Dear Editor,Torpedo maculopathy(TM),first described by Roseman and Gass in 1992[1],is a rare congenital unilateral retinal pigment epithelium(RPE)abnormality.The term“torpedo maculopathy”was coined by Daily[2]in 199...Dear Editor,Torpedo maculopathy(TM),first described by Roseman and Gass in 1992[1],is a rare congenital unilateral retinal pigment epithelium(RPE)abnormality.The term“torpedo maculopathy”was coined by Daily[2]in 1993.TM typically spares the foveal center,is asymptomatic,and is often detected incidentally during routine ophthalmic examinations.Through literature search,we did not identify racial or regional differences in TM.It predominantly affects children,with an estimated prevalence of 2 per 100000 in individuals under 16 ages[3].While previous reports have focused on pediatric and adult populations,this study presents four cases of TM in preterm infants.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 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
Preterm and low birth weight infants are at higher risk of neurodevelopmental outcomes;breastfeeding offers sev-eral beneficial aspects for them.This study aimed to describe the average neurodevelopmental outcomes of p...Preterm and low birth weight infants are at higher risk of neurodevelopmental outcomes;breastfeeding offers sev-eral beneficial aspects for them.This study aimed to describe the average neurodevelopmental outcomes of pre-term infants and examine the associations between neurodevelopment and breastfeeding among Hungarian preterm infants at 12 months of corrected age.154 preterm infants with low birth weight(<2500 g)and their mothers were participated in this study.Bayley-III Screening Test(Bayley Scales of Infant and Toddler Develop-ment Screening Test,Third Edition)was administered to measure the cognitive,language and motor skills of infants;breastfeeding data was obtained through parental anamnesis.To analyze data,independent sample t-test or the Welch t-test,Mann-Whitney tests,Chi-square tests of independence and Spearman’s rank correlation test were used to.Concerning the risk of developmental delay,Receptive and Expressive language and Fine motor subscales were the lowest.Examination of the associations between breastfeeding and neurodevelopmental per-formance identified significantly higher cognitive(U=2047.5;P=0.023)andfine motor(U=2096.0;P=0.037)skills in infants who were breastfed.We found significant positive correlations between the duration of breastfeeding and cognitive,expressive language andfine motor skills.The study draws the attention to the importance of breastfeeding and early screening.Further research is required to examine the casual relationship between neurodevelopmental outcomes and breastfeeding.展开更多
Background:Persistent patent ductus arteriosus(pPDA)is a common condition in preterm infants.This metaanalysis aimed to assess the safety and efficacy of transcatheter closure(TC)when compared to surgical ligation(SL)...Background:Persistent patent ductus arteriosus(pPDA)is a common condition in preterm infants.This metaanalysis aimed to assess the safety and efficacy of transcatheter closure(TC)when compared to surgical ligation(SL)in preterm infants with pPDA.Methods:A literature search of Ovid Cochrane Library,Medline,Embase,Epub,Scopus,PMC Preprints,and ClinicalTrials.Gov was conducted from inception to May 06,2022.Eligible studies reported infants diagnosed with pPDA born at≤2000 g birth weight or at≤37 weeks’who underwent TC or SL as treatment.This review was registered in PROSPERO(CRD42022325944).Results:From 97 studies screened,8 studies met the eligibility criteria,with a total of 756 preterm infants undergoing either TC(n=366)or SL(n=390).Compared to TC,SL had higher mortality rates(OR=0.32,95%CI:0.16,0.66,I^(2)=0%).No difference was seen in post-procedural complication rate(OR=0.90,95%CI:0.18,4.44,I^(2)=79%),mean duration of post-procedural mechanical ventilation(MD=−2.21 days,95%CI:−4.88,0.47,I^(2)=60%),hospital stay length(MD=−8.30 days,95%CI:−17.03,0.44,I^(2)=0%)or neonatal intensive care unit stay length(MD=−3.50 days,95%CI:−10.27,3.27,I^(2)=0%).Conclusion:Our meta-analysis demonstrated TC as a viable alternative option in managing preterm infants with pPDA in the context of SL.Despite the promising trends demonstrated in this meta-analysis,further studies with larger sample size and controlled baseline characteristics are needed to evaluate the safety and efficacy of TC and SL for preterm infants with pPDA.展开更多
The provision of breast milk and breastfeeding is recommended for preterm infants.Multidisciplinary cooperation is required to promote breastfeeding.Nurses play impor tant roles in breastfeeding preterm infants.First,...The provision of breast milk and breastfeeding is recommended for preterm infants.Multidisciplinary cooperation is required to promote breastfeeding.Nurses play impor tant roles in breastfeeding preterm infants.First,nurses are strong advocates to help families be aware of the significance of breastfeeding.Second,nurses are educators providing technical and emotional support to pregnant and lying-in women.Third,nurses are coordinators in a multidisciplinary team.Nurses’unawareness of the impor tance of breastfeeding,knowledge deficit,and unsupportive lactation policy are barriers to breastfeeding promotion for preterm infants.It is therefore suggested that hospital administrators provide appropriate breastfeeding policies,set up posts,and ensure nurses’responsibilities in breastfeeding.Additionally,tailored training should be strengthened to improve nurses’knowledge and skills and thereby enable them to fully exer t their roles in the breastfeeding promotion of preterm infants.展开更多
<strong>Background:</strong> <span style="font-family:Verdana;">Sustained lung inflation (SLI) would permit lung recruitment immediately after birth, improving lung mechanics and reducing t...<strong>Background:</strong> <span style="font-family:Verdana;">Sustained lung inflation (SLI) would permit lung recruitment immediately after birth, improving lung mechanics and reducing the need for intubation and subsequent respiratory support in the neonatal intensive care unit among preterm infants.</span><span style="font-family:""> </span><b><span style="font-family:Verdana;">Aim of the Study:</span></b><span style="font-family:Verdana;"> To assess the ef</span><span style="font-family:Verdana;">fi</span><span style="font-family:Verdana;">cacy of initial sustained lung in</span><span style="font-family:Verdana;">fl</span><span style="font-family:Verdana;">ation compared to standard intermittent positive pressure ventilation</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">(IPPV) in preterm infants who need resuscitation in delivery room. </span><b><span style="font-family:Verdana;">Methods:</span></b></span><b><span style="font-family:""> </span></b><span style="font-family:Verdana;">This was prospective randomized observational study that was conducted in the delivery room and NICU of A</span><span style="font-family:""> </span><span style="font-family:Verdana;">in shames University hospital from February 2019 to September 2019. The study included 115 preterm infants between 26</span><span style="font-family:""> </span><span style="font-family:Verdana;">-</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">32 weeks of gestation who needed resuscitation at delivery room. The infants were randomly allocated into 2 groups;SLI group: included the preterm infants who received the SLI at initial inflation pressure of 25 cm H</span><sub><span style="font-family:Verdana;">2</span></sub><span style="font-family:Verdana;">O for 15 seconds using the Neopuff/T piece. IPPV group: preterm infants who received standard resuscitation;IPPV using the self-inflating bag. The heart rate (HR), oxygen saturation (SpO</span><sub><span style="font-family:Verdana;">2</span></sub><span style="font-family:Verdana;">), oxygen requirement, and intubation rate as well as need of surfactant in the delivery room were assessed. </span><span style="font-family:Verdana;">All cases were evaluated after admission to the NICU for the need of me</span><span style="font-family:Verdana;">chanical ventilation in the </span></span><span style="font-family:Verdana;">fi</span><span style="font-family:Verdana;">rst 72 hours of life, death in delivery room or NICU and for bronchopulmonary dysplasia or death at 36 weeks post menstrual age</span><span style="font-family:""> </span><span style="font-family:Verdana;">(PMA).</span><span style="font-family:""> </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> The percentage of preterm infants who needed resuscitation was 25.5% from the total deliveries during the study period.</span><span style="font-family:""> </span><span style="font-family:Verdana;">56.5% of them received SLI and 43.4% received conventional IPPV. There were no significant differences between the studied groups regarding gestational age, birth weight.</span><span style="font-family:""> </span><span style="font-family:Verdana;">Apgar score, heart rate,</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">oxygen saturation was not significantly in</span><span style="font-family:Verdana;">creased in the SLI group at fifth minutes of age. The percentage of infants</span><span style="font-family:Verdana;"> who </span><span style="font-family:Verdana;">needed further resuscitation was 20% in SLI group and 12% in the IPPV </span><span style="font-family:Verdana;">group. There were no significant differences in need for surfactant, CPAP or ventilator among the studied groups.</span></span><span style="font-family:""> </span><span style="font-family:Verdana;">There were no</span><span style="font-family:""> </span><span style="font-family:Verdana;">significant differences in relation to complications as BPD, air leak or retinopathy and death between the two groups.</span><span style="font-family:""> </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> This study showed that there was no advantage from use of SLI in delivery room using T-piece upon the conventional IPPV using self-inflating bag.</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
Objective There is a dilemma of ibuprofen treatment with patent ductus arteriosus(PDA)as to how and when to treat.We aimed to clarify this issue in very preterm infants(VPIs;<32 weeks).Methods:This retrospective st...Objective There is a dilemma of ibuprofen treatment with patent ductus arteriosus(PDA)as to how and when to treat.We aimed to clarify this issue in very preterm infants(VPIs;<32 weeks).Methods:This retrospective study included 1659 VPIs who were diagnosed with PDA according to echocardiographic examinations and cardiovascular dysfunction scoring system(the CVD scoring).The VPIs were classified into six groups(A1,A2,A3,B1,B2,and B3)based on CVD scores(A,<3,and B,≥3),and treatment with ibuprofen for PDA(1,conservational management;2,early ibuprofen treatment;and 3,late ibuprofen treatment).Treatment was stopped when PDA was closed,CVD score was zero or PDA needed ligation.Results:VPIs with CVD scores<3 had most PDA closure without surgery,and early ibuprofen treatment did not significantly affect PDA closure.VPIs with CVD scores≥3 had some PDA closure after 2 courses of treatment,but closure rates decreased linearly with ibuprofen course(1^(st)75.2%,2^(nd)62.3%,3^(rd)50.0%,P<0.0001),and early ibuprofen treatment(group B2)did not increase PDA closure compared to late ibuprofen treatment(group B3).In these same infants,the longer they were in CVD scores≥3,the more the complications of preterm were increased(retinopathy of prematurity ROP 1^(st)16.5%,2^(nd)23.8%,3^(rd)29.6%,P=0.016;bronchopulmonary dysplasia BPD 1^(st)15.5%,2^(nd)26.7%,3^(rd)33.8%,P<0.0001;intraventricular hemorrhage IVH 1^(st)20.4%,2^(nd)32.4%,3^(rd)23.8%,P=0.015).Conclusion:Ibuprofen is suggested for PDA closure when the PDA reopens or has developed into the stage when the CVD score≥3.展开更多
Objective: to study the effect of developmental care on feeding intolerant preterm infants. Methods: 74 cases of feeding intolerant preterm infants received in our hospital were included, all from March 2019 to Septem...Objective: to study the effect of developmental care on feeding intolerant preterm infants. Methods: 74 cases of feeding intolerant preterm infants received in our hospital were included, all from March 2019 to September 2021. According to the random number table, they were divided into the study group (37 cases, developmental care) and the control group (37 cases, routine care) to observe their nursing effects. Results: compared with the two groups, the children in the study group had shorter start time of swallowing and sucking, time to reach normal body mass, time to reach total intestinal nutrition, longer average daily sleep time, more self milk intake on the first day, the third day, the seventh day and the fourteenth day after starting self milk intake, higher head circumference, height and weight after two months of nursing, higher scores of GMQ, FMQ and TMQ in Peabody motor development scale after one month of nursing, and lower incidence of adverse reactions. The parents satisfaction with nursing was higher, and the comparison between groups was p 0.05. Conclusion: developmental nursing care for feeding intolerant preterm infants can help improve their health status and reduce the occurrence of adverse reactions. The application of this intervention method has been praised by many parents of children, and is more valuable than the conventional nursing mode in general.展开更多
Objective:To study the effective value of introducing the concept of early oral exercise in the process of nursing intervention for preterm infants in the neonatal intensive care unit(NICU).Methods:96 cases of preterm...Objective:To study the effective value of introducing the concept of early oral exercise in the process of nursing intervention for preterm infants in the neonatal intensive care unit(NICU).Methods:96 cases of preterm infants diagnosed from January 2022 to August 2022 were selected and randomly divided into two groups:the general practice group(general nursing intervention),and the early practice group(early oral exercise intervention),and the effect of intervention on preterm infants in the two groups was observed.Results:After nursing care,the mean value of the non-nutritive sucking ability assessment(76.54±5.82),the mean value of the intellectual development degree assessment(104.57±8.45),the mean value of the psychomotor development degree assessment(102.33±6.74),and the mean value of behavioral neural reflexes ability assessment(38.71±2.40)in the early practice group were better than that as compared to the general practice group(P<0.05);the mean value of oral feeding start time of preterm infants in the early practice group(35.42±7.63)weeks,the mean value of all oral feeding time(34.12±5.28)weeks,and the mean time of hospital intervention(15.33±4.25)days were lesser than compared to those of the general practice group at 37.4±5.82 weeks,37.46±3.55 weeks,and 20.46±2.91 days,respectively(P<0.05);the rate of adverse reactions in preterm infants in the early practice group significantly lower than that of the general practice group(P<0.05).Conclusion:The introduction of the concept of early oral exercise intervention among NICU nurses improved the feeding effect,sucking ability of preterm infants,and intellectual development.Hence,early oral motor care should be popularized.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
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
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
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
BACKGROUND Preterm birth is the leading cause of mortality in newborns,with very-low-birthweight infants usually experiencing several complications.Breast milk is considered the gold standard of nutrition,especially f...BACKGROUND Preterm birth is the leading cause of mortality in newborns,with very-low-birthweight infants usually experiencing several complications.Breast milk is considered the gold standard of nutrition,especially for preterm infants with delayed gut colonization,because it contains beneficial microorganisms,such as Lactobacilli and Bifidobacteria.AIM To analyze the gut microbiota of breastfed preterm infants with a birth weight of 1500 g or less.METHODS An observational study was performed on preterm infants with up to 36.6 wk of gestation and a birth weight of 1500 g or less,born at the University Hospital Dr.JoséEleuterio González at Monterrey,Mexico.A total of 40 preterm neonates were classified into breast milk feeding(BM)and mixed feeding(MF)groups(21 in the BM group and 19 in the MF group),from October 2017 to June 2019.Fecal samples were collected before they were introduced to any feeding type.After full enteral feeding was achieved,the composition of the gut microbiota was analyzed using 16S rRNA gene sequencing.Numerical variables were compared using Student’s t-test or using the Mann–Whitney U test for nonparametric variables.Dominance,evenness,equitability,Margalef’s index,Fisher’s alpha,Chao-1 index,and Shannon’s diversity index were also calculated.RESULTS No significant differences were observed at the genus level between the groups.Class comparison indicated higher counts of Alphaproteobacteria and Betaproteobacteria in the initial compared to the final sample of the BM group(P<0.011).In addition,higher counts of Gammaproteobacteria were detected in the final than in the initial sample(P=0.040).According to the Margalef index,Fisher’s alpha,and Chao-1 index,a decrease in species richness from the initial to the final sample,regardless of the feeding type,was observed(P<0.050).The four predominant phyla were Bacteroidetes,Actinobacteria,Firmicutes,and Proteobacteria,with Proteobacteria being the most abundant.However,no significant differences were observed between the initial and final samples at the phylum level.CONCLUSION Breastfeeding is associated with a decrease in Alphaproteobacteria and Betaproteobacteria and an increase of Gammaproteobacteria,contributing to the literature of the gut microbiota structure of very low-birth-weight,preterm.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
Premature infants, especially those born with less than 1500 g, often exhibit slow overall growth. Lack of early nutritional support is an important element. The present authors describe parenteral nutritional practic...Premature infants, especially those born with less than 1500 g, often exhibit slow overall growth. Lack of early nutritional support is an important element. The present authors describe parenteral nutritional practices in a tertiary hospital and evaluate postnatal growth of preterm infants under 32 weeks of gestational age or with a birth weight < 1500 g. For population study, we examined 431 newborn files. Their median gestational age was 29.7 weeks. Of them, 25.4% were small for gestational age (SGA). 77.5% received parenteral nutrition (PN), 54.5% of which was provided on the first day. The average time was 14.7 days. The average weight gain by the 30th day was 425 g. At discharge, 37% were rd month 20% had their weight under P3, decreasing to 10% by the 12th month. Children who initiated PN in the first 24 hours of life had significantly better weight on the 30th day of their life (p th month of corrected age (p = 0.038). And they had better Body Mass Index (BMI) in the 3rd (p = 0.012) and 12th (p = 0.023) months. Despite better feeding practices, there is still significant failure in post natal growth. Early introduction of PN was associated with an improved weight gain, which suggests that nutrition that included amino acids may be critical during the first 24 hours of life.展开更多
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 This study aimed to systematically review and meta-analyze the available literature on the association between preterm infant bronchopulmonary dysplasia(BPD)and pre-adulthood asthma.Methods Studies examinin...Background This study aimed to systematically review and meta-analyze the available literature on the association between preterm infant bronchopulmonary dysplasia(BPD)and pre-adulthood asthma.Methods Studies examining the association between BPD and asthma in children and adolescents were systematically reviewed,and a meta-analysis was conducted.We searched Scopus,Embase,Web of Science,PubMed,and Cochrane Library from the database inception to March 26,2022.The pooled odds ratio(OR)estimate was used in our meta-analysis to calculate the correlation between BPD and the probability of developing asthma before adulthood.Stata 12.0 was used to conduct the statistical analysis.Results The correlation between asthma and BPD in preterm newborns was examined in nine studies.We used a random effect model to pool the OR estimate.Our results indicated a marked increase in the risk of subsequent asthma in preterm infants with BPD[OR=1.73,95% confidence interval(CI)=1.43-2.09].Moreover,there was no obvious heterogeneity across the studies(P=0.617,I^(2)=0%).The pooled OR remained stable and ranged from 1.65(95%CI=1.35-2.01)to 1.78(95%CI=1.43-2.21).Regarding publication bias,the funnel plot for asthma risk did not reveal any noticeable asymmetry.We further performed Begg’s and Egger’s tests to quantitatively evaluate publication bias.There was no evidence of a publication bias for asthma risk(P>|Z|=0.602 for Begg’s test,and P>|t|=0.991 for Egger’s test).Conclusions Our findings indicate that preterm infants with BPD have a much higher risk of developing asthma in the future(OR=1.73,95%CI=1.43-2.09).Preterm infants with BPD may benefit from long-term follow-up.展开更多
基金Supported by the National Natural Science Foundation of China(No.82070991).
文摘Dear Editor,Torpedo maculopathy(TM),first described by Roseman and Gass in 1992[1],is a rare congenital unilateral retinal pigment epithelium(RPE)abnormality.The term“torpedo maculopathy”was coined by Daily[2]in 1993.TM typically spares the foveal center,is asymptomatic,and is often detected incidentally during routine ophthalmic examinations.Through literature search,we did not identify racial or regional differences in TM.It predominantly affects children,with an estimated prevalence of 2 per 100000 in individuals under 16 ages[3].While previous reports have focused on pediatric and adult populations,this study presents four cases of TM in preterm infants.
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Preterm and low birth weight infants are at higher risk of neurodevelopmental outcomes;breastfeeding offers sev-eral beneficial aspects for them.This study aimed to describe the average neurodevelopmental outcomes of pre-term infants and examine the associations between neurodevelopment and breastfeeding among Hungarian preterm infants at 12 months of corrected age.154 preterm infants with low birth weight(<2500 g)and their mothers were participated in this study.Bayley-III Screening Test(Bayley Scales of Infant and Toddler Develop-ment Screening Test,Third Edition)was administered to measure the cognitive,language and motor skills of infants;breastfeeding data was obtained through parental anamnesis.To analyze data,independent sample t-test or the Welch t-test,Mann-Whitney tests,Chi-square tests of independence and Spearman’s rank correlation test were used to.Concerning the risk of developmental delay,Receptive and Expressive language and Fine motor subscales were the lowest.Examination of the associations between breastfeeding and neurodevelopmental per-formance identified significantly higher cognitive(U=2047.5;P=0.023)andfine motor(U=2096.0;P=0.037)skills in infants who were breastfed.We found significant positive correlations between the duration of breastfeeding and cognitive,expressive language andfine motor skills.The study draws the attention to the importance of breastfeeding and early screening.Further research is required to examine the casual relationship between neurodevelopmental outcomes and breastfeeding.
文摘Background:Persistent patent ductus arteriosus(pPDA)is a common condition in preterm infants.This metaanalysis aimed to assess the safety and efficacy of transcatheter closure(TC)when compared to surgical ligation(SL)in preterm infants with pPDA.Methods:A literature search of Ovid Cochrane Library,Medline,Embase,Epub,Scopus,PMC Preprints,and ClinicalTrials.Gov was conducted from inception to May 06,2022.Eligible studies reported infants diagnosed with pPDA born at≤2000 g birth weight or at≤37 weeks’who underwent TC or SL as treatment.This review was registered in PROSPERO(CRD42022325944).Results:From 97 studies screened,8 studies met the eligibility criteria,with a total of 756 preterm infants undergoing either TC(n=366)or SL(n=390).Compared to TC,SL had higher mortality rates(OR=0.32,95%CI:0.16,0.66,I^(2)=0%).No difference was seen in post-procedural complication rate(OR=0.90,95%CI:0.18,4.44,I^(2)=79%),mean duration of post-procedural mechanical ventilation(MD=−2.21 days,95%CI:−4.88,0.47,I^(2)=60%),hospital stay length(MD=−8.30 days,95%CI:−17.03,0.44,I^(2)=0%)or neonatal intensive care unit stay length(MD=−3.50 days,95%CI:−10.27,3.27,I^(2)=0%).Conclusion:Our meta-analysis demonstrated TC as a viable alternative option in managing preterm infants with pPDA in the context of SL.Despite the promising trends demonstrated in this meta-analysis,further studies with larger sample size and controlled baseline characteristics are needed to evaluate the safety and efficacy of TC and SL for preterm infants with pPDA.
基金supported by Peking University Longtai Nursing Grant(No.LTHL19ZD01)。
文摘The provision of breast milk and breastfeeding is recommended for preterm infants.Multidisciplinary cooperation is required to promote breastfeeding.Nurses play impor tant roles in breastfeeding preterm infants.First,nurses are strong advocates to help families be aware of the significance of breastfeeding.Second,nurses are educators providing technical and emotional support to pregnant and lying-in women.Third,nurses are coordinators in a multidisciplinary team.Nurses’unawareness of the impor tance of breastfeeding,knowledge deficit,and unsupportive lactation policy are barriers to breastfeeding promotion for preterm infants.It is therefore suggested that hospital administrators provide appropriate breastfeeding policies,set up posts,and ensure nurses’responsibilities in breastfeeding.Additionally,tailored training should be strengthened to improve nurses’knowledge and skills and thereby enable them to fully exer t their roles in the breastfeeding promotion of preterm infants.
文摘<strong>Background:</strong> <span style="font-family:Verdana;">Sustained lung inflation (SLI) would permit lung recruitment immediately after birth, improving lung mechanics and reducing the need for intubation and subsequent respiratory support in the neonatal intensive care unit among preterm infants.</span><span style="font-family:""> </span><b><span style="font-family:Verdana;">Aim of the Study:</span></b><span style="font-family:Verdana;"> To assess the ef</span><span style="font-family:Verdana;">fi</span><span style="font-family:Verdana;">cacy of initial sustained lung in</span><span style="font-family:Verdana;">fl</span><span style="font-family:Verdana;">ation compared to standard intermittent positive pressure ventilation</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">(IPPV) in preterm infants who need resuscitation in delivery room. </span><b><span style="font-family:Verdana;">Methods:</span></b></span><b><span style="font-family:""> </span></b><span style="font-family:Verdana;">This was prospective randomized observational study that was conducted in the delivery room and NICU of A</span><span style="font-family:""> </span><span style="font-family:Verdana;">in shames University hospital from February 2019 to September 2019. The study included 115 preterm infants between 26</span><span style="font-family:""> </span><span style="font-family:Verdana;">-</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">32 weeks of gestation who needed resuscitation at delivery room. The infants were randomly allocated into 2 groups;SLI group: included the preterm infants who received the SLI at initial inflation pressure of 25 cm H</span><sub><span style="font-family:Verdana;">2</span></sub><span style="font-family:Verdana;">O for 15 seconds using the Neopuff/T piece. IPPV group: preterm infants who received standard resuscitation;IPPV using the self-inflating bag. The heart rate (HR), oxygen saturation (SpO</span><sub><span style="font-family:Verdana;">2</span></sub><span style="font-family:Verdana;">), oxygen requirement, and intubation rate as well as need of surfactant in the delivery room were assessed. </span><span style="font-family:Verdana;">All cases were evaluated after admission to the NICU for the need of me</span><span style="font-family:Verdana;">chanical ventilation in the </span></span><span style="font-family:Verdana;">fi</span><span style="font-family:Verdana;">rst 72 hours of life, death in delivery room or NICU and for bronchopulmonary dysplasia or death at 36 weeks post menstrual age</span><span style="font-family:""> </span><span style="font-family:Verdana;">(PMA).</span><span style="font-family:""> </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> The percentage of preterm infants who needed resuscitation was 25.5% from the total deliveries during the study period.</span><span style="font-family:""> </span><span style="font-family:Verdana;">56.5% of them received SLI and 43.4% received conventional IPPV. There were no significant differences between the studied groups regarding gestational age, birth weight.</span><span style="font-family:""> </span><span style="font-family:Verdana;">Apgar score, heart rate,</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">oxygen saturation was not significantly in</span><span style="font-family:Verdana;">creased in the SLI group at fifth minutes of age. The percentage of infants</span><span style="font-family:Verdana;"> who </span><span style="font-family:Verdana;">needed further resuscitation was 20% in SLI group and 12% in the IPPV </span><span style="font-family:Verdana;">group. There were no significant differences in need for surfactant, CPAP or ventilator among the studied groups.</span></span><span style="font-family:""> </span><span style="font-family:Verdana;">There were no</span><span style="font-family:""> </span><span style="font-family:Verdana;">significant differences in relation to complications as BPD, air leak or retinopathy and death between the two groups.</span><span style="font-family:""> </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> This study showed that there was no advantage from use of SLI in delivery room using T-piece upon the conventional IPPV using self-inflating bag.</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.
文摘Objective There is a dilemma of ibuprofen treatment with patent ductus arteriosus(PDA)as to how and when to treat.We aimed to clarify this issue in very preterm infants(VPIs;<32 weeks).Methods:This retrospective study included 1659 VPIs who were diagnosed with PDA according to echocardiographic examinations and cardiovascular dysfunction scoring system(the CVD scoring).The VPIs were classified into six groups(A1,A2,A3,B1,B2,and B3)based on CVD scores(A,<3,and B,≥3),and treatment with ibuprofen for PDA(1,conservational management;2,early ibuprofen treatment;and 3,late ibuprofen treatment).Treatment was stopped when PDA was closed,CVD score was zero or PDA needed ligation.Results:VPIs with CVD scores<3 had most PDA closure without surgery,and early ibuprofen treatment did not significantly affect PDA closure.VPIs with CVD scores≥3 had some PDA closure after 2 courses of treatment,but closure rates decreased linearly with ibuprofen course(1^(st)75.2%,2^(nd)62.3%,3^(rd)50.0%,P<0.0001),and early ibuprofen treatment(group B2)did not increase PDA closure compared to late ibuprofen treatment(group B3).In these same infants,the longer they were in CVD scores≥3,the more the complications of preterm were increased(retinopathy of prematurity ROP 1^(st)16.5%,2^(nd)23.8%,3^(rd)29.6%,P=0.016;bronchopulmonary dysplasia BPD 1^(st)15.5%,2^(nd)26.7%,3^(rd)33.8%,P<0.0001;intraventricular hemorrhage IVH 1^(st)20.4%,2^(nd)32.4%,3^(rd)23.8%,P=0.015).Conclusion:Ibuprofen is suggested for PDA closure when the PDA reopens or has developed into the stage when the CVD score≥3.
文摘Objective: to study the effect of developmental care on feeding intolerant preterm infants. Methods: 74 cases of feeding intolerant preterm infants received in our hospital were included, all from March 2019 to September 2021. According to the random number table, they were divided into the study group (37 cases, developmental care) and the control group (37 cases, routine care) to observe their nursing effects. Results: compared with the two groups, the children in the study group had shorter start time of swallowing and sucking, time to reach normal body mass, time to reach total intestinal nutrition, longer average daily sleep time, more self milk intake on the first day, the third day, the seventh day and the fourteenth day after starting self milk intake, higher head circumference, height and weight after two months of nursing, higher scores of GMQ, FMQ and TMQ in Peabody motor development scale after one month of nursing, and lower incidence of adverse reactions. The parents satisfaction with nursing was higher, and the comparison between groups was p 0.05. Conclusion: developmental nursing care for feeding intolerant preterm infants can help improve their health status and reduce the occurrence of adverse reactions. The application of this intervention method has been praised by many parents of children, and is more valuable than the conventional nursing mode in general.
文摘Objective:To study the effective value of introducing the concept of early oral exercise in the process of nursing intervention for preterm infants in the neonatal intensive care unit(NICU).Methods:96 cases of preterm infants diagnosed from January 2022 to August 2022 were selected and randomly divided into two groups:the general practice group(general nursing intervention),and the early practice group(early oral exercise intervention),and the effect of intervention on preterm infants in the two groups was observed.Results:After nursing care,the mean value of the non-nutritive sucking ability assessment(76.54±5.82),the mean value of the intellectual development degree assessment(104.57±8.45),the mean value of the psychomotor development degree assessment(102.33±6.74),and the mean value of behavioral neural reflexes ability assessment(38.71±2.40)in the early practice group were better than that as compared to the general practice group(P<0.05);the mean value of oral feeding start time of preterm infants in the early practice group(35.42±7.63)weeks,the mean value of all oral feeding time(34.12±5.28)weeks,and the mean time of hospital intervention(15.33±4.25)days were lesser than compared to those of the general practice group at 37.4±5.82 weeks,37.46±3.55 weeks,and 20.46±2.91 days,respectively(P<0.05);the rate of adverse reactions in preterm infants in the early practice group significantly lower than that of the general practice group(P<0.05).Conclusion:The introduction of the concept of early oral exercise intervention among NICU nurses improved the feeding effect,sucking ability of preterm infants,and intellectual development.Hence,early oral motor care should be popularized.
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）.
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BACKGROUND Preterm birth is the leading cause of mortality in newborns,with very-low-birthweight infants usually experiencing several complications.Breast milk is considered the gold standard of nutrition,especially for preterm infants with delayed gut colonization,because it contains beneficial microorganisms,such as Lactobacilli and Bifidobacteria.AIM To analyze the gut microbiota of breastfed preterm infants with a birth weight of 1500 g or less.METHODS An observational study was performed on preterm infants with up to 36.6 wk of gestation and a birth weight of 1500 g or less,born at the University Hospital Dr.JoséEleuterio González at Monterrey,Mexico.A total of 40 preterm neonates were classified into breast milk feeding(BM)and mixed feeding(MF)groups(21 in the BM group and 19 in the MF group),from October 2017 to June 2019.Fecal samples were collected before they were introduced to any feeding type.After full enteral feeding was achieved,the composition of the gut microbiota was analyzed using 16S rRNA gene sequencing.Numerical variables were compared using Student’s t-test or using the Mann–Whitney U test for nonparametric variables.Dominance,evenness,equitability,Margalef’s index,Fisher’s alpha,Chao-1 index,and Shannon’s diversity index were also calculated.RESULTS No significant differences were observed at the genus level between the groups.Class comparison indicated higher counts of Alphaproteobacteria and Betaproteobacteria in the initial compared to the final sample of the BM group(P<0.011).In addition,higher counts of Gammaproteobacteria were detected in the final than in the initial sample(P=0.040).According to the Margalef index,Fisher’s alpha,and Chao-1 index,a decrease in species richness from the initial to the final sample,regardless of the feeding type,was observed(P<0.050).The four predominant phyla were Bacteroidetes,Actinobacteria,Firmicutes,and Proteobacteria,with Proteobacteria being the most abundant.However,no significant differences were observed between the initial and final samples at the phylum level.CONCLUSION Breastfeeding is associated with a decrease in Alphaproteobacteria and Betaproteobacteria and an increase of Gammaproteobacteria,contributing to the literature of the gut microbiota structure of very low-birth-weight,preterm.
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.
文摘Premature infants, especially those born with less than 1500 g, often exhibit slow overall growth. Lack of early nutritional support is an important element. The present authors describe parenteral nutritional practices in a tertiary hospital and evaluate postnatal growth of preterm infants under 32 weeks of gestational age or with a birth weight < 1500 g. For population study, we examined 431 newborn files. Their median gestational age was 29.7 weeks. Of them, 25.4% were small for gestational age (SGA). 77.5% received parenteral nutrition (PN), 54.5% of which was provided on the first day. The average time was 14.7 days. The average weight gain by the 30th day was 425 g. At discharge, 37% were rd month 20% had their weight under P3, decreasing to 10% by the 12th month. Children who initiated PN in the first 24 hours of life had significantly better weight on the 30th day of their life (p th month of corrected age (p = 0.038). And they had better Body Mass Index (BMI) in the 3rd (p = 0.012) and 12th (p = 0.023) months. Despite better feeding practices, there is still significant failure in post natal growth. Early introduction of PN was associated with an improved weight gain, which suggests that nutrition that included amino acids may be critical during the first 24 hours of life.
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the funding of Key R&D Guidance Plan Projects in Liaoning Province(2020JH1/10300001).
文摘Background This study aimed to systematically review and meta-analyze the available literature on the association between preterm infant bronchopulmonary dysplasia(BPD)and pre-adulthood asthma.Methods Studies examining the association between BPD and asthma in children and adolescents were systematically reviewed,and a meta-analysis was conducted.We searched Scopus,Embase,Web of Science,PubMed,and Cochrane Library from the database inception to March 26,2022.The pooled odds ratio(OR)estimate was used in our meta-analysis to calculate the correlation between BPD and the probability of developing asthma before adulthood.Stata 12.0 was used to conduct the statistical analysis.Results The correlation between asthma and BPD in preterm newborns was examined in nine studies.We used a random effect model to pool the OR estimate.Our results indicated a marked increase in the risk of subsequent asthma in preterm infants with BPD[OR=1.73,95% confidence interval(CI)=1.43-2.09].Moreover,there was no obvious heterogeneity across the studies(P=0.617,I^(2)=0%).The pooled OR remained stable and ranged from 1.65(95%CI=1.35-2.01)to 1.78(95%CI=1.43-2.21).Regarding publication bias,the funnel plot for asthma risk did not reveal any noticeable asymmetry.We further performed Begg’s and Egger’s tests to quantitatively evaluate publication bias.There was no evidence of a publication bias for asthma risk(P>|Z|=0.602 for Begg’s test,and P>|t|=0.991 for Egger’s test).Conclusions Our findings indicate that preterm infants with BPD have a much higher risk of developing asthma in the future(OR=1.73,95%CI=1.43-2.09).Preterm infants with BPD may benefit from long-term follow-up.
