Introduction: The purpose of this retrospective study is to identify medical conditions impacting neurodevelopmental outcomes of extremely low birth weight and very low birth weight preterm infants at three years of a...Introduction: The purpose of this retrospective study is to identify medical conditions impacting neurodevelopmental outcomes of extremely low birth weight and very low birth weight preterm infants at three years of age. Methods: Infants born in Banner Diamond Children’s University Medical Center, receiving services in the Newborn Intensive Care Unit, and attending Neonatal Developmental Follow-Up Clinic were identified. Participants received developmental assessment and follow-up from August 2012 through December 2018. Relevant clinical conditions during initial hospital stay and up to three years of age were obtained by reviewing medical and developmental records. Bayley Scales of Infant Toddler Development (Bayley III) was used to evaluate skill development at 6, 9, 12, 18, 24, 30, 36 months. Results: Data analysis did not reveal significant p-values;it did demonstrate that some predictor variables impact neurodevelopmental outcomes in cognitive, language and motor skill development. Conclusion: This retrospective study reports significant association between birth weight and low cognitive scores. Correlations were also found between gestational age and Total Language, and the longer an infant stayed in the NICU, the poorer the Total Language Scaled Scores at 8 to 12 months, 15 to 18 months, and 24 to 36 months. Birth weight was found to be the greatest predictor of poor motor scores.展开更多
Low birth weight（LBW） and preterm birth（PB） are associated with newborn mortality and diseases in adulthood.We explored factors related to LBW and PB by conducting a population-based case-control study from Januar...Low birth weight（LBW） and preterm birth（PB） are associated with newborn mortality and diseases in adulthood.We explored factors related to LBW and PB by conducting a population-based case-control study from January 2011 to December 2013 in Wuhan,China.A total of 337 LBW newborn babies,472 PB babies,and 708 babies with normal birth weights and born from term pregnancies were included in this study.Information of newborns and their parents was collected by trained investigators using questionnaires and referring to medical records.Univariate and logistic regression analyses with the stepwise selection method were used to determine the associations of related factors with LBW and PB.Results showed that maternal hypertension（OR=6.78,95% CI：2.27–20.29,P=0.001）,maternal high-risk pregnancy（OR=1.53,95% CI：1.06–2.21,P=0.022）,and maternal fruit intake ≥300 g per day during the first trimester（OR=1.70,95% CI：1.17–2.45,P=0.005） were associated with LBW.BMI ≥24 kg/m^2 of mother prior to delivery（OR=0.48,95% CI：0.32–0.74,P=0.001） and gestation ≥37 weeks（OR=0.01,95% CI：0.00–0.02,P〈0.034） were protective factors for LBW.Maternal hypertension（OR=3.36,95% CI：1.26–8.98,P=0.016）,maternal high-risk pregnancy（OR=4.38,95% CI：3.26–5.88,P〈0.001）,maternal meal intake of only twice per day（OR=1.88,95% CI：1.10–3.20,P=0.021）,and mother liking food with lots of aginomoto and salt（OR=1.60,95% CI：1.02–2.51,P=0.040） were risk factors for PB.BMI ≥24 kg/m^2 of mother prior to delivery（OR=0.66,95% CI：0.47–0.93,P=0.018）,distance of house from road ≥36 meters（OR=0.72,95% CI：0.53– 0.97,P=0.028）,and living in rural area（OR= 0.60,95% CI：0.37–0.99,P=0.047） were protective factors for PB.Our study demonstrated some risk factors and protective factors for LBW and PB,and provided valuable information for the prevention of the conditions among newborns.展开更多
Introduction: Low birth weight and prematurity are risk factors for perinatal morbidity and mortality, which is high in Sub Saharan African countries. We determined the frequency of and maternal and obstetric risk fac...Introduction: Low birth weight and prematurity are risk factors for perinatal morbidity and mortality, which is high in Sub Saharan African countries. We determined the frequency of and maternal and obstetric risk factors for low birth weight and preterm birth among hospital births in rural Gambia. Method: We performed a hospital-based retrospective analysis of deliveries from July to December 2008 in two rural hospitals. Maternity records were reviewed and abstracted of the mother’s demographic and reproductive characteristics, obstetric complications and foetal outcome. The maternity records contain important information maternal health and complications during pregnancy and intrapartum period. The records also contain information about the newborn’s vital status and birth weight. To determine the association between low birth weight (LBW), preterm birth (PTB) and maternal demographic characteristics and obstetric complications we calculated odds using logistic regression. Main outcome measure(s): Low birth weight (<2500 grams) and preterm birth (<37 weeks). Results: Our final sample included 1244 singleton live births with complete information about all variables. The rate of LBW and PTB were 10.5% and 10.9% respectively. Ninety-four percent of LBW infants were estimated to be preterm births. The mean birth weight was 3013 g (541 g standard deviation-SD), while the mean gestational age was 37 weeks. The pattern of risk factors was similar for LBW and PTB and both were strongly associated with antepartum haemorrhage and hypertensive pregnancy disorders. Additionally, primi parity was a risk factor for both PTB and LBW. Conclusion: The percentage of low birth weight and preterm birth in rural hospitals in The Gambia is high. The most significant risk factors were those that may be detected during the antepartum period. Thus, vigilant monitoring during pregnancy, early detection and management of obstetric complications coupled with provision of timely obstetric care interventions are crucial for展开更多
Objective: Very-low-birth-weight (VLBW) preterm infants are at risk of growth delay if they do not receive adequate nutritional support. This study evaluated the effect of aggressive early high-dose amino acid infusio...Objective: Very-low-birth-weight (VLBW) preterm infants are at risk of growth delay if they do not receive adequate nutritional support. This study evaluated the effect of aggressive early high-dose amino acid infusion plus early enteral trophic feeding on growth in VLBW infants within the first day of life. Study Design: The effect of a high-dose 3 g amino acid (HAA)/kg/d regimen beginning on the first day of life was compared with that of low-dose amino acid (LAA) supplementation at a dose of 0.5 or 1.0 g/kg/d. The primary outcome measures were the days of regained birth weight and achieved full enteral feeding. Result: Compared with the 19 infants in the LAA group, the 17 infants in the HAA group achieved significantly earlier full enteral feeding (7.8 ± 3.6 vs. 15.2 ± 8.9, p = 0.003) and regained birth weight (13.3 ± 3.8 vs. 17.5 ± 7.9, p = 0.047). In addition, shorter parenteral nutrition time was achieved by HAA administration (p Conclusion: Aggressive early simultaneous amino acid administration plus enteral feeding during the first few days of life for preterm infants was associated with improved weight gain and earlier full enteral feeding.展开更多
Background: Kangaroo mother care (KMC) is effective in preventing hypothermia, establishing breastfeeding, and reducing nosocomial infection in preterm babies in resource-limited areas. Relatively little is known abou...Background: Kangaroo mother care (KMC) is effective in preventing hypothermia, establishing breastfeeding, and reducing nosocomial infection in preterm babies in resource-limited areas. Relatively little is known about long-term morbidity and mortality outcomes among Ethiopian infants managed with KMC. Aims: To describe the follow up profiles and outcome of infants managed with KMC and discharged alive. Methods: This cross-sectional descriptive study examined outcomes among infants who were 1) managed by KMC at Black Lion Hospital, 2) discharged alive, and 3) available for follow-up. Structured, pretested questionnaires were administered to mothers. Results: Of the 110 infants included in the study, 9.1% died over the study period and 60% of the deaths occurred at home. Mortality was 100% in those babies with mothers aged less than 18 years. Thirty five percent of the deaths occurred in those from rural location. Common medical problems identified in study subjects were respiratory infections (10%), gastroenteritis (7%), rickets (7%), and anemia (6%). About 20% of infants were readmitted to hospital at least once. KMC initiation within one week was not found to be significantly associated with survival, but continued KMC after discharge significantly decreased mortality in our sample. Conclusion: Frequent follow up is very important especially those with teenage mothers and coming from a rural location. Follow up should be frequent in the first 2 months after discharge. Further research is needed to explore the determinants of mortality and morbidity after hospital discharge.展开更多
目的研究胎龄<32周极低出生体重儿初始无创通气(non-invasive ventilation,NIV)失败相关危险因素及不良预后。方法回顾性收集2019年1月—2021年12月江苏省28家三级医院新生儿重症监护室(neonatal intensive care unit,NICU)收治的早...目的研究胎龄<32周极低出生体重儿初始无创通气(non-invasive ventilation,NIV)失败相关危险因素及不良预后。方法回顾性收集2019年1月—2021年12月江苏省28家三级医院新生儿重症监护室(neonatal intensive care unit,NICU)收治的早产儿的临床资料,依据生后初始NIV结局分为成功组和失败组,分析NIV失败危险因素及不良预后。结果共纳入817例患儿,男性453例(55.4%),失败139例(17.0%)。失败组胎龄、出生体重、1 min和5 min Apgar评分均低于成功组(P<0.05)。失败组入NICU诊断呼吸窘迫综合征(respiratory distress syndrome,RDS)比例、NIV最大呼气末正压,以及初始NIV全过程中达到所需最高吸入气氧浓度(fraction of inspired oxygen,FiO2)≥30%、≥35%、≥40%比例均高于成功组(P<0.05)。胎龄(OR=0.671,95%CI:0.581~0.772)、入NICU诊断RDS(OR=1.955,95%CI:1.181~3.366)和初始NIV全过程中达到所需最高FiO2≥30%(OR=2.053,95%CI:1.106~4.044)是胎龄<32周极低出生体重儿初始NIV失败的危险因素(P<0.05)。失败组住院期间并发肺部感染、气胸、早产儿视网膜病、中重度支气管肺发育不良、重度脑室内出血的发生率,以及住院时长和总费用均高于成功组(P<0.05)。结论小胎龄、入NICU诊断RDS以及初始NIV全过程中达到所需最高FiO2≥30%是胎龄<32周极低出生体重儿初始NIV失败的高危因素,初始NIV失败将显著增加该人群不良结局的风险。展开更多
Background Six provinces in China accounted for 70%-80% of all reported HIV/AIDS cases in the country in 2009 and five provinces accounted for 78% of all reported mother-to-child transmission （MTCT） of HIV cases. Be...Background Six provinces in China accounted for 70%-80% of all reported HIV/AIDS cases in the country in 2009 and five provinces accounted for 78% of all reported mother-to-child transmission （MTCT） of HIV cases. Because Guangxi belonged to both groups, the Prevention of Mother-to-Child Transmission （PMTCT） Plus program was established there to understand better low birth weight （LBW） and preterm delivery （PD） birth outcomes and their associated risk factors better. Methods Pregnancy outcomes were examined among HIV-infected pregnant women who enrolled in the PMTCT Plus program from June 2006 to February 2009 in Guangxi, China. Multivariate Logistic regression analysis was used to explore the risk factors associated with LBW （〈2500 g） and PD （gestational age 〈37 weeks）. Results The prevalence of LBW and PD among 194 HIV-positive mothers was 19.6% （38/194） and 9.8% （19/194）, respectively. Multivariate Logistic regression analysis showed that CD4 cell count 〈100 cell/IJI （multivariate-adjusted odds ratio （AOR） 5.52; 95% Cl 1.11-25.55） and CD4 cell count 100-199 cells/IJI （AOR3.40; 95% Cl 1.03-11.25, compared to CD4 cell count 〉350 cells/IJI）, gestational age 〈37 weeks （AOR 4.38; 95% Cl 1.29-14.82, compared to 〉37 weeks）, maternal weight 〈45 kg （AOR 5.64; 95% Cl 1.09-29.07） and maternal weight 45-54 kg （AOR 3.55; 95% CI 1.31-9.60, compared to 〉55 kg） at enrollment, and H IV RNA 〉100 000 copies/ml at enrollment （AOR 4.22; 95% CI 1.24-14.32） and 20 000-99 999 （AOR 2.77; 95% Cl 1.01-7.77, compared to 〈20 000 copies/ml） were associated with a higher risk of LBW. For PD, only maternal injection drug use as the route of HIV transmission （AOR 5.30; 95% Cl 1.33-21.14, compared to those infected with HIV through sexual transmission） was significantly associated with a higher risk of PD. Conclusions Lower CD4 cell count and higher HIV RNA viral load at enrollment were associated with LBW. Optimal antenatal care, including earlier antenatal screening and HIV diagnosis, is critical to earlier PMTCT prophylaxis and/or HIV treatment to prevent transmission of HIV to the infant and also to prevent LBW pregnancy outcomes.展开更多
目的分析极低出生体质量(VLBW)早产儿出生后的血清总胆红素(TBIL)水平和上升率的变化及血清TBIL水平快速上升的危险因素。方法选取2019年1月至2021年12月出生并在该院新生儿重症监护病房接受治疗的VLBW早产儿317例作为研究对象,根据“血...目的分析极低出生体质量(VLBW)早产儿出生后的血清总胆红素(TBIL)水平和上升率的变化及血清TBIL水平快速上升的危险因素。方法选取2019年1月至2021年12月出生并在该院新生儿重症监护病房接受治疗的VLBW早产儿317例作为研究对象,根据“血清TBIL水平上升率”,研究对象被分为A组(血清TBIL水平上升率≤90%)275例和B组(血清TBIL水平上升率>90%)42例。比较两组早产儿的临床特征和血清TBIL水平的变化。采用Pearson相关分析光疗相关参数与血清TBIL上升率的关系。使用Logistic回归模型分析血清TBIL快速上升的相关因素。结果VLBW早产儿出生后血清TBIL水平随着出生时间的延长而增加(P<0.05),血清TBIL水平上升率与光疗开始时的年龄呈负相关,与光疗持续时间呈正相关(r=-0.766、0.478,P<0.05)。与A组相比,B组婴儿的胎龄明显减少,出生体质量明显降低,5 min Apgar评分明显减少,开始光疗的年龄较小,光疗总持续时间较长,差异有统计学意义(P<0.05)。胎龄、出生体质量和5 min Apgar评分为VLBW早产儿血清TBIL水平快速上升的相关因素。结论血清TBIL水平上升率可作为VLBW早产儿早期光疗的指标,血清TBIL水平的快速上升与较低胎龄、较低出生体质量和5 min Apgar评分有关。展开更多
文摘Introduction: The purpose of this retrospective study is to identify medical conditions impacting neurodevelopmental outcomes of extremely low birth weight and very low birth weight preterm infants at three years of age. Methods: Infants born in Banner Diamond Children’s University Medical Center, receiving services in the Newborn Intensive Care Unit, and attending Neonatal Developmental Follow-Up Clinic were identified. Participants received developmental assessment and follow-up from August 2012 through December 2018. Relevant clinical conditions during initial hospital stay and up to three years of age were obtained by reviewing medical and developmental records. Bayley Scales of Infant Toddler Development (Bayley III) was used to evaluate skill development at 6, 9, 12, 18, 24, 30, 36 months. Results: Data analysis did not reveal significant p-values;it did demonstrate that some predictor variables impact neurodevelopmental outcomes in cognitive, language and motor skill development. Conclusion: This retrospective study reports significant association between birth weight and low cognitive scores. Correlations were also found between gestational age and Total Language, and the longer an infant stayed in the NICU, the poorer the Total Language Scaled Scores at 8 to 12 months, 15 to 18 months, and 24 to 36 months. Birth weight was found to be the greatest predictor of poor motor scores.
基金supported by the National Natural Science Foundation of China(No.81573235)Health and Family Commission of Wuhan Municipality(No.WG15D20)Science and Technology Bureau of Wuhan Jiang-an District(No.2014111904)
文摘Low birth weight（LBW） and preterm birth（PB） are associated with newborn mortality and diseases in adulthood.We explored factors related to LBW and PB by conducting a population-based case-control study from January 2011 to December 2013 in Wuhan,China.A total of 337 LBW newborn babies,472 PB babies,and 708 babies with normal birth weights and born from term pregnancies were included in this study.Information of newborns and their parents was collected by trained investigators using questionnaires and referring to medical records.Univariate and logistic regression analyses with the stepwise selection method were used to determine the associations of related factors with LBW and PB.Results showed that maternal hypertension（OR=6.78,95% CI：2.27–20.29,P=0.001）,maternal high-risk pregnancy（OR=1.53,95% CI：1.06–2.21,P=0.022）,and maternal fruit intake ≥300 g per day during the first trimester（OR=1.70,95% CI：1.17–2.45,P=0.005） were associated with LBW.BMI ≥24 kg/m^2 of mother prior to delivery（OR=0.48,95% CI：0.32–0.74,P=0.001） and gestation ≥37 weeks（OR=0.01,95% CI：0.00–0.02,P〈0.034） were protective factors for LBW.Maternal hypertension（OR=3.36,95% CI：1.26–8.98,P=0.016）,maternal high-risk pregnancy（OR=4.38,95% CI：3.26–5.88,P〈0.001）,maternal meal intake of only twice per day（OR=1.88,95% CI：1.10–3.20,P=0.021）,and mother liking food with lots of aginomoto and salt（OR=1.60,95% CI：1.02–2.51,P=0.040） were risk factors for PB.BMI ≥24 kg/m^2 of mother prior to delivery（OR=0.66,95% CI：0.47–0.93,P=0.018）,distance of house from road ≥36 meters（OR=0.72,95% CI：0.53– 0.97,P=0.028）,and living in rural area（OR= 0.60,95% CI：0.37–0.99,P=0.047） were protective factors for PB.Our study demonstrated some risk factors and protective factors for LBW and PB,and provided valuable information for the prevention of the conditions among newborns.
文摘Introduction: Low birth weight and prematurity are risk factors for perinatal morbidity and mortality, which is high in Sub Saharan African countries. We determined the frequency of and maternal and obstetric risk factors for low birth weight and preterm birth among hospital births in rural Gambia. Method: We performed a hospital-based retrospective analysis of deliveries from July to December 2008 in two rural hospitals. Maternity records were reviewed and abstracted of the mother’s demographic and reproductive characteristics, obstetric complications and foetal outcome. The maternity records contain important information maternal health and complications during pregnancy and intrapartum period. The records also contain information about the newborn’s vital status and birth weight. To determine the association between low birth weight (LBW), preterm birth (PTB) and maternal demographic characteristics and obstetric complications we calculated odds using logistic regression. Main outcome measure(s): Low birth weight (<2500 grams) and preterm birth (<37 weeks). Results: Our final sample included 1244 singleton live births with complete information about all variables. The rate of LBW and PTB were 10.5% and 10.9% respectively. Ninety-four percent of LBW infants were estimated to be preterm births. The mean birth weight was 3013 g (541 g standard deviation-SD), while the mean gestational age was 37 weeks. The pattern of risk factors was similar for LBW and PTB and both were strongly associated with antepartum haemorrhage and hypertensive pregnancy disorders. Additionally, primi parity was a risk factor for both PTB and LBW. Conclusion: The percentage of low birth weight and preterm birth in rural hospitals in The Gambia is high. The most significant risk factors were those that may be detected during the antepartum period. Thus, vigilant monitoring during pregnancy, early detection and management of obstetric complications coupled with provision of timely obstetric care interventions are crucial for
文摘Objective: Very-low-birth-weight (VLBW) preterm infants are at risk of growth delay if they do not receive adequate nutritional support. This study evaluated the effect of aggressive early high-dose amino acid infusion plus early enteral trophic feeding on growth in VLBW infants within the first day of life. Study Design: The effect of a high-dose 3 g amino acid (HAA)/kg/d regimen beginning on the first day of life was compared with that of low-dose amino acid (LAA) supplementation at a dose of 0.5 or 1.0 g/kg/d. The primary outcome measures were the days of regained birth weight and achieved full enteral feeding. Result: Compared with the 19 infants in the LAA group, the 17 infants in the HAA group achieved significantly earlier full enteral feeding (7.8 ± 3.6 vs. 15.2 ± 8.9, p = 0.003) and regained birth weight (13.3 ± 3.8 vs. 17.5 ± 7.9, p = 0.047). In addition, shorter parenteral nutrition time was achieved by HAA administration (p Conclusion: Aggressive early simultaneous amino acid administration plus enteral feeding during the first few days of life for preterm infants was associated with improved weight gain and earlier full enteral feeding.
文摘Background: Kangaroo mother care (KMC) is effective in preventing hypothermia, establishing breastfeeding, and reducing nosocomial infection in preterm babies in resource-limited areas. Relatively little is known about long-term morbidity and mortality outcomes among Ethiopian infants managed with KMC. Aims: To describe the follow up profiles and outcome of infants managed with KMC and discharged alive. Methods: This cross-sectional descriptive study examined outcomes among infants who were 1) managed by KMC at Black Lion Hospital, 2) discharged alive, and 3) available for follow-up. Structured, pretested questionnaires were administered to mothers. Results: Of the 110 infants included in the study, 9.1% died over the study period and 60% of the deaths occurred at home. Mortality was 100% in those babies with mothers aged less than 18 years. Thirty five percent of the deaths occurred in those from rural location. Common medical problems identified in study subjects were respiratory infections (10%), gastroenteritis (7%), rickets (7%), and anemia (6%). About 20% of infants were readmitted to hospital at least once. KMC initiation within one week was not found to be significantly associated with survival, but continued KMC after discharge significantly decreased mortality in our sample. Conclusion: Frequent follow up is very important especially those with teenage mothers and coming from a rural location. Follow up should be frequent in the first 2 months after discharge. Further research is needed to explore the determinants of mortality and morbidity after hospital discharge.
文摘目的研究胎龄<32周极低出生体重儿初始无创通气(non-invasive ventilation,NIV)失败相关危险因素及不良预后。方法回顾性收集2019年1月—2021年12月江苏省28家三级医院新生儿重症监护室(neonatal intensive care unit,NICU)收治的早产儿的临床资料,依据生后初始NIV结局分为成功组和失败组,分析NIV失败危险因素及不良预后。结果共纳入817例患儿,男性453例(55.4%),失败139例(17.0%)。失败组胎龄、出生体重、1 min和5 min Apgar评分均低于成功组(P<0.05)。失败组入NICU诊断呼吸窘迫综合征(respiratory distress syndrome,RDS)比例、NIV最大呼气末正压,以及初始NIV全过程中达到所需最高吸入气氧浓度(fraction of inspired oxygen,FiO2)≥30%、≥35%、≥40%比例均高于成功组(P<0.05)。胎龄(OR=0.671,95%CI:0.581~0.772)、入NICU诊断RDS(OR=1.955,95%CI:1.181~3.366)和初始NIV全过程中达到所需最高FiO2≥30%(OR=2.053,95%CI:1.106~4.044)是胎龄<32周极低出生体重儿初始NIV失败的危险因素(P<0.05)。失败组住院期间并发肺部感染、气胸、早产儿视网膜病、中重度支气管肺发育不良、重度脑室内出血的发生率,以及住院时长和总费用均高于成功组(P<0.05)。结论小胎龄、入NICU诊断RDS以及初始NIV全过程中达到所需最高FiO2≥30%是胎龄<32周极低出生体重儿初始NIV失败的高危因素,初始NIV失败将显著增加该人群不良结局的风险。
文摘Background Six provinces in China accounted for 70%-80% of all reported HIV/AIDS cases in the country in 2009 and five provinces accounted for 78% of all reported mother-to-child transmission （MTCT） of HIV cases. Because Guangxi belonged to both groups, the Prevention of Mother-to-Child Transmission （PMTCT） Plus program was established there to understand better low birth weight （LBW） and preterm delivery （PD） birth outcomes and their associated risk factors better. Methods Pregnancy outcomes were examined among HIV-infected pregnant women who enrolled in the PMTCT Plus program from June 2006 to February 2009 in Guangxi, China. Multivariate Logistic regression analysis was used to explore the risk factors associated with LBW （〈2500 g） and PD （gestational age 〈37 weeks）. Results The prevalence of LBW and PD among 194 HIV-positive mothers was 19.6% （38/194） and 9.8% （19/194）, respectively. Multivariate Logistic regression analysis showed that CD4 cell count 〈100 cell/IJI （multivariate-adjusted odds ratio （AOR） 5.52; 95% Cl 1.11-25.55） and CD4 cell count 100-199 cells/IJI （AOR3.40; 95% Cl 1.03-11.25, compared to CD4 cell count 〉350 cells/IJI）, gestational age 〈37 weeks （AOR 4.38; 95% Cl 1.29-14.82, compared to 〉37 weeks）, maternal weight 〈45 kg （AOR 5.64; 95% Cl 1.09-29.07） and maternal weight 45-54 kg （AOR 3.55; 95% CI 1.31-9.60, compared to 〉55 kg） at enrollment, and H IV RNA 〉100 000 copies/ml at enrollment （AOR 4.22; 95% CI 1.24-14.32） and 20 000-99 999 （AOR 2.77; 95% Cl 1.01-7.77, compared to 〈20 000 copies/ml） were associated with a higher risk of LBW. For PD, only maternal injection drug use as the route of HIV transmission （AOR 5.30; 95% Cl 1.33-21.14, compared to those infected with HIV through sexual transmission） was significantly associated with a higher risk of PD. Conclusions Lower CD4 cell count and higher HIV RNA viral load at enrollment were associated with LBW. Optimal antenatal care, including earlier antenatal screening and HIV diagnosis, is critical to earlier PMTCT prophylaxis and/or HIV treatment to prevent transmission of HIV to the infant and also to prevent LBW pregnancy outcomes.
文摘目的分析极低出生体质量(VLBW)早产儿出生后的血清总胆红素(TBIL)水平和上升率的变化及血清TBIL水平快速上升的危险因素。方法选取2019年1月至2021年12月出生并在该院新生儿重症监护病房接受治疗的VLBW早产儿317例作为研究对象,根据“血清TBIL水平上升率”,研究对象被分为A组(血清TBIL水平上升率≤90%)275例和B组(血清TBIL水平上升率>90%)42例。比较两组早产儿的临床特征和血清TBIL水平的变化。采用Pearson相关分析光疗相关参数与血清TBIL上升率的关系。使用Logistic回归模型分析血清TBIL快速上升的相关因素。结果VLBW早产儿出生后血清TBIL水平随着出生时间的延长而增加(P<0.05),血清TBIL水平上升率与光疗开始时的年龄呈负相关,与光疗持续时间呈正相关(r=-0.766、0.478,P<0.05)。与A组相比,B组婴儿的胎龄明显减少,出生体质量明显降低,5 min Apgar评分明显减少,开始光疗的年龄较小,光疗总持续时间较长,差异有统计学意义(P<0.05)。胎龄、出生体质量和5 min Apgar评分为VLBW早产儿血清TBIL水平快速上升的相关因素。结论血清TBIL水平上升率可作为VLBW早产儿早期光疗的指标,血清TBIL水平的快速上升与较低胎龄、较低出生体质量和5 min Apgar评分有关。
