Objective:To explore the positive role of developmental care measures in promoting the growth and development of premature infants,and analyze their specific effects on improving the sleep duration and quality of prem...Objective:To explore the positive role of developmental care measures in promoting the growth and development of premature infants,and analyze their specific effects on improving the sleep duration and quality of premature infants.Methods:A total of 80 premature infants who met the inclusion criteria were selected by convenient sampling method and divided into an experimental group and a control group,with 40 cases in each group.The experimental group received comprehensive nursing intervention of developmental care during the nursing process;the control group adopted the traditional conventional nursing model.Results:There was no statistically significant difference in various physical indicators between the two groups of premature infants before nursing intervention.After nursing intervention,the scores of intellectual development level,psychomotor development index and various physical indicators of premature infants in the experimental group were significantly higher than those in the control group,and the difference was statistically significant.Conclusion:The implementation of developmental care for premature infants can significantly improve their various developmental indicators,which can not only effectively promote the rapid development of premature infants’mental and physical growth,but also improve their sleep quality.展开更多
BACKGROUND Cow's milk allergy(CMA)is a common condition in infants,requiring alternative protein sources in their diets.Soya milk has become a popular substitute,especially in developing countries where it is a mo...BACKGROUND Cow's milk allergy(CMA)is a common condition in infants,requiring alternative protein sources in their diets.Soya milk has become a popular substitute,especially in developing countries where it is a more affordable option compared to expensive hypoallergenic feeds for infants with insufficient breast milk supply.However,recent observations have shown an increase in soya cross-allergic reactions among infants with CMA.AIM To determine how often infants diagnosed with CMA also had soya cross-allergy and to examine the symptoms and outcomes of these infants at 2 years of age.METHODS Data from two pediatric centers were analyzed,looking at clinical records of children under 2 years old diagnosed with CMA from August 2015 to July 2023,divided into two four-year periods.RESULTS The records of 432 infants with CMA were analyzed.In the first four-year period from August 2015 to July 2019,142 infants were studied,with 27(19%)found to have soya-protein allergy as well.In the second four-year period,a total of 290 infants were studied,and soya allergy was found in 136 babies(47%).This represents a significant increase(P<0.0001)in cases of soya protein cross-allergy among infants with CMA.The most common symptoms observed were gastroesophageal reflux disorder(39%),followed by failure to thrive,bloody diarrhea,watery diarrhea,and constipation.At 2 years of age,these infants showed significant growth failure compared to infants with CMA only.CONCLUSION In conclusion,this study emphasizes the importance of being cautious when using soy protein in infants with cow's milk protein allergy,especially in areas where cost is a major concern.展开更多
The aim of this study is to analyze factors influencing the development of bronchopulmonary dysplasia(BPD)within 28 d after birth in very-low-birth-weight(VLBW)infants with a gestational age of less than 34 weeks who ...The aim of this study is to analyze factors influencing the development of bronchopulmonary dysplasia(BPD)within 28 d after birth in very-low-birth-weight(VLBW)infants with a gestational age of less than 34 weeks who were receiving early parenteral nutrition.Data were retrospectively collected from infants born between January and December 2021,who were admitted to the neonatal intensive care unit within 24 h of birth,had a gestational age of less than 34 weeks,and were classified as VLBW.The study included 14 cases without BPD and 20 cases with BPD,and it compared clinical data during hospitalization between these two groups.On the 1st day of life,the BPD group had a nitrogen-to-calorie ratio of 105.44±26.67,while the non-BPD group had a ratio of 146.81±37.04.This difference was statistically significant,with a P-value of 0.04,indicating a potential association between the nitrogen-to-calorie ratio and the development of BPD.However,no significant differences were observed in other clinical indicators between the two groups.These findings suggested that a larger sample size was needed to further explore and confirm the correlation between the nitrogen-to-calorie ratio and the risk of developing BPD in this population.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 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
High-risk infants,from fetal stage to 3-year-old,face severe physical and mental development threats due to biological,psychological,or environmental factors.These threats can lead to developmental delay and cognitive...High-risk infants,from fetal stage to 3-year-old,face severe physical and mental development threats due to biological,psychological,or environmental factors.These threats can lead to developmental delay and cognitive impairment,affecting their future quality of life and social integration.Scientific health management,with nutritional intervention as a key part,is urgently needed.Nutritional intervention,through targeted supplementation and feeding guidance,can optimize their development,avoid nutritional-related deviations,reduce long-term disease risk,and lay a healthy growth foundation.This study analyzes the positive effects of nutritional intervention on high-risk infants’physical growth,neural development,and disease prevention,providing scientific evidence for optimizing clinical follow-up strategies.展开更多
Objective:To understand the current status and influencing factors of family caregiving for infants and toddlers aged 6–36 months in Tianhe District,Guangzhou City,with the aim of better comprehending the physiologic...Objective:To understand the current status and influencing factors of family caregiving for infants and toddlers aged 6–36 months in Tianhe District,Guangzhou City,with the aim of better comprehending the physiological and psychological needs of infants and toddlers,and assisting families in developing effective intervention measures and support strategies.Methods:In November 2024,a random sample of 311 infants and toddlers aged 6–36 months from the permanent resident population in Tianhe District,Guangzhou City,was selected.Caregivers were surveyed using a questionnaire regarding family caregiving practices for infants and toddlers.The Kruskal-Wallis’s test,Mann-Whitney test,and multiple linear regression analysis were employed to examine the influencing factors of family caregiving for infants and toddlers.Results:The findings indicate that the quality of family caregiving is significantly influenced by the educational level of the parents(p<0.001)and the annual household income(p<0.001).Work-family conflict showed a significant negative correlation with the quality of family caregiving(β=-0.239,p<0.001),while family atmosphere demonstrated a significant positive correlation with the quality of family caregiving(β=0.225,p<0.001).Conclusion:In Tianhe District,Guangzhou City,the quality of infant and toddler caregiving is determined by a combination of key factors,including annual household income,parental educational background,work-family conflict,and family atmosphere.These elements collectively form the core determinants of caregiving practices for infants and toddlers.展开更多
BACKGROUND To prevent mother to child transmission(MTCT)of human immunodeficiency virus(HIV),sustained maternal viral load suppression(VLS)and early HIV testing among HIV exposed infants(HEI)is critical.AIM To investi...BACKGROUND To prevent mother to child transmission(MTCT)of human immunodeficiency virus(HIV),sustained maternal viral load suppression(VLS)and early HIV testing among HIV exposed infants(HEI)is critical.AIM To investigate maternal viral load results and infant HIV testing uptake at 6-weeks,and 9-months and 18-months in Rwanda.METHODS Between 2015 and 2022,VLS(<200 copies/mL)was measured among pregnant women living with HIV(WLHIV)from 38-healthcare facilities.Viral loads(VL)were measured at 6-months,12-months and 24-months,respectively.For maternal VL,the unit of analysis was visit-pair,and the pairs were created to define those with VL<200 copies/mL at two consecutive visits as having sustained VLS,persistent viremia(VL≥200 copies/mL at two consecutive visits),viral rebound(VL<200 copies/mL at prior visit only)and newly suppressed(VL<200 copies/mL at subsequent visit only).HEI were considered to have persistent HIV testing if they had all three HIV tests.Poisson regression models with generalized estimating equations were used to estimate the adjusted incidence rate ratio(aIRR)and 95%CI for factors associated with sustained VLS and persistent HIV testing.RESULTS A total of 1145 mother-infant pairs were analyzed.Infant HIV testing uptake at 6-weeks,9-months and 18-months was 1145(100.0%),1089(95.1%),1006(87.9%)respectively.Nine hundred ninety-nine HEI(87.3%)tested for HIV persistently.At 18-months,the incidence of HIV among HEI was 8(0.7%).Of 1145 mothers,1076(94.0%)had≥2 VL results making a total of 2010 visit-pairs(142-single;934-double visit-pairs).The incidence rate of sustained VLS,persistent viremia,viral rebound and new suppression were 91.0%,1.3%,3.6%and 4.0%respectively.Maternal disclosure of HIV status(aIRR=1.08,95%CI:1.02-1.14)was associated with increased likelihood of sustained VLS.Having peer support(aIRR=1.0595%CI:1.01-1.10)was associated with persistent HIV testing among HEI.CONCLUSION Sustained VLS is high among pregnant WLHIV in Rwanda.The low incidence of HIV among HEI may be attributed to high VLS levels.Targeted interventions,including enhanced HIV disclosure and peer support,are crucial for improving sustained VLS and increasing infant HIV testing uptake to reduce MTCT.展开更多
Objective:To explore the application effect of improved“Bird’s nest”nursing in the transport of premature infants.Methods:Collecting 100 cases of premature infants,randomly divided into experimental group and contr...Objective:To explore the application effect of improved“Bird’s nest”nursing in the transport of premature infants.Methods:Collecting 100 cases of premature infants,randomly divided into experimental group and control group,two groups of premature 50 cases each.The control group received the traditional“Bird’s nest”nursing.Experimental group in modified the“bird’s nest”nursing intervention,compared two groups of premature monitoring vital signs during the transfer process,transport after the body development indicators,the time and cure warmers intervention.Results:Compared with control group,experimental group premature temperature fluctuation is small,apnea and fewer times of low body temperature and oxygen saturation is higher,the contrast results with statistical significance(P<0.05).There was no significant difference in physical development,time to get out of the incubator,and cure rate.Conclusion:Modified the“bird’s nest”care in outside the hospital application,help to improve premature transfer process safety,and security for premature success implementation of transshipment is of great significance.展开更多
Background: Malnutrition, a serious public health concern, is influenced by various factors. Objective: The study aims to explore malnutrition issues among infants under five years old in Guéra Province. Methods:...Background: Malnutrition, a serious public health concern, is influenced by various factors. Objective: The study aims to explore malnutrition issues among infants under five years old in Guéra Province. Methods: The study used a cross-sectional design and a two-stage cluster sampling method to select participants. The study population was infants aged between 0 - 24 months. Data collection was done between June 2023 and September 2024;it included anthropometric measurements, blood analyses, and interviews. Anthropometric parameters were calculated using ENA for SMART software. Statistical analyses were performed by R Studio to investigate associations between different characteristics, using logistic regression models to identify risk factors. A p-value less than 0.05 was considered significant. Results: The study included 377 infants in eight villages in Guéra Province, Chad. The sample was predominantly girls (55.3%), with a median age of 16 months. Most infants (94%) were mixed-fed, and only 6% were exclusively breastfed. We found that 7.3% of children were globally malnourished, with higher rates in boys 9.6%. A significant disparity existed between boys and girls in global acute malnutrition (GAM) rates, with boys having a higher prevalence of 17.9%. A substantial proportion of Infants were underweight, with males 27.4%. Stunting was prevalent 20.1%. Several factors were associated with malnutrition, including gender, feeding practices, infectious diseases, and socioeconomic factors. Diarrhea, malaria, limited access to drinking water, and early diet diversification were significantly associated with malnutrition. Conclusion: Targeted interventions are necessary to address these issues and improve the nutritional status of children in the Guéra province.展开更多
Immunoprophylaxis is routinely recommended for infants born to mothers with hepatitis B virus(HBV)infection within the first 12-24 hours.Detection of he-patitis B surface antibody(HBsAb)resulting from hepatitis B immu...Immunoprophylaxis is routinely recommended for infants born to mothers with hepatitis B virus(HBV)infection within the first 12-24 hours.Detection of he-patitis B surface antibody(HBsAb)resulting from hepatitis B immunoglobulin administered at birth may be perceived as a real vaccine response.This makes it difficult to detect HBV infection.For this reason,it is recommended that infants born to hepatitis B surface antigen positive mothers and who received immunop-rophylaxis at birth should have HBsAb testing when they are 9-15 months old.展开更多
BACKGROUND Enhanced recovery after surgery(ERAS)represents an innovative,protocoldriven perioperative care program designed to optimize patient outcomes.However,its application and efficacy in infants and children wit...BACKGROUND Enhanced recovery after surgery(ERAS)represents an innovative,protocoldriven perioperative care program designed to optimize patient outcomes.However,its application and efficacy in infants and children with Hirschsprung disease(HD)remain underexplored.AIM To delve into the impact of ERAS on perioperative recovery and the overall medical experience in HD infants and children.METHODS Thirty-eight infants and children with HD who received the Soave surgical procedure were enrolled in this case-control study.According to age-and sexstratified single-blind randomized tables,20 cases received ERAS treatment(ERAS group)and 18 cases received conventional treatment(control group).The two treatments were then compared in terms of perioperative recovery and medical experience.RESULTS Significant differences were observed in pain scores at awakening(4.2±1.3 vs 5.2±1.2,t=2.516,P=0.017)and pain duration(85.69±7.46 hours vs 67.00±8.56 hours,t=7.139,P<0.001)between the ERAS and control group.The recovery of bowel movement was earlier in the ERAS group than in the control group(borborygmus time:33.63±9.83 hours vs 44.69±16.85 hours,t=2.501,P=0.017;feeding time:36.63±9.55 hours vs 49.36±16.99 hours,t=2.884,P=0.007;anal catheter indwelling time:75.83±13.80 hours vs 93.36±20.65 hours,t=3.104,P=0.004),and fever duration(40.73±14.42 hours vs 52.63±18.69 hours,t=2.211,P=0.034).In the ERAS group,hospital stay was shorter(7.5±0.9 days vs 8.3±1.2 days)and the cost was lower(14203±2381 yuan vs 16847±3558 yuan).During the 1-month follow-up period,of the multiple postoperative complications observed,the occurrence of perianal dermatitis(PFisher=0.016)and defecation dysfunction(PFisher=0.027)were lower in the ERAS group than in the control group.CONCLUSION The ERAS protocol has the potential to profoundly enhance postoperative recovery and significantly elevate the overall comfort and quality of the medical experience,making it an indispensable approach that warrants widespread adoption.Continuous refinement through evidence-based practices is anticipated to further optimize its efficacy.展开更多
BACKGROUND The primary complication associated with gestational diabetes mellitus(GDM)is delivery of an infant that is large for gestational age(LGA).Epidemiological findings have demonstrated that irregular lipid met...BACKGROUND The primary complication associated with gestational diabetes mellitus(GDM)is delivery of an infant that is large for gestational age(LGA).Epidemiological findings have demonstrated that irregular lipid metabolism significantly con-tributes to insulin resistance,a key pathophysiological mechanism in GDM.However,the correlation between various lipid indices and the probability of delivering LGA infants remains inconsistent.AIM To explore the relationships between lipid indices and the possibility of having LGA infants among GDM-affected pregnant females.METHODS Binary logistic regression methods were employed to evaluate the odds ratios and corresponding 95%confidence intervals for LGA according to five lipid indices.Restricted cubic spline models were applied to investigate dose-response relationships.The association between lipid indices and the risk of delivering LGA infants was further investigated among different subgroups.Receiver operating characteristic curves were utilized to assess the diagnostic performance of lipid indices.RESULTS Across crude and adjusted models,females with lipid indices in the upper two tertiles presented a markedly elevated risk of delivering LGA infants compared with the lowest tertile category.Conversely,high-density lipoprotein cholesterol levels demonstrated the contrary trend.Restricted cubic spline analyses revealed linear associations between the five lipid indices,except triglyceride levels,and the prevalence of LGA.The subgroup analysis highlighted that the correlation between lipid indices and the probability of LGA was inconsistent.The five lipid indices presented significant diagnostic efficacy,as indicated by receiver operating characteristic curve areas.CONCLUSION Our research demonstrated that lipid indices were effective predictors of the incidence of LGA infants in GDM-affected pregnancies irrespective of potential confounding factors.展开更多
BACKGROUND Being too light at birth can increase the risk of various diseases during infancy.AIM To explore the effect of perinatal factors on term low-birth-weight(LBW)infants and build a predictive model.This model ...BACKGROUND Being too light at birth can increase the risk of various diseases during infancy.AIM To explore the effect of perinatal factors on term low-birth-weight(LBW)infants and build a predictive model.This model aims to guide the clinical management of pregnant women’s healthcare during pregnancy and support the healthy growth of newborns.METHODS A retrospective analysis was conducted on data from 1794 single full-term pregnant women who gave birth.Newborns were grouped based on birth weight:Those with birth weight<2.5 kg were classified as the low-weight group,and those with birth weight between 2.5 kg and 4 kg were included in the normal group.Multiple logistic regression analysis was used to identify the factors influencing the occurrence of full-term LBW.A risk prediction model was established based on the analysis results.The effectiveness of the model was analyzed using the Hosmer–Leme show test and receiver operating characteristic(ROC)curve to verify the accuracy of the predictions.RESULTS Among the 1794 pregnant women,there were 62 cases of neonatal weight<2.5 kg,resulting in an LBW incidence rate of 3.46%.The factors influencing full-term LBW included low maternal education level[odds ratio(OR)=1.416],fewer prenatal examinations(OR=2.907),insufficient weight gain during pregnancy(OR=3.695),irregular calcium supplementation during pregnancy(OR=1.756),and pregnancy hypertension syndrome(OR=2.192).The prediction model equation was obtained as follows:Logit(P)=0.348×maternal education level+1.067×number of prenatal examinations+1.307×insufficient weight gain during pregnancy+0.563×irregular calcium supplementation during pregnancy+0.785×pregnancy hypertension syndrome−29.164.The area under the ROC curve for this model was 0.853,with a sensitivity of 0.852 and a specificity of 0.821.The Hosmer–Leme show test yieldedχ^(2)=2.185,P=0.449,indicating a good fit.The overall accuracy of the clinical validation model was 81.67%.CONCLUSION The occurrence of full-term LBW is related to maternal education,the number of prenatal examinations,weight gain during pregnancy,calcium supplementation during pregnancy,and pregnancy-induced hypertension.The constructed predictive model can effectively predict the risk of full-term LBW.展开更多
BACKGROUND In endemic areas,vertical transmission of hepatitis B virus(HBV)remains a major source of the global reservoir of infected people.Eliminating mother-to-child transmission(MTCT)of HBV is at the heart of Worl...BACKGROUND In endemic areas,vertical transmission of hepatitis B virus(HBV)remains a major source of the global reservoir of infected people.Eliminating mother-to-child transmission(MTCT)of HBV is at the heart of World Health Organization’s goal of reducing the incidence of HBV in children to less than 0.1%by 2030.Universal screening for hepatitis B during pregnancy and neonatal vaccination are the main preventive measures.AIM To evaluate the efficacy of HBV vaccination combined with one dose of immunoglobulin in children born to hepatitis B surface antigen(HBsAg)-positive mothers in Djibouti city.METHODS We conducted a study in a prospective cohort of HBsAg-positive pregnant women and their infants.The study ran from January 2021 to May 2022,and infants were followed up to 7 mo of age.HBV serological markers and viral load in pregnant women were measured using aVidas microparticle enzyme-linked immunosorbent assay(Biomérieux,Paris,France)and the automated Amplix platform(Biosynex,Strasbourg,France).All infants received hepatitis B immunoglobulin and were vaccinated against HBV at birth.These infants were closely monitored to assess their seroprotective response and for failure of immunoprophylaxis.Simple logistic regression was also used to identify risk factors associated with immunoprophylaxis failure and poor vaccine response.All statistical analyses were performed with version 4.0.1 of the R software.RESULTS Of the 50 pregnant women recruited,the median age was 31 years,ranging from 18 years to 41 years.The MTCT rate in this cohort was 4%(2/50)in HBsAg-positive women and 67%(2/3)in hepatitis B e antigen-positive women with a viral load>200000 IU/mL.Of the 48 infants who did not fail immunoprophylaxis,8(16%)became poor responders(anti-HB<100 mIU/mL)after HBV vaccination and hepatitis B immunoglobulin,while 40(84%)infants achieved a good level of seroprotection(anti-HB>100 mIU/mL).Factors associated with this failure of immunoprophylaxis were maternal HBV DNA levels(>200000 IU/mL)and hepatitis B e antigen-positive status(odds ratio=158,95%confidence interval:5.05-4958,P<0.01).Birth weight<2500 g was associated with a poor immune response to vaccination(odds ratio=34,95%confidence interval:3.01-383.86,P<0.01).CONCLUSION Despite a failure rate of immunoprophylaxis higher than the World Health Organization target,this study showed that the combination of immunoglobulin and HBV vaccine was effective in preventing MTCT of HBV.Therefore,further studies are needed to better understand the challenges associated with immunoprophylaxis failure in infants in Djibouti city.展开更多
AIM:To quantitatively assess the changes in mean vascular tortuosity(mVT)and mean vascular width(mVW)around the optic disc and their correlation with gestational age(GA)and birth weight(BW)in premature infants without...AIM:To quantitatively assess the changes in mean vascular tortuosity(mVT)and mean vascular width(mVW)around the optic disc and their correlation with gestational age(GA)and birth weight(BW)in premature infants without retinopathy of prematurity(ROP).METHODS:A single-center retrospective study included a total of 133(133 eyes)premature infants[mean corrected gestational age(CGA)43.6wk]without ROP as the premature group and 130(130 eyes)CGA-matched fullterm infants as the control group.The peripapillary mVT and mVW were quantitatively measured using computerassisted techniques.RESULTS:Premature infants had significantly higher mVT(P=0.0032)and lower mVW(P=0.0086)by 2.68(10^(4) cm^(-3))and 1.85μm,respectively.Subgroup analysis with GA showed significant differences(P=0.0244)in mVT between the early preterm and middle to late preterm groups,but the differences between mVW were not significant(P=0.6652).The results of the multiple linear regression model showed a significant negative correlation between GA and BW with mVT after adjusting sex and CGA(P=0.0211 and P=0.0006,respectively).For each day increase in GA at birth,mVT decreased by 0.1281(10^(4) cm^(-3))and for each 1 g increase in BW,mVT decreased by 0.006(10^(4) cm^(-3)).However,GA(P=0.9402)and BW(P=0.7275)were not significantly correlated with mVW.CONCLUSION:Preterm birth significantly affects the peripapillary vascular parameters that indicate higher mVT and narrower mVW in premature infants without ROP.Alterations in these parameters may provide new insights into the pathogenesis of ocular vascular disease.展开更多
Appropriate feeding practices are important during infancy for good health, growth and development of infants and children. WHO revised its earlier recommendation of Exclusive Breastfeeding (EBF) of infants from 4 to ...Appropriate feeding practices are important during infancy for good health, growth and development of infants and children. WHO revised its earlier recommendation of Exclusive Breastfeeding (EBF) of infants from 4 to 6 months of age to EBF until about 6 months of age, with the addition of complementary foods thereafter. This recommendation confirms that breast milk alone is sufficient to meet infants’ nutritional requirements for the first 6 months of life. The main objective of this study was to investigate the effect of various feeding practices on the Nutritional status of infants 0 - 12-month-old in the Kumba 1 Sub-Division. A descriptive cross-sectional study was conducted from December 2019 to August 2020. A total of 341 nursing mothers and their infants 0 - 12 months of age were recruited. Socio-demographic factors and the different feeding habits of the children were assessed using a semi-structured questionnaire. Nutritional status was assessed using anthropometric measurements. The overall proportion of infants who exclusively breastfed for 6 months was 69.2% and those who were mix-fed were 30.8% in the study area. The overall prevalence of malnutrition in the population was 61.0%. Among the malnourished children, 53.1% were underweight, 19.6% were wasted and 10.0% were stunted. Though not significant, the prevalence of wasting (21.0%) and underweight (58.3%) was higher among Mix-Fed (MF) children when compared to their EBF counterparts. Feeding practices affected the nutritional status of the infants. Underweight and wasting were observed among infants on Complementary Feeding (CF), although some exclusively breast-fed infants were stunted. Hence, nursing mothers should try as much as possible to practice EBF as recommended by WHO and can practice CF when the child is above six months.展开更多
Background The neutrophil-to-lymphocyte ratio(NLR)stands as a valuable marker for assessing inflammation and predicting adverse outcomes post-cardiac surgery.This study aimed to ascertain the prognostic relevance of p...Background The neutrophil-to-lymphocyte ratio(NLR)stands as a valuable marker for assessing inflammation and predicting adverse outcomes post-cardiac surgery.This study aimed to ascertain the prognostic relevance of preoperative NLR concerning prolonged ICU stay among infants undergoing congenital heart surgery employing cardiopulmonary bypass.Methods A retrospective review was conducted involving 187 consecutive infants(≤1 year)who underwent congenital heart disease surgery between January and April 2019,stratified into two groups based on NLR(NLR<0.484,NLR≥0.484).The primary outcome was prolonged intensive care unit(ICU)length of stay,defined patients with ICU stays duration higher than the third quartile.Correlations between preoperative NLR and clinical outcomes were assessed.Receiver operating characteristic curve analysis,multivariable Logistic regression,and restricted cube plots were utilized to gauge the association of preoperative NLR with prolonged ICU stay.Results The area under the receiver operating characteristic curve of NLRpredictive capability for prolonged ICU length of staywas 0.691.Subgroup analyses revealed poorer prognoses among patients with high NLR(≥0.484).Multivariable Logistic regression analysis indicated that heightened preoperative NLR(OR:2.63,95%CI:1.18-5.83,P=0.018)independently was correlated with prolonged ICU length of stay in infants'post-cardiac surgery.Conclusions In summary,the NLR emerges as a significant predictive factor for prolonged ICU stay in infants undergoing cardiac surgery.Nevertheless,further research is warranted to comprehensively grasp the relationship between the NLR and prolonged ICU stay.展开更多
Background Thered cell distribution width(RDW)is a parameter that reflects the heterogeneity of red blood cell volume and size,and it is commonly used in the diagnosis of anemia in patients.RDW may serve as a predicto...Background Thered cell distribution width(RDW)is a parameter that reflects the heterogeneity of red blood cell volume and size,and it is commonly used in the diagnosis of anemia in patients.RDW may serve as a predictor of the postoperative prognosis of surgical patients in the intensive care unit.This study evaluated the predictive capability of RDW for outcomes in infants after cardiopulmonary bypass surgery.Methods A retrospective cohort study was conducted at Guangdong Provincial People's Hospital enrolling infants(≤1 year)who underwent cardiac surgery between January 2019 and April 2019.The infants were divided into two groups based on their preoperative RDW levels(<14.5% and≥14.5%).The primary outcome measured was the prolonged hospital stay post-operation.The association between RDW levels and prolonged hospital length of stay was evaluated using multivariate Logistic regression,presenting the adjusted odds ratio with a 95%confidence interval(CI).Additionally,interaction and subgroup analyses were performed to assess the consistency of these correlations.Results A total of 186 infants were included in the study.After adjusting for potential confounders,multivariate logistic regression models demonstrated a significant association between RDW and prolonged length of stay(LOS)in hospital when treated as a continuous variable(change per 1SD,OR:1.50,95%CI:1.06-2.11,P=0.021).Categorizing RDW as a variable revealed that higher RDW levels(≥14.5%)were significantly associated with an increased risk of prolonged LOS compared to lower levels(<14.5%)(OR:9.72,95%CI:2.87-32.91,P<0.001).Receiver operating curves(ROC)analysis showed that RDW levels exhibited relatively higher diagnostic value for predicting prolonged LOS(AUC=0.697,95%CI:0.617-0.776,P<0.05).Stratified analyses further showed that depending on the variable testing,an association between higher RDW levels and prolonged hospital length of stay in different subgroups was observed.Conclusions Elevated RDW levels in infants undergoing cardiac surgery involving cardiopulmonary bypass may signify prolonged recovery periods.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
文摘Objective:To explore the positive role of developmental care measures in promoting the growth and development of premature infants,and analyze their specific effects on improving the sleep duration and quality of premature infants.Methods:A total of 80 premature infants who met the inclusion criteria were selected by convenient sampling method and divided into an experimental group and a control group,with 40 cases in each group.The experimental group received comprehensive nursing intervention of developmental care during the nursing process;the control group adopted the traditional conventional nursing model.Results:There was no statistically significant difference in various physical indicators between the two groups of premature infants before nursing intervention.After nursing intervention,the scores of intellectual development level,psychomotor development index and various physical indicators of premature infants in the experimental group were significantly higher than those in the control group,and the difference was statistically significant.Conclusion:The implementation of developmental care for premature infants can significantly improve their various developmental indicators,which can not only effectively promote the rapid development of premature infants’mental and physical growth,but also improve their sleep quality.
文摘BACKGROUND Cow's milk allergy(CMA)is a common condition in infants,requiring alternative protein sources in their diets.Soya milk has become a popular substitute,especially in developing countries where it is a more affordable option compared to expensive hypoallergenic feeds for infants with insufficient breast milk supply.However,recent observations have shown an increase in soya cross-allergic reactions among infants with CMA.AIM To determine how often infants diagnosed with CMA also had soya cross-allergy and to examine the symptoms and outcomes of these infants at 2 years of age.METHODS Data from two pediatric centers were analyzed,looking at clinical records of children under 2 years old diagnosed with CMA from August 2015 to July 2023,divided into two four-year periods.RESULTS The records of 432 infants with CMA were analyzed.In the first four-year period from August 2015 to July 2019,142 infants were studied,with 27(19%)found to have soya-protein allergy as well.In the second four-year period,a total of 290 infants were studied,and soya allergy was found in 136 babies(47%).This represents a significant increase(P<0.0001)in cases of soya protein cross-allergy among infants with CMA.The most common symptoms observed were gastroesophageal reflux disorder(39%),followed by failure to thrive,bloody diarrhea,watery diarrhea,and constipation.At 2 years of age,these infants showed significant growth failure compared to infants with CMA only.CONCLUSION In conclusion,this study emphasizes the importance of being cautious when using soy protein in infants with cow's milk protein allergy,especially in areas where cost is a major concern.
基金Science and Technology Program Project of Jiangxi Provincial Health Commission(Grant No.202210200).
文摘The aim of this study is to analyze factors influencing the development of bronchopulmonary dysplasia(BPD)within 28 d after birth in very-low-birth-weight(VLBW)infants with a gestational age of less than 34 weeks who were receiving early parenteral nutrition.Data were retrospectively collected from infants born between January and December 2021,who were admitted to the neonatal intensive care unit within 24 h of birth,had a gestational age of less than 34 weeks,and were classified as VLBW.The study included 14 cases without BPD and 20 cases with BPD,and it compared clinical data during hospitalization between these two groups.On the 1st day of life,the BPD group had a nitrogen-to-calorie ratio of 105.44±26.67,while the non-BPD group had a ratio of 146.81±37.04.This difference was statistically significant,with a P-value of 0.04,indicating a potential association between the nitrogen-to-calorie ratio and the development of BPD.However,no significant differences were observed in other clinical indicators between the two groups.These findings suggested that a larger sample size was needed to further explore and confirm the correlation between the nitrogen-to-calorie ratio and the risk of developing BPD in this population.
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.
文摘High-risk infants,from fetal stage to 3-year-old,face severe physical and mental development threats due to biological,psychological,or environmental factors.These threats can lead to developmental delay and cognitive impairment,affecting their future quality of life and social integration.Scientific health management,with nutritional intervention as a key part,is urgently needed.Nutritional intervention,through targeted supplementation and feeding guidance,can optimize their development,avoid nutritional-related deviations,reduce long-term disease risk,and lay a healthy growth foundation.This study analyzes the positive effects of nutritional intervention on high-risk infants’physical growth,neural development,and disease prevention,providing scientific evidence for optimizing clinical follow-up strategies.
基金Undergraduate Innovation and Entrepreneurship Training Program,Guangzhou Xinhua University(Project No.:2413092083)。
文摘Objective:To understand the current status and influencing factors of family caregiving for infants and toddlers aged 6–36 months in Tianhe District,Guangzhou City,with the aim of better comprehending the physiological and psychological needs of infants and toddlers,and assisting families in developing effective intervention measures and support strategies.Methods:In November 2024,a random sample of 311 infants and toddlers aged 6–36 months from the permanent resident population in Tianhe District,Guangzhou City,was selected.Caregivers were surveyed using a questionnaire regarding family caregiving practices for infants and toddlers.The Kruskal-Wallis’s test,Mann-Whitney test,and multiple linear regression analysis were employed to examine the influencing factors of family caregiving for infants and toddlers.Results:The findings indicate that the quality of family caregiving is significantly influenced by the educational level of the parents(p<0.001)and the annual household income(p<0.001).Work-family conflict showed a significant negative correlation with the quality of family caregiving(β=-0.239,p<0.001),while family atmosphere demonstrated a significant positive correlation with the quality of family caregiving(β=0.225,p<0.001).Conclusion:In Tianhe District,Guangzhou City,the quality of infant and toddler caregiving is determined by a combination of key factors,including annual household income,parental educational background,work-family conflict,and family atmosphere.These elements collectively form the core determinants of caregiving practices for infants and toddlers.
文摘BACKGROUND To prevent mother to child transmission(MTCT)of human immunodeficiency virus(HIV),sustained maternal viral load suppression(VLS)and early HIV testing among HIV exposed infants(HEI)is critical.AIM To investigate maternal viral load results and infant HIV testing uptake at 6-weeks,and 9-months and 18-months in Rwanda.METHODS Between 2015 and 2022,VLS(<200 copies/mL)was measured among pregnant women living with HIV(WLHIV)from 38-healthcare facilities.Viral loads(VL)were measured at 6-months,12-months and 24-months,respectively.For maternal VL,the unit of analysis was visit-pair,and the pairs were created to define those with VL<200 copies/mL at two consecutive visits as having sustained VLS,persistent viremia(VL≥200 copies/mL at two consecutive visits),viral rebound(VL<200 copies/mL at prior visit only)and newly suppressed(VL<200 copies/mL at subsequent visit only).HEI were considered to have persistent HIV testing if they had all three HIV tests.Poisson regression models with generalized estimating equations were used to estimate the adjusted incidence rate ratio(aIRR)and 95%CI for factors associated with sustained VLS and persistent HIV testing.RESULTS A total of 1145 mother-infant pairs were analyzed.Infant HIV testing uptake at 6-weeks,9-months and 18-months was 1145(100.0%),1089(95.1%),1006(87.9%)respectively.Nine hundred ninety-nine HEI(87.3%)tested for HIV persistently.At 18-months,the incidence of HIV among HEI was 8(0.7%).Of 1145 mothers,1076(94.0%)had≥2 VL results making a total of 2010 visit-pairs(142-single;934-double visit-pairs).The incidence rate of sustained VLS,persistent viremia,viral rebound and new suppression were 91.0%,1.3%,3.6%and 4.0%respectively.Maternal disclosure of HIV status(aIRR=1.08,95%CI:1.02-1.14)was associated with increased likelihood of sustained VLS.Having peer support(aIRR=1.0595%CI:1.01-1.10)was associated with persistent HIV testing among HEI.CONCLUSION Sustained VLS is high among pregnant WLHIV in Rwanda.The low incidence of HIV among HEI may be attributed to high VLS levels.Targeted interventions,including enhanced HIV disclosure and peer support,are crucial for improving sustained VLS and increasing infant HIV testing uptake to reduce MTCT.
基金Health Commission of Guangxi Zhuang Autonomous Region,Self-Financing Scientific Research Subject(Project No.:Z20210327)。
文摘Objective:To explore the application effect of improved“Bird’s nest”nursing in the transport of premature infants.Methods:Collecting 100 cases of premature infants,randomly divided into experimental group and control group,two groups of premature 50 cases each.The control group received the traditional“Bird’s nest”nursing.Experimental group in modified the“bird’s nest”nursing intervention,compared two groups of premature monitoring vital signs during the transfer process,transport after the body development indicators,the time and cure warmers intervention.Results:Compared with control group,experimental group premature temperature fluctuation is small,apnea and fewer times of low body temperature and oxygen saturation is higher,the contrast results with statistical significance(P<0.05).There was no significant difference in physical development,time to get out of the incubator,and cure rate.Conclusion:Modified the“bird’s nest”care in outside the hospital application,help to improve premature transfer process safety,and security for premature success implementation of transshipment is of great significance.
文摘Background: Malnutrition, a serious public health concern, is influenced by various factors. Objective: The study aims to explore malnutrition issues among infants under five years old in Guéra Province. Methods: The study used a cross-sectional design and a two-stage cluster sampling method to select participants. The study population was infants aged between 0 - 24 months. Data collection was done between June 2023 and September 2024;it included anthropometric measurements, blood analyses, and interviews. Anthropometric parameters were calculated using ENA for SMART software. Statistical analyses were performed by R Studio to investigate associations between different characteristics, using logistic regression models to identify risk factors. A p-value less than 0.05 was considered significant. Results: The study included 377 infants in eight villages in Guéra Province, Chad. The sample was predominantly girls (55.3%), with a median age of 16 months. Most infants (94%) were mixed-fed, and only 6% were exclusively breastfed. We found that 7.3% of children were globally malnourished, with higher rates in boys 9.6%. A significant disparity existed between boys and girls in global acute malnutrition (GAM) rates, with boys having a higher prevalence of 17.9%. A substantial proportion of Infants were underweight, with males 27.4%. Stunting was prevalent 20.1%. Several factors were associated with malnutrition, including gender, feeding practices, infectious diseases, and socioeconomic factors. Diarrhea, malaria, limited access to drinking water, and early diet diversification were significantly associated with malnutrition. Conclusion: Targeted interventions are necessary to address these issues and improve the nutritional status of children in the Guéra province.
文摘Immunoprophylaxis is routinely recommended for infants born to mothers with hepatitis B virus(HBV)infection within the first 12-24 hours.Detection of he-patitis B surface antibody(HBsAb)resulting from hepatitis B immunoglobulin administered at birth may be perceived as a real vaccine response.This makes it difficult to detect HBV infection.For this reason,it is recommended that infants born to hepatitis B surface antigen positive mothers and who received immunop-rophylaxis at birth should have HBsAb testing when they are 9-15 months old.
基金Supported by the Project of Mianyang Central Hospital,School of Medicine,University of Electronic Science and Technology of China,No.2021YJ005the Science&Technology Department of Sichuan Province,China,No.2019YJ0701。
文摘BACKGROUND Enhanced recovery after surgery(ERAS)represents an innovative,protocoldriven perioperative care program designed to optimize patient outcomes.However,its application and efficacy in infants and children with Hirschsprung disease(HD)remain underexplored.AIM To delve into the impact of ERAS on perioperative recovery and the overall medical experience in HD infants and children.METHODS Thirty-eight infants and children with HD who received the Soave surgical procedure were enrolled in this case-control study.According to age-and sexstratified single-blind randomized tables,20 cases received ERAS treatment(ERAS group)and 18 cases received conventional treatment(control group).The two treatments were then compared in terms of perioperative recovery and medical experience.RESULTS Significant differences were observed in pain scores at awakening(4.2±1.3 vs 5.2±1.2,t=2.516,P=0.017)and pain duration(85.69±7.46 hours vs 67.00±8.56 hours,t=7.139,P<0.001)between the ERAS and control group.The recovery of bowel movement was earlier in the ERAS group than in the control group(borborygmus time:33.63±9.83 hours vs 44.69±16.85 hours,t=2.501,P=0.017;feeding time:36.63±9.55 hours vs 49.36±16.99 hours,t=2.884,P=0.007;anal catheter indwelling time:75.83±13.80 hours vs 93.36±20.65 hours,t=3.104,P=0.004),and fever duration(40.73±14.42 hours vs 52.63±18.69 hours,t=2.211,P=0.034).In the ERAS group,hospital stay was shorter(7.5±0.9 days vs 8.3±1.2 days)and the cost was lower(14203±2381 yuan vs 16847±3558 yuan).During the 1-month follow-up period,of the multiple postoperative complications observed,the occurrence of perianal dermatitis(PFisher=0.016)and defecation dysfunction(PFisher=0.027)were lower in the ERAS group than in the control group.CONCLUSION The ERAS protocol has the potential to profoundly enhance postoperative recovery and significantly elevate the overall comfort and quality of the medical experience,making it an indispensable approach that warrants widespread adoption.Continuous refinement through evidence-based practices is anticipated to further optimize its efficacy.
基金Supported by Nanjing Medical Science and Technique Development Foundation,No.YKK23151the Opening Foundation of Key Laboratory,No.JSHD202313+3 种基金Yingke Xinchuang Research Foundation of Jiangsu Blood Transfusion Association,No.JSYK2024006the Jiangsu Province Capability Improvement Project through Science,Technology and Education,No.ZDXYS202210Open Project of the State Key Laboratory of Reproductive Medicine of Nanjing Medical University,No.SKLRM-K202107the Jiangsu Provincial Maternal and Child Health Research Program,No.F202040.
文摘BACKGROUND The primary complication associated with gestational diabetes mellitus(GDM)is delivery of an infant that is large for gestational age(LGA).Epidemiological findings have demonstrated that irregular lipid metabolism significantly con-tributes to insulin resistance,a key pathophysiological mechanism in GDM.However,the correlation between various lipid indices and the probability of delivering LGA infants remains inconsistent.AIM To explore the relationships between lipid indices and the possibility of having LGA infants among GDM-affected pregnant females.METHODS Binary logistic regression methods were employed to evaluate the odds ratios and corresponding 95%confidence intervals for LGA according to five lipid indices.Restricted cubic spline models were applied to investigate dose-response relationships.The association between lipid indices and the risk of delivering LGA infants was further investigated among different subgroups.Receiver operating characteristic curves were utilized to assess the diagnostic performance of lipid indices.RESULTS Across crude and adjusted models,females with lipid indices in the upper two tertiles presented a markedly elevated risk of delivering LGA infants compared with the lowest tertile category.Conversely,high-density lipoprotein cholesterol levels demonstrated the contrary trend.Restricted cubic spline analyses revealed linear associations between the five lipid indices,except triglyceride levels,and the prevalence of LGA.The subgroup analysis highlighted that the correlation between lipid indices and the probability of LGA was inconsistent.The five lipid indices presented significant diagnostic efficacy,as indicated by receiver operating characteristic curve areas.CONCLUSION Our research demonstrated that lipid indices were effective predictors of the incidence of LGA infants in GDM-affected pregnancies irrespective of potential confounding factors.
文摘BACKGROUND Being too light at birth can increase the risk of various diseases during infancy.AIM To explore the effect of perinatal factors on term low-birth-weight(LBW)infants and build a predictive model.This model aims to guide the clinical management of pregnant women’s healthcare during pregnancy and support the healthy growth of newborns.METHODS A retrospective analysis was conducted on data from 1794 single full-term pregnant women who gave birth.Newborns were grouped based on birth weight:Those with birth weight<2.5 kg were classified as the low-weight group,and those with birth weight between 2.5 kg and 4 kg were included in the normal group.Multiple logistic regression analysis was used to identify the factors influencing the occurrence of full-term LBW.A risk prediction model was established based on the analysis results.The effectiveness of the model was analyzed using the Hosmer–Leme show test and receiver operating characteristic(ROC)curve to verify the accuracy of the predictions.RESULTS Among the 1794 pregnant women,there were 62 cases of neonatal weight<2.5 kg,resulting in an LBW incidence rate of 3.46%.The factors influencing full-term LBW included low maternal education level[odds ratio(OR)=1.416],fewer prenatal examinations(OR=2.907),insufficient weight gain during pregnancy(OR=3.695),irregular calcium supplementation during pregnancy(OR=1.756),and pregnancy hypertension syndrome(OR=2.192).The prediction model equation was obtained as follows:Logit(P)=0.348×maternal education level+1.067×number of prenatal examinations+1.307×insufficient weight gain during pregnancy+0.563×irregular calcium supplementation during pregnancy+0.785×pregnancy hypertension syndrome−29.164.The area under the ROC curve for this model was 0.853,with a sensitivity of 0.852 and a specificity of 0.821.The Hosmer–Leme show test yieldedχ^(2)=2.185,P=0.449,indicating a good fit.The overall accuracy of the clinical validation model was 81.67%.CONCLUSION The occurrence of full-term LBW is related to maternal education,the number of prenatal examinations,weight gain during pregnancy,calcium supplementation during pregnancy,and pregnancy-induced hypertension.The constructed predictive model can effectively predict the risk of full-term LBW.
基金Supported by the Attestation de Financement de These de Doctorat,Dakar le 28/10/2019.
文摘BACKGROUND In endemic areas,vertical transmission of hepatitis B virus(HBV)remains a major source of the global reservoir of infected people.Eliminating mother-to-child transmission(MTCT)of HBV is at the heart of World Health Organization’s goal of reducing the incidence of HBV in children to less than 0.1%by 2030.Universal screening for hepatitis B during pregnancy and neonatal vaccination are the main preventive measures.AIM To evaluate the efficacy of HBV vaccination combined with one dose of immunoglobulin in children born to hepatitis B surface antigen(HBsAg)-positive mothers in Djibouti city.METHODS We conducted a study in a prospective cohort of HBsAg-positive pregnant women and their infants.The study ran from January 2021 to May 2022,and infants were followed up to 7 mo of age.HBV serological markers and viral load in pregnant women were measured using aVidas microparticle enzyme-linked immunosorbent assay(Biomérieux,Paris,France)and the automated Amplix platform(Biosynex,Strasbourg,France).All infants received hepatitis B immunoglobulin and were vaccinated against HBV at birth.These infants were closely monitored to assess their seroprotective response and for failure of immunoprophylaxis.Simple logistic regression was also used to identify risk factors associated with immunoprophylaxis failure and poor vaccine response.All statistical analyses were performed with version 4.0.1 of the R software.RESULTS Of the 50 pregnant women recruited,the median age was 31 years,ranging from 18 years to 41 years.The MTCT rate in this cohort was 4%(2/50)in HBsAg-positive women and 67%(2/3)in hepatitis B e antigen-positive women with a viral load>200000 IU/mL.Of the 48 infants who did not fail immunoprophylaxis,8(16%)became poor responders(anti-HB<100 mIU/mL)after HBV vaccination and hepatitis B immunoglobulin,while 40(84%)infants achieved a good level of seroprotection(anti-HB>100 mIU/mL).Factors associated with this failure of immunoprophylaxis were maternal HBV DNA levels(>200000 IU/mL)and hepatitis B e antigen-positive status(odds ratio=158,95%confidence interval:5.05-4958,P<0.01).Birth weight<2500 g was associated with a poor immune response to vaccination(odds ratio=34,95%confidence interval:3.01-383.86,P<0.01).CONCLUSION Despite a failure rate of immunoprophylaxis higher than the World Health Organization target,this study showed that the combination of immunoglobulin and HBV vaccine was effective in preventing MTCT of HBV.Therefore,further studies are needed to better understand the challenges associated with immunoprophylaxis failure in infants in Djibouti city.
基金Supported by the Fundamental Research Funds for the Central Universities (No.WK2100000045)the National Natural Science Foundation of China (No.U19B2044)+1 种基金Hefei Health Care Commission 2022 Applied Medical Research Project (No.Hwk2022yb028)Zhejiang Lab Open Research Project (No.K2022QA0AB04).
文摘AIM:To quantitatively assess the changes in mean vascular tortuosity(mVT)and mean vascular width(mVW)around the optic disc and their correlation with gestational age(GA)and birth weight(BW)in premature infants without retinopathy of prematurity(ROP).METHODS:A single-center retrospective study included a total of 133(133 eyes)premature infants[mean corrected gestational age(CGA)43.6wk]without ROP as the premature group and 130(130 eyes)CGA-matched fullterm infants as the control group.The peripapillary mVT and mVW were quantitatively measured using computerassisted techniques.RESULTS:Premature infants had significantly higher mVT(P=0.0032)and lower mVW(P=0.0086)by 2.68(10^(4) cm^(-3))and 1.85μm,respectively.Subgroup analysis with GA showed significant differences(P=0.0244)in mVT between the early preterm and middle to late preterm groups,but the differences between mVW were not significant(P=0.6652).The results of the multiple linear regression model showed a significant negative correlation between GA and BW with mVT after adjusting sex and CGA(P=0.0211 and P=0.0006,respectively).For each day increase in GA at birth,mVT decreased by 0.1281(10^(4) cm^(-3))and for each 1 g increase in BW,mVT decreased by 0.006(10^(4) cm^(-3)).However,GA(P=0.9402)and BW(P=0.7275)were not significantly correlated with mVW.CONCLUSION:Preterm birth significantly affects the peripapillary vascular parameters that indicate higher mVT and narrower mVW in premature infants without ROP.Alterations in these parameters may provide new insights into the pathogenesis of ocular vascular disease.
文摘Appropriate feeding practices are important during infancy for good health, growth and development of infants and children. WHO revised its earlier recommendation of Exclusive Breastfeeding (EBF) of infants from 4 to 6 months of age to EBF until about 6 months of age, with the addition of complementary foods thereafter. This recommendation confirms that breast milk alone is sufficient to meet infants’ nutritional requirements for the first 6 months of life. The main objective of this study was to investigate the effect of various feeding practices on the Nutritional status of infants 0 - 12-month-old in the Kumba 1 Sub-Division. A descriptive cross-sectional study was conducted from December 2019 to August 2020. A total of 341 nursing mothers and their infants 0 - 12 months of age were recruited. Socio-demographic factors and the different feeding habits of the children were assessed using a semi-structured questionnaire. Nutritional status was assessed using anthropometric measurements. The overall proportion of infants who exclusively breastfed for 6 months was 69.2% and those who were mix-fed were 30.8% in the study area. The overall prevalence of malnutrition in the population was 61.0%. Among the malnourished children, 53.1% were underweight, 19.6% were wasted and 10.0% were stunted. Though not significant, the prevalence of wasting (21.0%) and underweight (58.3%) was higher among Mix-Fed (MF) children when compared to their EBF counterparts. Feeding practices affected the nutritional status of the infants. Underweight and wasting were observed among infants on Complementary Feeding (CF), although some exclusively breast-fed infants were stunted. Hence, nursing mothers should try as much as possible to practice EBF as recommended by WHO and can practice CF when the child is above six months.
文摘Background The neutrophil-to-lymphocyte ratio(NLR)stands as a valuable marker for assessing inflammation and predicting adverse outcomes post-cardiac surgery.This study aimed to ascertain the prognostic relevance of preoperative NLR concerning prolonged ICU stay among infants undergoing congenital heart surgery employing cardiopulmonary bypass.Methods A retrospective review was conducted involving 187 consecutive infants(≤1 year)who underwent congenital heart disease surgery between January and April 2019,stratified into two groups based on NLR(NLR<0.484,NLR≥0.484).The primary outcome was prolonged intensive care unit(ICU)length of stay,defined patients with ICU stays duration higher than the third quartile.Correlations between preoperative NLR and clinical outcomes were assessed.Receiver operating characteristic curve analysis,multivariable Logistic regression,and restricted cube plots were utilized to gauge the association of preoperative NLR with prolonged ICU stay.Results The area under the receiver operating characteristic curve of NLRpredictive capability for prolonged ICU length of staywas 0.691.Subgroup analyses revealed poorer prognoses among patients with high NLR(≥0.484).Multivariable Logistic regression analysis indicated that heightened preoperative NLR(OR:2.63,95%CI:1.18-5.83,P=0.018)independently was correlated with prolonged ICU length of stay in infants'post-cardiac surgery.Conclusions In summary,the NLR emerges as a significant predictive factor for prolonged ICU stay in infants undergoing cardiac surgery.Nevertheless,further research is warranted to comprehensively grasp the relationship between the NLR and prolonged ICU stay.
基金supported by the Guangdong Provincial People's Hospital Climb Plan Project(No.DFJH2021020)。
文摘Background Thered cell distribution width(RDW)is a parameter that reflects the heterogeneity of red blood cell volume and size,and it is commonly used in the diagnosis of anemia in patients.RDW may serve as a predictor of the postoperative prognosis of surgical patients in the intensive care unit.This study evaluated the predictive capability of RDW for outcomes in infants after cardiopulmonary bypass surgery.Methods A retrospective cohort study was conducted at Guangdong Provincial People's Hospital enrolling infants(≤1 year)who underwent cardiac surgery between January 2019 and April 2019.The infants were divided into two groups based on their preoperative RDW levels(<14.5% and≥14.5%).The primary outcome measured was the prolonged hospital stay post-operation.The association between RDW levels and prolonged hospital length of stay was evaluated using multivariate Logistic regression,presenting the adjusted odds ratio with a 95%confidence interval(CI).Additionally,interaction and subgroup analyses were performed to assess the consistency of these correlations.Results A total of 186 infants were included in the study.After adjusting for potential confounders,multivariate logistic regression models demonstrated a significant association between RDW and prolonged length of stay(LOS)in hospital when treated as a continuous variable(change per 1SD,OR:1.50,95%CI:1.06-2.11,P=0.021).Categorizing RDW as a variable revealed that higher RDW levels(≥14.5%)were significantly associated with an increased risk of prolonged LOS compared to lower levels(<14.5%)(OR:9.72,95%CI:2.87-32.91,P<0.001).Receiver operating curves(ROC)analysis showed that RDW levels exhibited relatively higher diagnostic value for predicting prolonged LOS(AUC=0.697,95%CI:0.617-0.776,P<0.05).Stratified analyses further showed that depending on the variable testing,an association between higher RDW levels and prolonged hospital length of stay in different subgroups was observed.Conclusions Elevated RDW levels in infants undergoing cardiac surgery involving cardiopulmonary bypass may signify prolonged recovery periods.
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.
