing bronchopulmonary dysplasia (BPD) in premature infants with neonatal respiratory distress syndrome (NRDS). The related studies were retrieved in PubMed, EMBASE, the Cochrane Library, Clinical Trial, CNKI, Wanfang and VIP Database from inception to August 2018. Two reviewers independently screened the studies to ensure that all patients with diagnosis of NRDS were enrolled to studies within 1 day after birth, assessed the quality of included studies by GRADEpro system and extracted the data for review. The meta-analysis was performed by RevMan 5.2 software. A subgroup analysis about inhaled corticosteroid (ICS) delivery method was made between ICS inhalation subgroup [inhalation of ICS by nebulizer or metered dose inhaler (MDI)] and ICS intratracheal instillation subgroup (PS used as a vehicle). Eight randomized controlled trials were enrolled in the meta-analysis, 5 trials of which stated the randomized method, grouping and blinded method, and the follow-up procedures were reported. GRADEpro system showed high quality of 4 trials (5 articles), and the rest 4 trials had moderate quality. Meta-analysis showed that the incidence of BPD was decreased in ICS group, the relative risk (RR) was 0.56 (95% CI: 0.42-0.76), and similar trends were found in ICS inhalation subgroup and ICS intratracheal instillation subgroup, with the corresponding RR being 0.58 (95% CI: 0.41-0.82) and 0.47 (95% CI: 0.24-0.95) respectively. ICS could also significantly reduce the mortality risk as compared with placebo control group (RR: 0.67;95% CI: 0.45-0.99), with RR of ICS inhalation subgroup and ICS intratracheal instillation subgroup being 0.81 (95% CI: 0.34-1.94) and 0.64 (95% CI: 0.41-0.99) respectively. Moreover, the percentage of infants using PS more than one time was lower in ICS group than in the placebo control group, with the RR and 95% CI being 0.55 (95% CI: 0.45-0.67), and that in ICS intratracheal instillation subgroup lower than in ICS inhalation subgroup (RR: 0.56;95% CI: 0.45-0.69, and RR: 0.35;95% CI:0.08-1.52 respectively). There was no significant difference in the incidence of infection or retinopathy of prematurity and neuro-motor system impairment between ICS group and placebo control group, with the corresponding RR being 0.95 (95% CI:0.59-1.52), 0.92 (95% CI: 0.62-1.38) and 1.13 (95% CI: 0.92-1.39), respectively. It was concluded that early administration of ICS and PS is an effective and safe option for preterm infants with NRDS in preventing BPD and reducing mortality, decreasing the additional PS usage, especially for the ICS intratracheal instillation subgroup. Furthermore, the appropriate dose and duration of ICS, combined use of inhalation or instillation of ICS with PS and the long-term safety of airway administration of corticosteroids need to be assessed in large trials.
基金supported by Science and Technology Project of Beijing Health and Family Planning Commission[2016001]the CAMS Initiative for Innovative Medicine[2016-12M-1-008]
文摘Objective To investigate the current enteral feeding practices in hospitalized late preterm infants in the Beijing area of China. Methods A multi-center, cross-sectional study was conducted. Infants born after 34 weeks and before 37 weeks of gestation were enrolled from 25 hospitals in the Beijing area of China from October 2015 to October 2017. Data on enteral feeding practices were collected and analyzed. Results A total of 1,463 late preterm infants were enrolled, with a mean gestational age（GA） of 35.6（34.9, 36.1） weeks. The percentage of exclusive breastfeeding was 4.5% at the initiation of enteral feeding but increased to 14.4% at discharge. When human milk was not available, most infants（46.1%） were fed with preterm infant formula. The rate of exclusive human milk feeding in infants born at 34 weeks gestation was higher than at discharge（21.1% of infants born at 34 weeks＇ GA versus 12.1% of infants born at 35 weeks＇ GA versus 12.3% of infants born at 36 weeks＇ GA, P 〈 0.001）. Only 28.4% of late preterm infants achieved full enteral feeding at discharge, and only 19.2% achieved 120 kcal/（kg·d） by enteral feeding at discharge. Importantly, 40.5% of infants did not regain the birth weight at discharge. Conclusion Enteral feeding support of late preterm infants has not been standardized to achieve optimal growth. Moreover, the human milk feeding rate was low, and many late preterm infants did not achieve the goal of enteral feeding and failed to regain birth weight at the time of discharge. More aggressive enteral feedings protocols are needed to promote human milk feeding and optimize growth for late preterm infants.
文摘Background: The Readiness for Hospital Discharge Scale (RHDS)-Parent Form shows satisfactory reli-ability and validity to assess the readiness of parents to take care of their children discharged from hospitals in Western countries. However, the reliability and validity of this instrument has not been evaluated in Chinese populations.Objectives: Evaluate the psychometric features of the RHDS-Parent Form among Chinese parents of preterm infants. Methods: The RHDS-Parent Form was translated into a Chinese version following an international in-strument translation guideline. A total of 168 parents with preterm infants were recruited from the neonatal intensive care units of two tertiary-level hospitals in China. The internal consistency of this measure was assessed using the Cronbach's a coefficient;confirmatory factor analysis was conducted to evaluate the construct validity;and Pearson correlation coefficient was used to report the convergent validity. Results: The Chinese version of RHDS (C-RHDS)-Parent Form included 22 items with 4 subscales, ac-counting for 56.71% of the total variance. The C-RHDS-Parent Form and its subscales showed good reliability (Cronbach's a values 0.78-0.92). This measure and its subscales showed positive correlations with the score of Quality of Discharge Teaching Scale. Conclusion: The factor structure of C-RHDS-Parent Form is partially consistent with the original English version. Future studies are needed to explore the factors within this measure before it is widely used in Chinese clinical care settings.
基金the Key Laboratory of Biomedical Spectroscopy of Xi’an Municipality,China(Y839S11D0Z)an Autonomous Deployment Project of Xi’an Institute of Optics and Precision Mechanics of the Chinese Academy of Sciences(Y855W31213).
文摘Preterm infants are vulnerable to brain injuries,and have a greater chance of experiencing neurodevelopmental disorders throughout development. Early screening for motor and cognitive functions is critical to assessing the developmental trajectory in preterm infants, especially those who may have motor or cognitive deficits. The brain imaging technology functional near-infrared spectroscopy(fNIRS) is a portable and low-cost method of assessing cerebral hemodynamics, making it suitable for large-scale use even in remote and underdeveloped areas. In this article, we review peer-reviewed, scientific f NIRS studies of motor performance, speech perception, and facial recognition in preterm infants. f NIRS provides a link between hemodynamic activity and the development of brain functions in preterm infants. Research using fNIRS has shown different patterns of hemoglobin change during some behavioral tasks in early infancy. fNIRS helps to promote our understanding of the developmental mechanisms of brain function in preterm infants when performing motor or cognitive tasks in a less-restricted environment.
文摘Background: Respiratory distress syndrome (RDS) or hyaline membrane disease (HMD) is the most common cause of neonatal morbidity and mortality in preterm infants. We aimed to determine the frequency of RDS among 3 groups of preterm infants and the value of some related factors. Methods: A cross-sectional, descriptive analytical investigation was carried out in the NICU ward of Akbarabadi Hospital (Tehran-Iran) during spring 2011. Newborns’ data were collected and assessed by using their hospital medical records. Seventy-three preterm infants with gestational age < 34 weeks were hospitalized in the NICU. All participants were divided into 3 groups: extremely preterm (<28 weeks), very preterm (28 to <32 weeks) and moderate preterm (32 to 34 weeks). Frequency of RDS and some related factors were compared among 3 groups. Results: RDS was observed in 65.6% of all participants;however frequency of RDS was not different between three groups. An inversely correlation was found between gestational age and mortality rate (p = 0.05). In regard to Betamethasone administration prior to birth, this interval was significantly longer in alive neonates in comparison to infants who died (p < 0.05). Conclusion: RDS was frequent in preterm neonates with gestational age < 32 weeks. Time of Betamethasone administration prior to birth can significantly influence on neonatal mortality rate.
文摘Despite significant advances in perinatal medicine, the management of extremely preterm infants in the delivery room remains a challenge. There is an increasing evidence for improved outcomes regarding the resuscitation and stabilisation of extremely preterm infants but there is a lack of evidence in the periviable(gestational age 23-25 wk) preterm subgroup. Presence of an experienced team during the delivery of extremely preterm infant to improve outcome is reviewed. Adaptation from foetal to neonatal cardiorespiratory haemodynamics is dependent on establishing an optimal functional residual capacity in the extremely preterm infants, thus enabling adequate gas exchange. There is sufficient evidence for a gentle approach to stabilisation of these fragile infants in the delivery room. Evidence for antenatal steroids especially in the periviable infants, delayed cord clamping, strategies to establish optimal functional residual capacity, importance of temperature control and oxygenation in delivery room in extremely premature infants is reviewed in this article.
文摘Purpose:To evaluate the effect of an oral stimulation program on preterm infants.Methods:Preterm infants(n=72)were randomly assigned to experimental and control groups.Controls(n=36)received routine care while the experimental group(n=36)received oral stimulation in addition to routine care.Postmenstrual age,total intake volume,body weight,the transition time from initiation of oral feeding to full oral feeding and feeding efficiency were calculated.Results:Postmenstrual age and full oral feeding weight were significantly lower in the experimental group(p<0.05).The time from initiation of oral feeding to full oral feeding was significantly shorter in the experimental group(p<0.05)while feeding efficiency was higher in the experimental group(p<0.05)compared to controls.No significant differences existed in hospital stay length or weight gain rate.Conclusions:An early oral stimulation program is beneficial in preterm infants.
文摘Extravasation injuries occur in up to 70% of neonates in intensive care, majority being preterm infants. Their fragile and premature anatomy makes prevention and management of extravasation extra difficult compared to those of full-term. With increasing advances of intensive care for preterm infants, the use of intravenous medication and nutrition will increase, thus lead to further potential risk of extravasation injuries, which has serious complications, such as full-thickness skin loss, tissue necrosis and acute limb compartment syndrome, with long-term functional and cosmetic sequelae. There is a current lack of evidence in the literature on the most appropriate therapeutic strategy for this vulnerable patient group. This review aims to highlight our trust regime on the management of extravasation injuries (non-chemotherapeutic) for preterm infants, including injury classification and assessment, and implementation of initial interventions.
文摘Objective:To determine the predictive role of stress,self-efficacy,and perceived social support on readiness for discharge in mothers of preterm infants.Methods:The present cross-sectional,descriptive-analytical study was conducted on 120 mothers of preterm infants admitted to hospitals affiliated to Lorestan University of Medical Sciences,Iran in 2019.Participants were selected by a convenience sampling method and based on inclusion criteria.Data collection tools included the demographic questionnaire of mothers and infants,parent perceptions of their child's hospital discharge,parental stressor scale:neonatal intensive care unit,perceived maternal parenting,and multidimensional scale of perceived social support.Data were analyzed using Pearson correlation and stepwise regression at the significance level of 0.05.Results:Infant behavior and appearance,situational belief,and family support achieved the highest mean score from parents'stress,self-efficacy,and perceived social support dimensions,respectively.There was a significant relationship between stress,self-efficacy,and perceived social support with readiness for discharge in mothers of preterm infants(P<0.001).The score of mothers'readiness for discharge decreased by 0.07 per 1-point increase in stress score,and the score of readiness for discharge in mothers of preterm infants rose by 0.35 and 0.43,respectively,for a unit increase in the scores of self-efficacy and perceived social support.Conclusions:Stress,self-efficacy,and perceived social support can be considered as predictors of readiness for discharge in mothers of preterm infants.It is suggested that nurses in neonatal intensive care units provide a better platform for the readiness for discharge in mothers of preterm infants by reducing stressors and increasing maternal self-efficacy and social support.
文摘Breastfeeding and human milk are the normative standards for feeding and nutrition of both term and pre-term infants. Fresh mother’s own milk is recognized as the optimal choice for feeding all newborns, including preterm and very low birth weight infants. Evidence documents short and long-term metabolic, immunologic and neurodevelopmental advantages of breastfeeding when compared to formula. Moreover, benefits of breastfeeding on psychological and relational aspects have to be considered. Currently, human milk supplementation is usually performed to meet the specific nutritional requirements of preterm infants. When mother’s milk is unavailable or in short supply, donor milk represents the best alternative, although some nutritional elements are inactivated by the necessary pasteurization process. Aim of this review is to briefly summarize the main biological and nutritional factors that contribute to the beneficial effects of human milk feeding for preterm infants.
文摘Many preterm infants suffer from neural disorders caused by early birth complications. The detection of children with neurological risk is an important challenge. The electroencephalogram is an important technique for establishing long-term neurological prognosis. Within this scope, the goal of this study is to propose an automatic detection of abnormal preterm babies’ electroencephalograms (EEG). A corpus of 316 neonatal EEG recordings of 100 infants born after less than 35 weeks of gestation were preprocessed and a time series of standard deviation was computed. This time series was thresholded to detect Inter Burst Intervals (IBI). Temporal features were extracted from bursts and IBI. Feature selection was carried out with classification in one step so as to select the best combination of features in terms of classification performance. Two classifiers were tested: Multiple Linear Regressions and Support Vector Machines (SVM). Performance was computed using cross validations. Methods were validated on a corpus of 100 infants with no serious brain damage. The Multiple Linear Regression method shows the best results with a sensitivity of 86.11% ± 10.01%, a specificity of 77.44% ± 7.62% and an AUC (Area under the ROC curves) of 0.82 ± 0.04. An accurate detection of abnormal EEG for preterm infants is feasible. This study is a first step towards an automatic analysis of the premature brain, making it possible to lighten the physician’s workload in the future.
文摘<span style="font-family:Verdana;"><strong>Background:</strong></span><span "=""><span style="font-family:Verdana;"> Ea</span><span><span style="font-family:Verdana;">rly intervention is beneficial for improving preterm infant motor and cognitive outcomes in early childhood;however, little is known about whether early intervention can influence a preterm infant’s participation. Additionally, many studies investigating the impact of early intervention for preterm infants have been conducted in large metropolitan centres, leaving preterm infants who reside i</span><span style="font-family:Verdana;">n regional areas underrepresented in the literature to date. Consequentia</span></span><span style="font-family:Verdana;">lly, it is not yet known whether there are service delivery models, such as using telehealth as an adjunct to face-to-face intervention, that might cater to the needs of preterm infants residing outside metropolitan centres. PreEMPT (Preterm infant Early intervention for Movement and Participation Trial) is a novel early physiotherapy intervention that has been designed to use a participation goal-directed intervention approach via a mixture of face-to-face clinic sessions and telehealth sessions to improve the motor and participation outcomes of preterm born infants. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> This study aims to evaluate the feasibility of PreEMPT using an assessor-blinded, randomised controlled trial to compare PreEMPT to Usual Physiotherapy Care (UPC) for preterm infants residing in a regional Australian hospital catchment area. Twenty-six preterm infants (≤34 + 6 weeks gestational age) will be recruited prior to term corrected age from the special care nursery of a regional hospital. Following informed consent and baseline assessments, infants will be randomly allocated to receive either PreEMPT, a novel participation-focused early physiotherapy intervention delivered weekly for 14 forty-five-minute sessions alternating face-to-face sessions with telehealth into the infant’s home, or UPC, two - three physiotherapy sessions in the 4-month intervention period. Outcome measures relating to infant neuromotor development, motor performance, general development, and parental mental health and well-being will be assessed at 4-, 6- and 8-months corrected age. Feasibility will be evaluated by acceptability (parental satisfaction), demand and practicality (recruitment rate and telehealth session implementation), implementation (attendance at assessment and treatment sessions), and limited efficacy testing (comparing outcomes listed above for infants in PreEMPT and UPC). </span><b><span style="font-family:Verdana;">Discussion:</span></b><span style="font-family:Verdana;"> This study will be the first of its kind to use the participation of preterm infants in meaningful life situations as the foundation for intervention delivered via alternating face-to-face clinic sessions with telehealth into the home. The feasibility of this approach will be evaluated and used to inform future iterations of research about PreEMPT’s efficacy for improving preterm infant motor and participation outcomes.</span></span>
文摘Motor development at late preterm infants has significant importance as it composes the picture of the severe evidences of motor impairments or other developmental difficulties. Early detection is crucial as early intervention is the unique immediate solution option to catch up the developmental milestones. Method: Α systematic search for scientific articles of the decade 2010-2020 investigating the motor profile of late preterm infants was conducted. Results: The search identified 9 studies, many of which highlighted the risk of motor and developmental delays even at 36 months of age. Conclusions: The stability of motor and developmental delays indicates the need of further investigation at a later age and intervention to avoid possible academic difficulties.
