BACKGROUND For over half a century,the administration of maternal corticosteroids before anticipated preterm birth has been regarded as a cornerstone intervention for enhancing neonatal outcomes,particularly in preven...BACKGROUND For over half a century,the administration of maternal corticosteroids before anticipated preterm birth has been regarded as a cornerstone intervention for enhancing neonatal outcomes,particularly in preventing respiratory distress syndrome.Ongoing research on antenatal corticosteroids(ACS)is continuously refining the evidence regarding their efficacy and potential side effects,which may alter the application of this treatment.Recent findings indicate that in resource-limited settings,the effectiveness of ACS is contingent upon meeting specific conditions,including providing adequate medical support for preterm newborns.Future studies are expected to concentrate on developing evidence-based strategies to safely enhance ACS utilization in low-and middle-income countries.AIM To analyze the clinical effectiveness of antenatal corticosteroids in improving outcomes for preterm newborns in a tertiary care hospital setting in Kazakhstan,following current World Health Organization guidelines.METHODS This study employs a comparative retrospective cohort design to analyze single-center clinical data collected from January 2022 to February 2024.A total of 152 medical records of preterm newborns with gestational ages between 24 and 34 weeks were reviewed,focusing on the completeness of the ACS received.Quantitative variables are presented as means with standard deviations,while frequency analysis of qualitative indicators was performed using Pearson'sχ^(2) test(χ^(2))and Fisher's exact test.If statistical significance was identified,pairwise comparisons between the three observation groups were conducted using the Bonferroni correction.RESULTS The obtained data indicate that the complete implementation of antenatal steroid prophylaxis(ASP)improves neonatal outcomes,particularly by reducing the frequency of birth asphyxia(P=0.002),the need for primary resuscitation(P=0.002),the use of nasal continuous positive airway pressure(P=0.022),and the need for surfactant replacement therapy(P=0.038)compared to groups with incomplete or no ASP.Furthermore,complete ASP contributed to a decrease in morbidity among preterm newborns(e.g.,respiratory distress syndrome,intrauterine pneumonia,cerebral ischemia,bronchopulmonary dysplasia,etc.),improved Apgar scores,and reduced the need for re-intubation and the frequency of mechanical ventilation.However,it was associated with an increased incidence of uterine atony in postpartum women(P=0.0095).CONCLUSION In a tertiary hospital setting,the implementation of ACS therapy for pregnancies between 24 and 34 weeks of gestation at high risk for preterm birth significantly reduces the incidence of neonatal complications and related interventions.This,in turn,contributes to better outcomes for this cohort of children.However,the impact of ACS on maternal outcomes requires further thorough investigation.展开更多
Background: To examine the differences in prevalence of respiratory distress syndrome, early-onset sepsis and jaundice, between late preterm infants versus term infants in Ecuadorian newborns. Methods: Study design: E...Background: To examine the differences in prevalence of respiratory distress syndrome, early-onset sepsis and jaundice, between late preterm infants versus term infants in Ecuadorian newborns. Methods: Study design: Epidemiological, observational, and cross-sectional, with two cohorts of patients. Settings: IESS Quito Sur Hospital at Quito, Ecuador, from February to April of 2020. Participants: This study included 204 newborns, 102 preterm infants, 102 term infants. Results: There are significant differences between late preterm infants and term infants, with a p-value of 0.000 in the prevalence of early sepsis, 70.59% vs. 35.29%. In respiratory distress syndrome between late and term premature infants, significant differences were observed with a p-value of 0.000, the proportion being 55.58% vs. 24.51% respectively. The prevalence of jaundice is higher in term infants with a p value of 0.002, 72.55%, versus 51.96% in late preterm infants, and the mean value of bilirubins in mg/dL was higher in term infants 14.32 versus 12.33 in late preterm infants;this difference is statistically significant with a p value of 0.004. Admission to the NICU is more frequent in late preterm infants with a p-value of 0.000, being 42.16% for late preterm infants vs. 7.84% in term infants;the mean of the hospital days with p-value 0.005, was higher in late preterm infants 4.97 days vs. 3.55 days for term newborns. Conclusion: Due to the conditions of their immaturity, late preterm infants are 2.86 times more likely to present early sepsis than full-term newborns. It is shown that late preterm infants are 2.69 times more likely to have respiratory distress syndrome compared to term infants, therefore, late preterm infants have a longer hospital stay of 4.97 days versus 3.55 days in term infants. Jaundice and mean bilirubin levels are higher in term infants due to blood group incompatibility and insufficient breastfeeding.展开更多
Low birth weight（LBW） and preterm birth（PB） are associated with newborn mortality and diseases in adulthood.We explored factors related to LBW and PB by conducting a population-based case-control study from Januar...Low birth weight（LBW） and preterm birth（PB） are associated with newborn mortality and diseases in adulthood.We explored factors related to LBW and PB by conducting a population-based case-control study from January 2011 to December 2013 in Wuhan,China.A total of 337 LBW newborn babies,472 PB babies,and 708 babies with normal birth weights and born from term pregnancies were included in this study.Information of newborns and their parents was collected by trained investigators using questionnaires and referring to medical records.Univariate and logistic regression analyses with the stepwise selection method were used to determine the associations of related factors with LBW and PB.Results showed that maternal hypertension（OR=6.78,95% CI：2.27–20.29,P=0.001）,maternal high-risk pregnancy（OR=1.53,95% CI：1.06–2.21,P=0.022）,and maternal fruit intake ≥300 g per day during the first trimester（OR=1.70,95% CI：1.17–2.45,P=0.005） were associated with LBW.BMI ≥24 kg/m^2 of mother prior to delivery（OR=0.48,95% CI：0.32–0.74,P=0.001） and gestation ≥37 weeks（OR=0.01,95% CI：0.00–0.02,P〈0.034） were protective factors for LBW.Maternal hypertension（OR=3.36,95% CI：1.26–8.98,P=0.016）,maternal high-risk pregnancy（OR=4.38,95% CI：3.26–5.88,P〈0.001）,maternal meal intake of only twice per day（OR=1.88,95% CI：1.10–3.20,P=0.021）,and mother liking food with lots of aginomoto and salt（OR=1.60,95% CI：1.02–2.51,P=0.040） were risk factors for PB.BMI ≥24 kg/m^2 of mother prior to delivery（OR=0.66,95% CI：0.47–0.93,P=0.018）,distance of house from road ≥36 meters（OR=0.72,95% CI：0.53– 0.97,P=0.028）,and living in rural area（OR= 0.60,95% CI：0.37–0.99,P=0.047） were protective factors for PB.Our study demonstrated some risk factors and protective factors for LBW and PB,and provided valuable information for the prevention of the conditions among newborns.展开更多
Objective: To determine the usefulness of sonographic screening of the newborn kidneys and urinary tract over a 10-year time period. Methods: Ultrasound screening of the kidneys and the urinary tract was performed bet...Objective: To determine the usefulness of sonographic screening of the newborn kidneys and urinary tract over a 10-year time period. Methods: Ultrasound screening of the kidneys and the urinary tract was performed between the third and tenth day after birth on 11.887 newborn infants. The classification of renal pyelectasis (RPE) according to the Society for Fetal Urology (SFU) was used. We evaluated infant renal pathologies and correlated them with the gestational age and weight at birth. Results: Renal pyelectasis (grades 1-4) was detected in 179 cases (1.5%);it was significantly more common in male (vs female) infants (p 4.000 g were the most significant risk factors (p < 0.01). Conclusions: Renal pyelectasis grades 1-4 was detected in only 1.5% of 11.887 consecutive infants subjected to sonographic screening of the kidneys and the urinary tract within the first 10 days after birth. Sonographic screening of the kidneys and the urinary tract is a non-invasive and effective screening method after birth. It allows planning for appropriate diagnostic tests and therapeutic procedures in a timely fashion.展开更多
基金Supported by Non-profit Joint Stock Company“S.D.Asfendiyarov Kazakh National Medical University”,Almaty,Kazakhstan。
文摘BACKGROUND For over half a century,the administration of maternal corticosteroids before anticipated preterm birth has been regarded as a cornerstone intervention for enhancing neonatal outcomes,particularly in preventing respiratory distress syndrome.Ongoing research on antenatal corticosteroids(ACS)is continuously refining the evidence regarding their efficacy and potential side effects,which may alter the application of this treatment.Recent findings indicate that in resource-limited settings,the effectiveness of ACS is contingent upon meeting specific conditions,including providing adequate medical support for preterm newborns.Future studies are expected to concentrate on developing evidence-based strategies to safely enhance ACS utilization in low-and middle-income countries.AIM To analyze the clinical effectiveness of antenatal corticosteroids in improving outcomes for preterm newborns in a tertiary care hospital setting in Kazakhstan,following current World Health Organization guidelines.METHODS This study employs a comparative retrospective cohort design to analyze single-center clinical data collected from January 2022 to February 2024.A total of 152 medical records of preterm newborns with gestational ages between 24 and 34 weeks were reviewed,focusing on the completeness of the ACS received.Quantitative variables are presented as means with standard deviations,while frequency analysis of qualitative indicators was performed using Pearson'sχ^(2) test(χ^(2))and Fisher's exact test.If statistical significance was identified,pairwise comparisons between the three observation groups were conducted using the Bonferroni correction.RESULTS The obtained data indicate that the complete implementation of antenatal steroid prophylaxis(ASP)improves neonatal outcomes,particularly by reducing the frequency of birth asphyxia(P=0.002),the need for primary resuscitation(P=0.002),the use of nasal continuous positive airway pressure(P=0.022),and the need for surfactant replacement therapy(P=0.038)compared to groups with incomplete or no ASP.Furthermore,complete ASP contributed to a decrease in morbidity among preterm newborns(e.g.,respiratory distress syndrome,intrauterine pneumonia,cerebral ischemia,bronchopulmonary dysplasia,etc.),improved Apgar scores,and reduced the need for re-intubation and the frequency of mechanical ventilation.However,it was associated with an increased incidence of uterine atony in postpartum women(P=0.0095).CONCLUSION In a tertiary hospital setting,the implementation of ACS therapy for pregnancies between 24 and 34 weeks of gestation at high risk for preterm birth significantly reduces the incidence of neonatal complications and related interventions.This,in turn,contributes to better outcomes for this cohort of children.However,the impact of ACS on maternal outcomes requires further thorough investigation.
文摘Background: To examine the differences in prevalence of respiratory distress syndrome, early-onset sepsis and jaundice, between late preterm infants versus term infants in Ecuadorian newborns. Methods: Study design: Epidemiological, observational, and cross-sectional, with two cohorts of patients. Settings: IESS Quito Sur Hospital at Quito, Ecuador, from February to April of 2020. Participants: This study included 204 newborns, 102 preterm infants, 102 term infants. Results: There are significant differences between late preterm infants and term infants, with a p-value of 0.000 in the prevalence of early sepsis, 70.59% vs. 35.29%. In respiratory distress syndrome between late and term premature infants, significant differences were observed with a p-value of 0.000, the proportion being 55.58% vs. 24.51% respectively. The prevalence of jaundice is higher in term infants with a p value of 0.002, 72.55%, versus 51.96% in late preterm infants, and the mean value of bilirubins in mg/dL was higher in term infants 14.32 versus 12.33 in late preterm infants;this difference is statistically significant with a p value of 0.004. Admission to the NICU is more frequent in late preterm infants with a p-value of 0.000, being 42.16% for late preterm infants vs. 7.84% in term infants;the mean of the hospital days with p-value 0.005, was higher in late preterm infants 4.97 days vs. 3.55 days for term newborns. Conclusion: Due to the conditions of their immaturity, late preterm infants are 2.86 times more likely to present early sepsis than full-term newborns. It is shown that late preterm infants are 2.69 times more likely to have respiratory distress syndrome compared to term infants, therefore, late preterm infants have a longer hospital stay of 4.97 days versus 3.55 days in term infants. Jaundice and mean bilirubin levels are higher in term infants due to blood group incompatibility and insufficient breastfeeding.
基金supported by the National Natural Science Foundation of China(No.81573235)Health and Family Commission of Wuhan Municipality(No.WG15D20)Science and Technology Bureau of Wuhan Jiang-an District(No.2014111904)
文摘Low birth weight（LBW） and preterm birth（PB） are associated with newborn mortality and diseases in adulthood.We explored factors related to LBW and PB by conducting a population-based case-control study from January 2011 to December 2013 in Wuhan,China.A total of 337 LBW newborn babies,472 PB babies,and 708 babies with normal birth weights and born from term pregnancies were included in this study.Information of newborns and their parents was collected by trained investigators using questionnaires and referring to medical records.Univariate and logistic regression analyses with the stepwise selection method were used to determine the associations of related factors with LBW and PB.Results showed that maternal hypertension（OR=6.78,95% CI：2.27–20.29,P=0.001）,maternal high-risk pregnancy（OR=1.53,95% CI：1.06–2.21,P=0.022）,and maternal fruit intake ≥300 g per day during the first trimester（OR=1.70,95% CI：1.17–2.45,P=0.005） were associated with LBW.BMI ≥24 kg/m^2 of mother prior to delivery（OR=0.48,95% CI：0.32–0.74,P=0.001） and gestation ≥37 weeks（OR=0.01,95% CI：0.00–0.02,P〈0.034） were protective factors for LBW.Maternal hypertension（OR=3.36,95% CI：1.26–8.98,P=0.016）,maternal high-risk pregnancy（OR=4.38,95% CI：3.26–5.88,P〈0.001）,maternal meal intake of only twice per day（OR=1.88,95% CI：1.10–3.20,P=0.021）,and mother liking food with lots of aginomoto and salt（OR=1.60,95% CI：1.02–2.51,P=0.040） were risk factors for PB.BMI ≥24 kg/m^2 of mother prior to delivery（OR=0.66,95% CI：0.47–0.93,P=0.018）,distance of house from road ≥36 meters（OR=0.72,95% CI：0.53– 0.97,P=0.028）,and living in rural area（OR= 0.60,95% CI：0.37–0.99,P=0.047） were protective factors for PB.Our study demonstrated some risk factors and protective factors for LBW and PB,and provided valuable information for the prevention of the conditions among newborns.
文摘Objective: To determine the usefulness of sonographic screening of the newborn kidneys and urinary tract over a 10-year time period. Methods: Ultrasound screening of the kidneys and the urinary tract was performed between the third and tenth day after birth on 11.887 newborn infants. The classification of renal pyelectasis (RPE) according to the Society for Fetal Urology (SFU) was used. We evaluated infant renal pathologies and correlated them with the gestational age and weight at birth. Results: Renal pyelectasis (grades 1-4) was detected in 179 cases (1.5%);it was significantly more common in male (vs female) infants (p 4.000 g were the most significant risk factors (p < 0.01). Conclusions: Renal pyelectasis grades 1-4 was detected in only 1.5% of 11.887 consecutive infants subjected to sonographic screening of the kidneys and the urinary tract within the first 10 days after birth. Sonographic screening of the kidneys and the urinary tract is a non-invasive and effective screening method after birth. It allows planning for appropriate diagnostic tests and therapeutic procedures in a timely fashion.
