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Delivery room resuscitation intensity and associated neonatal outcomes of 24^(+0)-31^(+6) weeks'preterm infants in China:a retrospective cross-sectional study

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World Journal of Pediatrics 2024年第1期20卷 64-72页

作者： Si-Lu Wang Chun Chen Xin-Yue Gu Zhao-Qing Yin Le Su Si-Yuan Jiang Yun Cao Li-Zhong Du Jian-Hua Sun Jiang-Qin Liu Chuan-Zhong Yang Department of Neonatology Shanghai Key Laboratory of Maternal Fetal MedicineShanghai Institute of Maternal-Fetal Medicine and Gynecologic OncologyShanghai First Maternity and Infant HospitalSchool of MedicineTongji UniversityNo.2699Gaoke Western RoadPudong DistrictShanghai 201204China Department of Neonatology Affiliated Shenzhen Maternity and Child Healthcare HospitalSouthern Medical UniversityNo.2004Hongli RoadFutian DistrictShenzhen 518028China NHC Key Laboratory of Neonatal Diseases Fudan UniversityChildren's Hospital of Fudan UniversityShanghaiChina Department of Neonatology People's Hospital of DehongKunming Medical UniversityDehongChina Department of Neonatology Children's Hospital of Fudan UniversityShanghaiChina Department of Neonatology Children's HospitalZhejiang University School of MedicineHangzhouChina Department of Neonatology Shanghai Children's Medical CenterSchool of MedicineShanghai Jiao Tong UniversityShanghaiChina

Background The aim of this study was to review current delivery room(DR)resuscitation intensity in Chinese tertiary neonatal intensive care units and to investigate the association between DR resuscitation intensity and short-term outcomes in preterm infants born at 24+0_31+6 weeks gestation age(GA).Methods This was a retrospective cross-sectional *** source population was infants born at 24+0_31+6 weeks'GA who were enrolled in the Chinese Neonatal Network 2019 *** infants were categorized into five groups:(1)regular care;(2)oxygen supplementation and/or continuous positive airway pressure(O2/CPAP);(3)mask ventilation;(4)endotracheal intubation;and(5)cardiopulmonary resuscitation(CPR).The association between DR resuscitation and shortterm outcomes was evaluated by inverse propensity score-weighted logistic *** Of 7939 infants included in this cohort,2419(30.5%)received regular care,1994(25.1%)received O,/CPAP,1436(18.1%)received mask ventilation,1769(22.3%)received endotracheal intubation,and 321(4.0%)received CPR in the *** maternal age and maternal hypertension correlated with a higher need for resuscitation,and antenatal steroid use tended to be associated with a lower need for resuscitation(Ppreterm infants in eight centers requiring higher intensity *** Increased intensity of DR interventions was associated with increased mortality and morbidities in very preterm infants in *** is wide variation in resuscitative approaches across delivery centers,and ongoing quality improvement to standardize resuscitation practices is needed.

关键词： Cardiopulmonary resuscitation Delivery room Endotracheal intubation Neonatal resuscitation preterm

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Variations in length of stay among survived very preterm infants admitted to Chinese neonatal intensive care units

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World Journal of Pediatrics 2022年第2期18卷 126-134页

作者： Min Zhang Yan-Chen Wang Jin-Xing Feng Ai-Zhen Yu Jing-Wei Huang Si-Yuan Jiang Xin-Yue Gu Jian-Hua Sun Yun Cao Wen-Hao Zhou Shoo KLee Li-Li Wang Rong Yin Division of Neonatology The First Affiliated Hospital of Anhui Medical UniversityNo.218Jixi RoadShushan DistrictHefei 230022China NHC Key Laboratory of Neonatal Diseases Fudan UniversityChildren's Hospital of Fudan UniversityShanghai 201102China Division of Neonatology Shenzhen Children's HospitalShenzhen 518038China Division of Neonatology.Children's Hospital of Fudan University 399 Wanyuan RoadMinhang DistrictShanghai 201102China Division of Neonatology Shanghai Children's Medical CenterShanghai Jiao Tong University School of MedicineShanghai 200127China Maternal-Infants Care Research Centre and Department of Pediatrics Mount Sinai HospitalTorontoON M5G 1X5.Canada Professor Emeritus University of Toronto.TorontoON M5T 3M7Canada

Background This study aimed to describe length of stay(LOS)to discharge and site variations among very preterm infants(VPIs)admitted to 57 Chinese neonatal intensive care units(NICUs)and to investigate factors associated with LOS for *** This retrospective multicenter cohort study enrolled all infants<32 weeks’gestation and admitted to 57 NICUs which had participated in the Chinese Neonatal Network,within 7 days after birth in *** criteria included major congenital anomalies,NICU deaths,discharge against medical advice,transfer to non-participating hospitals,and missing discharge *** multivariable linear models were used to estimate the association of infant characteristics and *** A total of 6580 infants were included in our *** overall median LOS was 46 days[interquartile range(IQR):35-60],and the median corrected gestational age at discharge was 36 weeks(IQR:35-38).LOS and corrected gestational age at discharge increased with decreasing gestational *** median corrected gestational age at discharge for infants at 24 weeks,25 weeks,26 weeks,27-28 weeks,and 29-31 weeks were 41 weeks,39 weeks,38 weeks,37 weeks and 36 weeks,*** site variation of LOS was identified with observed median LOS from 33 to 71 days in different *** The study provided concurrent estimates of LOS for VPIs which survived in Chinese NICUs that could be used as references for medical staff and *** variation of LOS independent of infant characteristics existed,indicating variation of care practices requiring further investigation and quality improvement.

关键词： Length of stay to discharge home Neonatal intensive care preterm Risk factors

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Pharmacogenomics-based individualized treatment of hypertension in preterm infants: A case report and review of the literature

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World Journal of Clinical Cases 2023年第30期11卷 7440-7449页

作者： Lian-Fang Tang Ao Xu Kai Liu Department of Pediatrics The First People’s Hospital of Yunnan ProvinceKunming 650000Yunnan ProvinceChina Pulmonary and Critical Care Medicine Kunming Children’s HospitalKunming 650000Yunnan ProvinceChina

BACKGROUND Neonatal hypertension is a rare but potentially serious condition that requires careful monitoring and *** can help guide individualized drug therapy and improve *** SUMMARY We report a case of a preterm infant with multiple complications,including bronchopulmonary dysplasia(BPD),sepsis,intracranial hemorrhage,and *** infant was treated with various drugs,including dexamethasone and *** infant was diagnosed with neonatal hypertension based on blood pressure measurements exceeding the 95th percentile for his age and *** possible causes of hypertension included dexamethasone,hydrochlorothiazide,spironolactone,and *** infant was treated with oral amlodipine to lower his blood pressure.A pharmacogenomic test was performed to evaluate the genetic polymorphisms of ABCB1 and CYP3A5,which are involved in the metabolism and transport of dexamethasone and *** infant’s blood pressure was well controlled after the dose of amlodipine was reduced according to the pharmacogenomic *** infant had a stable general condition and was discharged on the 100th d after *** This case illustrates the importance of regular blood pressure monitoring and etiological investigation in preterm infants with *** can provide useful information for individualized drug therapy and safety in this population.

关键词： Pharmacogenomics Hypertension preterm Infants Case report

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Association of maternal depression with dietary intake, growth,and development of preterm infants： a cohort study in Beijing,China

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Frontiers of Medicine 2018年第5期12卷 533-541页

作者： Han Wang Hong Zhou Yan Zhang Yan Wang Jing Sun Department of Maternal and Child Health School of Public Health Peking University Beijing 100191 China Menzies Health InstituteQueensland Griffith University Gold Coast Queensland QLD 4222 Australia School of Medicine Grifffith University Gold CoastQueensland QLD 4222 Australia

This study aimed to explore the association of maternal depression with nutrient intake, growth, and development of preterm infants. A cohort study of 201 infants was conducted in Beijing. Based on the gestational age of an infant and status of the mother, the infants were divided into four groups: non-depression-fullterm (64), non-depression-preterm (70), depression-fullterm (36), and depression-preterm (31). Data on sociodemographic characteristics, nutritional intake, growth, and developmental status of children at 8 months (corrected ages) were collected using a quantitative questionnaire, a 24-Hour Dietary Recall, anthropometric measurements, and the Bayley-III scale. A multivariate analysis was used to evaluate the effects of maternal depression and preterm birth on infant growth and development. The energy, protein, and carbohydrate intake in the depression group was lower than the recommended amounts. The depression preterm groups indicated the lowest Z-scores for length and weight and the lowest Bayley-III scores. preterm infants of depressed mothers are at high risks of poor growth and development delay.

关键词： maternal depression preterm infant nutrition growth development

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Vγ9Vδ2-T lymphocytes have impaired antiviral function in small-for-gestational-age and preterm neonates

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Cellular & Molecular Immunology 2013年第3期10卷 253-260页

作者： Jinrong Li Hong Li Huawei Mao Meixing Yu Ting Feng Fan Yang Yingying Fan Qiao Lu Chongyang Shen Zhongwei Yin Wenwei Tu Meng Mao The Joint Research Center of West China Second University Hospital of Sichuan University and Faculty of Medicine of the University of Hong Kong Chengdu China Department of Pediatric West China Second University Hospital Sichuan University Chengdu China Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education West China Second University Hospital Sichuan University Chengdu China Department of Pediatrics & Adolescent Medicine Li Ka Shing Faculty of Medicine The University of Hong Kong Hong Kong China These authors contributed equally to this work.

preterm and small-for-gestational-age （SGA） neonates are vulnerable groups that are susceptible to various microbial infections. Vγ9Vδ2-T cells are critical components of the host immune system and have been demonstrated to play an important role in the defense against viral infection in adults. However, the characteristics of Vγ9Vδ2-T cells in children, especially the preterm and SGA populations, are poorly understood. Here, we examined the frequency and antiviral function of Vγ9Vδ2-T cells in neonates, including preterm, SGA and full-term babies. When compared to adults, neonates had a significantly lower percentage of Vγ9Vδ2-T cells in the blood. Upon influenza virus stimulation, neonatalVγ9Vδ2-T cells, especially from preterm and SGA babies, showed markedly decreased and delayed antiviral cytokine responses than those of adults. In addition, the antiviral responses of neonatal Vγ9Vδ2-T cells were positively correlated with gestational age and birth weight. Finally, a weaker expansion ofVγ9Vδ2-T cells by isopentenyl pyrophosphate （IPP） was shown in neonates than the expansion in adults. Our data suggest that the depressed antiviral activity and decreased frequency of Vγ9Vδ2-T cells may likely account for the high susceptibility to microbial infection in neonates, particularly in preterm and SGA babies. Improving Vγ9Vδ2-T -cell function of neonates may provide a new way to defend against virus infection.

关键词： cord blood influenza A virus preterm small for gestational age Vγ9Vδ2 T cell

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A Review of Functional Near-Infrared Spectroscopy Studies of Motor and Cognitive Function in preterm Infants

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Neuroscience Bulletin 2020年第3期36卷 321-329页

作者： Quan Wang Guang-Pu Zhu Li Yi Xin-Xin Cui Hui Wang Ru-Yi Wei Bing-Liang Hu Key Laboratory of Spectral Imaging Technology Xi’an Institute of Optics and Precision Mechanics of the Chinese Academy of SciencesXi’an 710119China University of Chinese Academy of Sciences Beijing 100049China Key Laboratory of Biomedical Spectroscopy of Xi’an Xi’an Institute of Optics and Precision Mechanics of the Chinese Academy of SciencesXi’an 710119China Child Study Center Yale School of MedicineYale UniversityNew HavenCT 06520USA School of Psychological and Cognitive Sciences and Beijing Key Laboratory of Behavior and Mental Health Peking UniversityBeijing 100871China

preterm infants are vulnerable to brain injuries,and have a greater chance of experiencing neurodevelopmental disorders throughout development. Early screening for motor and cognitive functions is critical to assessing the developmental trajectory in preterm infants, especially those who may have motor or cognitive deficits. The brain imaging technology functional near-infrared spectroscopy(fNIRS) is a portable and low-cost method of assessing cerebral hemodynamics, making it suitable for large-scale use even in remote and underdeveloped areas. In this article, we review peer-reviewed, scientific f NIRS studies of motor performance, speech perception, and facial recognition in preterm infants. f NIRS provides a link between hemodynamic activity and the development of brain functions in preterm infants. Research using fNIRS has shown different patterns of hemoglobin change during some behavioral tasks in early infancy. fNIRS helps to promote our understanding of the developmental mechanisms of brain function in preterm infants when performing motor or cognitive tasks in a less-restricted environment.

关键词： Functional near infrared spectroscopy preterm infant Motor performance Speech perception Facial recognition Cerebral hemodynamics

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Impact of preterm birth and low birth weight on medical conditions, medication use and mortality among neonates: a prospective observational cohort study

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World Journal of Pediatrics 2019年第3期15卷 281-288页

作者： Krishna Undela Bashar Talal Saad Mohammed Parthasarathi Gurumurthy Srinivasa Murthy Doreswamy Department of Pharmacy Practice JSS College of Pharmacy.JSS Academy of Higher Education and ResearchSS NagaraMysuru.Karnataka 570 015.India Department of Pediatrics JSS Medical College and Hospital.JSS Academy of Higher Education and ResearchMahatma Gandhi RoadMysuruKarnataka 570 004India

Background There is a paucity of studies conducted in India on neonatal outcomes of preterm birth and low birth ***,we aimed to assess the impact of preterm birth and low birth weight on medical conditions,medication use and mortality among *** A prospective observational cohort study was conducted at the neonatal intensive care unit (NICU) over a period of 9 *** of either sex,admitted to NICU and who received at least one medication were enrolled in the *** and demographic data,reason(s) for NICU admission,diagnoses,medications prescribed,medication-related problems,discharge status and the direct medical cost were documented and *** Four hundred and five neonates Were included in the study:60.5% were boys,32.7% were preterm and 44.2% were born *** sepsis (n =125,16.7%),unconjugated hyperbilirubinemia (n =83,11.1%) and respiratory distress syndrome (n =62,8.3%) were the most common medical conditions and were significantly more common among preterm and underweight *** half of the medications prescribed were anti-infectives for systemic use (n =1310,47.4%).The mean number of medications received by neonates increased from term to extremely preterm (5.2-15.0) and normal birth weight to extremely low birth weight (5.0-14.9).Mortality rate was significantly higher among extremely preterm (66.7%),and very preterm (15.2%) neonates compared to term (2.9%) *** median direct medical cost for NICU admission was INR 21,430 (USD 331).Conclusion Medical conditions,medications prescribed and mortality rate were significantly higher among preterm and underweight neonates admitted to NICU.

关键词： Low birth weight Medical conditions Medications Mortality preterm birth

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Improving fetal to neonatal transition of the very preterm infant： novel approaches

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Chinese Medical Journal 2010年第20期123卷 2924-2928页

作者： Maximo Vento Neonatal Researcla Unit Division of Neonatology University Hospital La Fe Avenida de Campanar 21E46009 Valencia Spain

Two main issues are crucial for neonatology at present： first, the increased rate of preterm delivery （〉 10%） especially in low and middle income countries or even in industrialized countries lacking a universal a... 详细信息

关键词： newborn oxygen oxidative stress meta-analysis preterm oxygen saturation

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Weaning of nasal CPAP in preterm infants:who,when and how?a systematic review of the literature

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World Journal of Pediatrics 2015年第1期11卷 7-13页

作者： Shaili Amatya Deepa Rastogi Alok Bhutada Shantanu Rastogi Division of Neonatology Maimonides Infants&Children's Hospital4802 Tenth AveK-113Brooklyn NY 11219USA Children's Hospital at Montefiore Albert Einstein College of MedicineBronxNY 10467USA

Background:There is increased use of early nasal continuous positive airway pressure(NCPAP)to manage respiratory distress in preterm infants but optimal methods and factors associated with successful wean are not well defined.A systematic review was performed to define the corected gestational age(CGA),weight to wean NCPAP and the methods associated with successful weaning of the NCPAP among preterm infants,along with factors affecting ***:Searches were made of PubMed using the keywords-NCPAP,CPAP,weaning,withdrawal,preterm,and infants from its inception to January 1st,2014,for studies in all languages but limited to *** reviews(including cross references)were also *** included all randomized and quasi-randomized controlled trials where preterm neonates were randomized to different NCPAP weaning *** of CGA,weight and methods used for weaning NCPAP were extracted along with factors which affect its ***:Seven studies met the search *** successful wean was at 32 to 33 weeks CGA and at 1600 *** different methods were used for weaning were sudden,gradual pressure wean and gradual graded time off *** for readiness,success and failure to wean were *** affecting successful weaning were intubation,anemia,infection and gastro-esophageal ***:The successful wean was at 32 to 33 weeks CGA and 1600 *** for readiness,success and failure to wean are well *** weaning may be associated with a shorter weaning *** trials are needed comparing weaning methods using defined criteria for readiness and success of NCPAP wean and stratify the results by gestational age and birth weight.

关键词： continuous positive airway pressure infants preterm systematic review weaning

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Bedside cardiopulmonary ultrasonography evaluates lung water content in very low-weight preterm neonates with patent ductus arteriosus

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World Journal of Clinical Cases 2021年第8期9卷 1827-1834页

作者： Li-Fang Yu Chen-Ke Xu Min Zhao Lin Niu Xian-Mei Huang Zhi-Qun Zhang Department of Ultrasound Affiliated Hangzhou First People’s HospitalZhejiang University School of MedicineHangzhou 310006Zhejiang ProvinceChina Department of Pediatrics Affiliated Hangzhou First People’s HospitalZhejiang University School of MedicineHangzhou 310006Zhejiang ProvinceChina

BACKGROUND Patent ductus arteriosus(PDA)is a common congenital heart abnormality in preterm neonates with a high incidence in neonates with very low birth *** PDA persists,interstitial lung water content increases,which could lead to abnormal circulation hemodynamics and pulmonary *** is important to perform early and reliable assessment of lung water content in very low-weight preterm neonates with persistent *** To evaluate the role of bedside cardiopulmonary ultrasonography in the lung water content assessment in very low-weight preterm neonates with persistent *** From January 2018 to March 2020,69 very low-weight preterm neonates with echocardiography-confirmed PDA were selected as the PDA *** the same time,89 very low-weight preterm neonates without PDA were randomly selected as the control *** neonates underwent echocardiography and 6-segment lung ultrasonography on the fourth day after *** clinical characteristics and main ultrasonography results were compared between the two ***’s analysis was used to analyze the correlation between lung ultrasonography score(LUS)and other related clinical and ultrasonography results in all *** the PDA group,PDA diameters were recorded,and the correlation with LUS and left atrium to aortic(LA/AO)dimension ratio were also ***/AO ratio is one of the ultrasonic diagnostic criteria for hemodynamically significant *** the ratio is≥1.5,it suggests the possibility of hemodynamic changes in persistent PDA.A receiver operating characteristic curve was established using the sensitivity of LUS to predict the hemodynamic changes in neonates with PDA as the ordinate and 1-specificity as the *** A total of 158 neonates were enrolled in this study,including 69 in the PDA group and 89 in the control *** were no statistical differences in sex,gestational age,birth weight,ventilator dependence,hospitalization length and left ventricular ejection f

关键词： Patent ductus arteriosus Cardiopulmonary Ultrasonography Lung ultrasound score Very low-weight neonates preterm

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