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1.
Croat Med J ; 62(2): 165-172, 2021 Apr 30.
Artículo en Inglés | MEDLINE | ID: mdl-33938656

RESUMEN

AIM: To evaluate the relationship between the neurological outcome, neonatal epileptic seizures, and signal-intensity visibility of the frontal and parietal periventricular crossroads of pathways on brain magnetic resonance imaging (MRI) in preterm infants at term-equivalent age. METHODS: The study enrolled 48 preterm infants born between 2012 and 2016. The signal-intensity characteristics of the frontal and parietal periventricular crossroads were evaluated and classified into four grades. A non-favorable outcome was defined as a motor and functional disorder with developmental delay and/or cerebral palsy. RESULTS: Neonatal seizures, epilepsy, pathological EEG and brain ultrasound finding, and brain MRI abnormalities were mostly found in neonates with non-favorable outcomes. Visible frontal and parietal periventricular crossroads were associated with a normal neurologic outcome (P=0.0004; P=0.0009, respectively). Not-visible or slightly visible periventricular crossroads were associated with non-favorable outcomes in the case of frontal crossroads (P=0.036) and not-visible periventricular crossroads in the case of both frontal and parietal crossroads (P=0.001, P=0.015, respectively). The visibility of the frontal and parietal periventricular crossroads was associated with a lack of neonatal epileptic seizures (P=0.03; P=0.02, respectively). The frontal crossroads were more frequently slightly visible, while the parietal periventricular crossroads were more frequently visible. CONCLUSION: Poor visibility of the frontal and parietal crossroads of pathways on MRI is associated with neonatal epileptic seizures and poor neurological outcomes in preterm infants at term-equivalent age.


Asunto(s)
Parálisis Cerebral , Recien Nacido Prematuro , Encéfalo/diagnóstico por imagen , Humanos , Lactante , Recién Nacido , Imagen por Resonancia Magnética , Convulsiones
2.
J Med Case Rep ; 15(1): 213, 2021 Apr 23.
Artículo en Inglés | MEDLINE | ID: mdl-33892788

RESUMEN

BACKGROUND: Vertical transmission of coronavirus disease 2019 (COVID-19) from mother to newborn infant is doubtful, and very little is known about disease severity and neonatal outcome. CASE PRESENTATION: We present a preterm Iranian infant born to a Persian mother with severe COVID-19 pneumonia. The mother underwent cesarean delivery, and amniotic fluid yielded a positive result for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by real-time reverse transcription polymerase chain reaction (RT-PCR). The newborn infant showed early-onset infection with SARS-CoV-2 confirmed on pharyngeal swabs by RT-PCR assay within 24 hours after birth, suggesting vertical transmission. Unfortunately, the mother died 14 days after delivery. We describe the clinical course and outcome of the infant up to 7 months of age. CONCLUSION: COVID-19 infection in pregnant women may increase maternal morbidity, mortality and possibly vertical transmission in severe cases. However, it does not seem to progress to serious early or late neonatal complications.


Asunto(s)
/diagnóstico , Transmisión Vertical de Enfermedad Infecciosa , Complicaciones Infecciosas del Embarazo/diagnóstico , Nacimiento Prematuro , Líquido Amniótico/virología , Cesárea , Resultado Fatal , Femenino , Humanos , Recién Nacido , Recien Nacido Prematuro , Irán , Embarazo , Complicaciones Infecciosas del Embarazo/virología , Resultado del Embarazo , Resucitación , Adulto Joven
3.
Zhongguo Dang Dai Er Ke Za Zhi ; 23(4): 332-337, 2021 Apr.
Artículo en Chino | MEDLINE | ID: mdl-33840403

RESUMEN

OBJECTIVE: To compare the effect of delayed cord clamping (DCC) versus umbilical cord milking (UCM) on cerebral blood flow in preterm infants. METHODS: This was a single-center, prospective, double-blind, randomized controlled trial. A total of 46 preterm infants, with a gestational age of 30-33+6 weeks, who were born in Suining Central Hospital from November 2, 2018 to November 15, 2019 were enrolled and randomly divided into DCC group and UCM group, with 23 infants in each group. The primary outcome indexes included cerebral hemodynamic parameters[peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistance index (RI)] measured by ultrasound within 0.5-1 hour, (24±1) hours, (48±1) hours, and (72±1) hours after birth. Secondary outcome indexes included hematocrit, hemoglobin, red blood cell count, and serum total bilirubin levels on the first day after birth and the incidence rate of intraventricular hemorrhage during hospitalization. RESULTS: A total of 21 preterm infants in the DCC group and 23 in the UCM group were included in the statistical analysis. There was no significant difference in PSV, EDV, and RI between the two groups at all time points after birth (P > 0.05). There was also no significant difference between the two groups in the hematocrit, hemoglobin, red blood cell count and total bilirubin levels on the first day after birth, and the incidence rate of intraventricular hemorrhage during hospitalization (P > 0.05). CONCLUSIONS: DCC and UCM have a similar effect on cerebral hemodynamics in preterm infants with a gestational age of 30-33+6 weeks.


Asunto(s)
Recien Nacido Prematuro , Cordón Umbilical , Constricción , Hemodinámica , Humanos , Lactante , Recién Nacido , Estudios Prospectivos
4.
Zhongguo Dang Dai Er Ke Za Zhi ; 23(4): 369-374, 2021 Apr.
Artículo en Chino | MEDLINE | ID: mdl-33840409

RESUMEN

OBJECTIVE: To explore the risk factors for endotracheal intubation during resuscitation in the delivery room among very preterm infants. METHODS: A retrospective analysis was performed for 455 very preterm infants who were admitted to the neonatal intensive care unit from January 2017 to December 2019. They were divided into an intubation group (n=79) and a non-intubation group (n=376) according to whether endotracheal intubation was performed during resuscitation. The risk factors for endotracheal intubation during resuscitation were evaluated by multivariate logistic regression analysis. RESULTS: The intubation rate was 17.4% (79/455). Compared with the intubation group, the non-intubation group had significantly higher gestational age, birth weight, and rates of caesarean birth, delayed cord clamping (DCC), resuscitation quality improvement, regular use of antenatal glucocorticoids in mothers and premature rupture of membranes > 18 hours (P < 0.05), but significantly lower rates of maternal gestational diabetes mellitus, placental abruption, placenta previa or placenta previa status, and maternal thyroid dysfunction (P < 0.05). Regular use of antenatal glucocorticoids in mothers (OR=0.368, P < 0.05) and DCC (OR=0.222, P < 0.05) were protective factors against intubation during resuscitation, while younger gestational age, birth weight < 750 g, maternal gestational diabetes mellitus, and placenta previa or placenta previa status were risk factors for intubation during resuscitation (P < 0.05). CONCLUSIONS: Very preterm infants with younger gestational age, birth weight < 750 g, maternal diabetes mellitus, placenta previa or placenta previa status may have a higher risk for endotracheal intubation after birth. The regular use of antenatal glucocorticoids and DCC can reduce the risk of intubation during resuscitation in very preterm infants.


Asunto(s)
Salas de Parto , Recien Nacido Prematuro , Femenino , Edad Gestacional , Humanos , Lactante , Recién Nacido , Intubación Intratraqueal , Embarazo , Estudios Retrospectivos , Factores de Riesgo
5.
Zhongguo Dang Dai Er Ke Za Zhi ; 23(4): 375-380, 2021 Apr.
Artículo en Chino | MEDLINE | ID: mdl-33840410

RESUMEN

OBJECTIVE: To study the risk factors and treatment for neutropenia of late newborns (NLN). METHODS: Related clinical data were collected from the preterm infants and critically ill neonates who were admitted to the neonatal intensive care unit from July 2019 to January 2020. A total of 46 newborns with a blood absolute neutrophil count (ANC) of < 1.5×109/L for two consecutive times at weeks 2-4 after birth were enrolled as the NLN group. A total of 92 late newborns with a blood ANC of ≥ 1.5×109/L, matched at a ratio of 1:2, were enrolled as the control group. Possible risk factors associated with NLN and the treatment process were recorded. A logistic regression analysis was performed to identify the risk factors for NLN. RESULTS: Among the 46 neonates in the NLN group, 29 had a gestational age of < 32 weeks, 14 had a gestational age of 32-37 weeks, and 3 had a gestational age of > 37 weeks. There was no significant difference between the two groups in the incidence rates of gestational hypertension, premature rupture of membranes > 18 hours and intrauterine distress, 5-minute Apgar score, the duration of positive pressure ventilation, the incidence rate of early-onset sepsis, and the type of initially used antibiotics (P > 0.05). Compared with the control group, the NLN group had a higher incidence rate of late-onset sepsis and a longer duration of antibiotic use (P < 0.05). Late-onset sepsis and prolonged duration of antibiotic use were independent risk factors for NLN (P < 0.05). With the presence of late-onset sepsis, the risk of NLN was increased by 1.537 times in neonates, and the risk of NLN was increased by 76.9% for every 3-day increase in the duration of antibiotic use. The mean age at the diagnosis of NLN was (21±6) days for the 46 neonates in the NLN group. Thirteen neonates with NLN were administered with recombinant human granulocyte colony-stimulating factor (G-CSF, 10 µg/kg) once or twice. O the 13 neonates, 6 had an ANC of < 0.5×109/L and 7 had a gestational age of < 32 weeks or severe disease conditions. After treatment the ANC returned to > 1.0×109/L in the 13 neonates. No drug-related adverse reactions were found. After the diagnosis of NLN, 2 neonates developed sepsis, and the remaining 44 neonates did not develop any common purulent infections. CONCLUSIONS: The risk of NLN increases with the presence of late-onset sepsis and the increase in the duration of antibiotic use. NLN is generally a benign process. G-CSF appears to be safe and effective for NLN with severe disease conditions or severe reduction in ANC.


Asunto(s)
Neutropenia , Sepsis , Factor Estimulante de Colonias de Granulocitos , Humanos , Lactante , Recién Nacido , Recien Nacido Prematuro , Recuento de Leucocitos , Factores de Riesgo
6.
Zhongguo Dang Dai Er Ke Za Zhi ; 23(4): 390-396, 2021 Apr.
Artículo en Chino | MEDLINE | ID: mdl-33840412

RESUMEN

OBJECTIVE: To systematically evaluate the association of early nutrition intake with the risk of bronchopulmonary dysplasia (BPD). METHODS: PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, Wanfang Data, and Weipu Periodical Database were searched for the observational studies on the association between early nutrition intake and BPD. RevMan 5.3 software was used to perform a Meta analysis of eligible studies. RESULTS: Eight observational studies were included, with 548 infants with BPD and 522 infants without BPD. The Meta analysis showed that the BPD group had a significantly lower caloric intake than the non-BPD group within the first week after birth and in the first 2 weeks after birth (P < 0.05). The BPD group had a significantly lower enteral nutrition intake than the non-BPD group (WMD=-18.27, 95%CI:-29.70 to -6.84, P < 0.05), as well as a significantly lower intake of carbohydrate, fat, and protein (P < 0.05). The BPD group had a significantly longer duration of parenteral nutrition than the non-BPD group (WMD=14.26, 95%CI:13.26-15.25, P < 0.05). CONCLUSIONS: Early nutrition deficiency may be associated with the development of BPD, and more attention should be paid to enteral feeding of infants at a high risk of BPD to achieve total enteral feeding as soon as possible.


Asunto(s)
Displasia Broncopulmonar , Desnutrición , Displasia Broncopulmonar/epidemiología , Displasia Broncopulmonar/etiología , China , Humanos , Lactante , Recién Nacido , Recien Nacido Prematuro , Nutrición Parenteral
7.
Nutrients ; 13(3)2021 Mar 18.
Artículo en Inglés | MEDLINE | ID: mdl-33803743

RESUMEN

Ensuring the nutritional demands of preterm (PT) infants during complementary feeding could contribute significantly to the infants' long-term health and development. However, the dietary guidelines for complementary feeding in PT are scarce. Thus, describing dietary intake and identifying nutritional targets for these infants could be of great interest. The aim of this study is to assess the food intake and anthropometric parameters in a Mediterranean infant cohort from 6 to 24 months and to identify nutritional targets especially focused on late preterm infants. This is a longitudinal prospective study analyzing information from administered questionnaires about general characteristics and food frequency consumption in 115 infants (20 PT (32 to 36 gestational weeks), 95 full-term (FT)) at 6, 12 and 24 months of age. Results show that the differences in the prevalence of underweight observed in PT infants vs. FT infants are maintained for up to 6 months of age but disappear at 12 and 24 months. The age of inclusion of new foods and the average intake of the main food groups was not different from that of FTs. Although protein intake at 6 months was directly correlated with weight gain and growth in FT, these associations were not observed in PT. At the nutritional level, the low intake of vitamin D in preterm infants is noteworthy. These findings may be useful when designing new intervention strategies for this population group.


Asunto(s)
Antropometría , Dieta/estadística & datos numéricos , Fenómenos Fisiológicos Nutricionales del Lactante/fisiología , Recien Nacido Prematuro/crecimiento & desarrollo , Delgadez/epidemiología , Dieta/efectos adversos , Encuestas sobre Dietas , Ingestión de Alimentos , Femenino , Edad Gestacional , Humanos , Lactante , Recién Nacido , Estudios Longitudinales , Masculino , Región Mediterránea/epidemiología , Política Nutricional , Prevalencia , Estudios Prospectivos , Delgadez/etiología , Aumento de Peso
8.
Medicine (Baltimore) ; 100(14): e25470, 2021 Apr 09.
Artículo en Inglés | MEDLINE | ID: mdl-33832161

RESUMEN

RATIONALE: Pentalogy of Cantrell (POC) is an extremely rare syndrome with an estimated incidence of 1:65,000 to 200,000 live births. Its complete form includes a midline epigastric abdominal wall defect, defects affecting the lower sternum, anterior diaphragm, diaphragmatic pericardium, and various intracardiac defects. PATIENT CONCERNS: We report a case of complete POC affecting only the first-born of a set of premature dizygotic twins. DIAGNOSIS: A giant omphalocele with an eviscerated liver and bowel on prenatal, obstetric ultrasonography at 24 gestational weeks was observed. At birth, physical examination confirmed a massive (10 × 8 cm) epigastric omphalocele in which a significant part of the liver was seen. A postnatal echocardiogram revealed the presence of an ostium secundum atrial septal defect, perimembranous ventricular septal defect, and moderate pulmonary stenosis. X-ray showed an abnormal intrathoracic positioned stomach, which was confirmed with a plain x-ray of the upper intestinal tract with hydrosoluble contrast. Computed tomography (CT) scan revealed the sternum's absence and a close connection between the pericardial sac and the stomach wall. INTERVENTIONS: The patient underwent surgical intervention at 18 days of age. OUTCOMES: Despite adequate and appropriate postoperative treatment, the baby rapidly deteriorated and died 72 hours after surgery. LESSONS: POC is a complex, high-mortality syndrome whose management requires a multidisciplinary approach and meticulous planning. Despite all efforts, POC carries a poor prognosis, particularly in patients affected by its complete form.


Asunto(s)
Enfermedades en Gemelos/diagnóstico , Enfermedades del Prematuro/diagnóstico , Pentalogía de Cantrell/diagnóstico , Gemelos Dicigóticos , Resultado Fatal , Humanos , Recién Nacido , Recien Nacido Prematuro , Masculino
9.
BMC Pregnancy Childbirth ; 21(1): 273, 2021 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-33794829

RESUMEN

BACKGROUND: To determine whether severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, the cause of COVID-19 disease) exposure in pregnancy, compared to non-exposure, is associated with infection-related obstetric morbidity. METHODS: We conducted a multicentre prospective study in pregnancy based on a universal antenatal screening program for SARS-CoV-2 infection. Throughout Spain 45 hospitals tested all women at admission on delivery ward using polymerase-chain-reaction (PCR) for COVID-19 since late March 2020. The cohort of positive mothers and the concurrent sample of negative mothers was followed up until 6-weeks post-partum. Multivariable logistic regression analysis, adjusting for known confounding variables, determined the adjusted odds ratio (aOR) with 95% confidence intervals (95% CI) of the association of SARS-CoV-2 infection and obstetric outcomes. MAIN OUTCOME MEASURES: Preterm delivery (primary), premature rupture of membranes and neonatal intensive care unit admissions. RESULTS: Among 1009 screened pregnancies, 246 were SARS-CoV-2 positive. Compared to negative mothers (763 cases), SARS-CoV-2 infection increased the odds of preterm birth (34 vs 51, 13.8% vs 6.7%, aOR 2.12, 95% CI 1.32-3.36, p = 0.002); iatrogenic preterm delivery was more frequent in infected women (4.9% vs 1.3%, p = 0.001), while the occurrence of spontaneous preterm deliveries was statistically similar (6.1% vs 4.7%). An increased risk of premature rupture of membranes at term (39 vs 75, 15.8% vs 9.8%, aOR 1.70, 95% CI 1.11-2.57, p = 0.013) and neonatal intensive care unit admissions (23 vs 18, 9.3% vs 2.4%, aOR 4.62, 95% CI 2.43-8.94, p <  0.001) was also observed in positive mothers. CONCLUSION: This prospective multicentre study demonstrated that pregnant women infected with SARS-CoV-2 have more infection-related obstetric morbidity. This hypothesis merits evaluation of a causal association in further research.


Asunto(s)
/epidemiología , Rotura Prematura de Membranas Fetales/epidemiología , Complicaciones Infecciosas del Embarazo/epidemiología , Nacimiento Prematuro/epidemiología , Adolescente , Adulto , Estudios de Casos y Controles , Cesárea/estadística & datos numéricos , Femenino , Edad Gestacional , Humanos , Recien Nacido Extremadamente Prematuro , Recién Nacido , Recien Nacido Prematuro , Unidades de Cuidado Intensivo Neonatal/estadística & datos numéricos , Trabajo de Parto Inducido/estadística & datos numéricos , Modelos Logísticos , Persona de Mediana Edad , Análisis Multivariante , Oportunidad Relativa , Embarazo , Estudios Prospectivos , España/epidemiología , Adulto Joven
12.
Artículo en Inglés | MEDLINE | ID: mdl-33802268

RESUMEN

In this study, we observed physiological reactions of premature infants during sponge bathing in the neonatal intensive care unit (NICU). The infants' body temperature, heart rate, and oxygen saturation were monitored to examine hypothermia risks during bathing. The participants of the study were 32 premature infants who were hospitalized right after their birth in the V hospital in Korea between December 2012 and August 2013. The informed consents of the study were received from the infants' parents. The infants were randomly assigned into two-day and four-day bath cycle groups and their physiological reactions were monitored before bathing as well as 5 and 10 min after bathing. The collected data were analyzed using the SPSS statistical package through t-test. A significant drop in body temperature was noted in both groups; that is, 4-day bathing cycle and 2-day bathing cycle (p < 0.001). However, there were no significant changes in heart rate or transcutaneous oxygen levels. There was no significant change between groups at each measurement point. In order to minimize the physiological instability that may be caused during bathing, the care providers should try to complete bathing within the shortest possible time and to make bathing a pleasant and useful stimulus for infants.


Asunto(s)
Enfermedades del Prematuro , Recien Nacido Prematuro , Baños , Humanos , Recién Nacido , Unidades de Cuidado Intensivo Neonatal , República de Corea
13.
Artículo en Inglés | MEDLINE | ID: mdl-33809933

RESUMEN

The purpose of this study was to describe the trends of research on follow-up care after neonatal intensive care unit (NICU) graduation for children born preterm. This scoping review was conducted according to Arksey and O'Malley's guidelines. Reviewed studies were searched in PubMed, CHINAHL, and Web of Science. Fifteen studies were analyzed according to general characteristics, elements of follow-up care after NICU graduation, and characteristics of follow-up care intervention after NICU graduation. Most research was conducted in the medical field (60%), with experimental studies (40%) being the majority, and a few studies focused on families (3%) and parents (3%). The major follow-up care after NICU graduation elements were growth/developmental monitoring and support, continuity of care, parent- and family-centered elements, and a multidisciplinary approach. The intervention methods included home visits, phone calls, video calls, and applications. In addition, the intervention period ranged from two weeks to three years. It is suggested that multidisciplinary research with interactive media for a various age of children over longer periods for further study.


Asunto(s)
Cuidados Posteriores , Unidades de Cuidado Intensivo Neonatal , Niño , Femenino , Humanos , Recién Nacido , Recien Nacido Prematuro , Parto , Embarazo
16.
Zhonghua Yan Ke Za Zhi ; 57(5): 353-357, 2021 May 11.
Artículo en Chino | MEDLINE | ID: mdl-33915638

RESUMEN

Objective: To investigate the characteristics and associated factors of early refractive parameters in premature infants. Methods: Case-control study. Premature infants who underwent the first fundus screening in the ophthalmic clinic of Xiamen children's Hospital from May 2018 to February 2019 were collected. The screening time was 4 to 6 weeks after birth or corrected gestational age from 31 to 32 weeks. The premature infants who were diagnosed with mild retinopathy of prematurity (ROP) in one eye or both eyes but did not receive any treatment were divided into ROP group and divided into zone Ⅱ subgroup and zone Ⅲ subgroup according to the region of ROP; the premature infants without ROP were divided into non-ROP group. The gestational age, birth weight, spherical equivalent, anterior chamber depth, vitreous depth, axial length, lens thickness and corneal refractive power were recorded and compared. Independent sample t-test, multiple linear regression analysis and Pearson correlation analysis were used. Results: A total of 180 premature infants, 101 males and 79 females, with gestational age of (30.82±3.10) weeks, corrected gestational age of (37.21±1.44) weeks and birth weight of (1 577.85±572.12) g were included in this study. Ninety premature infants were included in the ROP group (162 eyes, of which 85 right eyes were included in the analysis) and 90 in the non-ROP group (90 right eyes). There was no significant difference in the distribution of gestational age, birth weight and corrected gestational age between the ROP group and non-ROP group (all P>0.05), but there was significant difference in the spherical equivalent between the two groups [(1.90±1.39) D vs. (3.04±1.88) D, t=-4.653, P<0.01], and ROP group was relatively smaller. In the ROP group, the anterior chamber depth was (1.82±0.23) mm, the lens thickness was (4.54±0.18) mm, and the corneal refractive power was (43.99±0.99) D. In the non-ROP group, the anterior chamber depth was (1.91±0.94) mm, the lens thickness was (4.23±0.50) mm, and the corneal refractive power was (43.72±0.92) D. The difference between the two groups was statistically significant (all P<0.01). In ROP group, the anterior chamber depth was shallower, the lens was thicker, and the corneal refractive power was higher. In ROP group, the corneal refractive power of 48 right eyes in zone Ⅱ subgroup and 37 right eyes in Zone Ⅲ subgroup were (43.92±0.78) D and (43.39±1.05) D respectively, and the spherical equivalent were (2.08±0.95) D and (2.52±1.12) D respectively. The corneal refractive power of zone Ⅱ subgroup was higher and the spherical equivalent was smaller, and the differences were statistically significant (all P<0.05). Multiple regression analysis showed that birth weight, gestational age and corneal refractive power were the influencing factors of spherical equivalent (P<0.01). The results of Pearson correlation analysis showed that the gestational age (r=0.182), birth weight (r=0.223) and corneal refractive power (r=-0.125) of premature infants were closely related to the spherical equivalent (all P<0.05). Conclusions: In premature infants, the larger spherical equivalent is related to greater gestational age and heavier birth weight. The refractive parameters of mild ROP are characterized by shallow anterior chamber, thick lens, high corneal refractive power and small spherical equivalent. The spherical equivalent is closely related to the development of ROP. (Chin J Ophthalmol, 2021, 57: 353-357).


Asunto(s)
Recien Nacido Prematuro , Retinopatía de la Prematuridad , Estudios de Casos y Controles , Niño , Femenino , Edad Gestacional , Humanos , Lactante , Recién Nacido de Bajo Peso , Recién Nacido , Masculino , Retinopatía de la Prematuridad/epidemiología
17.
Zhonghua Yan Ke Za Zhi ; 57(5): 379-385, 2021 May 11.
Artículo en Chino | MEDLINE | ID: mdl-33915643

RESUMEN

With improved neonatal care, the survival rate of premature infants has been greatly increased, and retinopathy of prematurity (ROP) has already been the leading cause of blindness in children. Thereupon screening and treatment of ROP have been deeply performed in China. However, the implementation and the detection rate vary greatly in different regions. In this article, based on the 20-year prevalence data of ROP in all parts of the country before 2010, we review and summarize the literatures from 2008 to 2018, in order to track and update the screening data of ROP in the mainland of China and to find the incidence trend during the decade. The evidence of the changing prevalence of ROP would benefit further prevention of this serious eye disease. (Chin J Ophthalmol, 2021, 57: 379-385).


Asunto(s)
Retinopatía de la Prematuridad , Niño , China/epidemiología , Edad Gestacional , Humanos , Incidencia , Lactante , Recién Nacido de Bajo Peso , Recién Nacido , Recien Nacido Prematuro , Tamizaje Neonatal , Prevalencia , Retinopatía de la Prematuridad/epidemiología , Factores de Riesgo
18.
Ital J Pediatr ; 47(1): 66, 2021 Mar 16.
Artículo en Inglés | MEDLINE | ID: mdl-33726805

RESUMEN

BACKGROUND: Early postanal growth of preterm infants has many effects on early and late health. However, evidence on growth pattern in Chinese preterm infant population during early life is insufficient. This study aims to describe the growth trajectory, catch-up growth, and risk of overweight of preterm infants during the first 2 years of life in a Chinese community population. METHODS: All preterm infants (n = 10,624) received routine childcare in one primary maternal and child healthcare network in 8 years were included. Body weight and length/height at corrected age (CA) 40 weeks, CA 3 months, 6 months, 9 months, 12 months, 18 months, and 24 months were extracted and converted to z-scores based on the World Health Organization (WHO) standards. According to the intrauterine growth status, infants were divided into small for gestational age (SGA), appropriate for gestational age (AGA), and large for gestational age (LGA) infants. Changes of z-score were used to describe the growth velocity. Generalized estimating equation (GEE) model was used to analyze growth trajectory trends over time. RESULTS: Body weight and length/height were overall above the WHO standards during the first 2 years of life. Z-score increased significantly by 0.08 (95% CI: 0.06-0.10) in weight and 0.07 (95% CI: 0.04-0.09) in length/height from CA 40 weeks to 3 months and then levelled off until CA 24 months after adjustment. Almost 90% of AGA and LGA infants achieved growth targets (≥25th percentile of WHO standards), and over 85% of SGA infants achieved catch-up growth (≥10th percentile of WHO standards) before CA 24 months. However, the risk of overweight appeared during this period, with the proportion of infants with the risk of overweight being at the peak at CA 3 months (25.6% of all preterm infants and 39.4% of LGA infants). Growth trajectories of SGA showed increasing trends, but those of LGA showed decreasing trends during the first 2 years. CONCLUSIONS: Body weight and length/height of preterm infants are above the WHO standards in the Chinese community population during the first 2 years of life. Catch-up growth is accompanied by risk of overweight as early as CA 3 months. (349 words).


Asunto(s)
Recien Nacido Prematuro/crecimiento & desarrollo , Sobrepeso , Antropometría , China , Femenino , Humanos , Lactante , Recién Nacido , Recién Nacido Pequeño para la Edad Gestacional/crecimiento & desarrollo , Masculino , Factores de Riesgo
19.
Cochrane Database Syst Rev ; 3: CD009969, 2021 03 30.
Artículo en Inglés | MEDLINE | ID: mdl-33781001

RESUMEN

BACKGROUND: Preterm infants and neonates with respiratory conditions commonly require intubation and conventional mechanical ventilation (CMV) to maintain airway patency and support their respiration. Whilst this therapy is often lifesaving, it simultaneously carries the risk of lung injury. The use of lung recruitment manoeuvres (LRMs) has been found to reduce the incidence of lung injury, and improve oxygenation and lung compliance in ventilated adults. However, evidence pertaining to their use in neonates is limited, and there is no consensus of opinion as to whether LRMs are appropriate or effective in this population. OBJECTIVES: To determine the effects of LRMs on mortality and respiratory outcomes in mechanically ventilated neonates, when compared to no recruitment (routine care).  SEARCH METHODS: We used the standard search strategy of Cochrane Neonatal to search the Cochrane Central Register of Controlled Trials (CENTRAL 2020, Issue 4) in the Cochrane Library, MEDLINE via Ovid (1946 to 13 April 2020), and CINAHL via EBSCOhost (1989 to 13 April 2020). We also handsearched the reference lists of retrieved studies to source additional articles.  SELECTION CRITERIA: We included randomised controlled trials (RCTs), quasi-RCTs and randomised cross-over studies that compared the effect of LRMs to no recruitment (routine care) in mechanically ventilated neonates. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed trial eligibility, extracted data and evaluated risk of bias in the included studies. When studies were sufficiently similar, we performed a meta-analysis using mean difference (MD) for continuous data and risk ratio (RR) for dichotomous data, with their respective 95% confidence intervals (CIs). We used the GRADE approach to assess the certainty of the evidence for key (clinically important) outcomes. MAIN RESULTS: We included four studies (152 participants in total) in this review. Three of these studies, enrolling 56 participants, contributed data to our prespecified outcomes. Two studies enrolling 44 participants on CMV for respiratory distress syndrome compared a stepwise LRM with positive end-expiratory pressure (PEEP) to routine care. Meta-analysis demonstrated no evidence of a difference between the LRM and routine care on mortality by hospital discharge (RR 1.00, 95% CI 0.17 to 5.77; low-certainty evidence), incidence of bronchopulmonary dysplasia (RR 0.25, 95% CI 0.03 to 2.07; low-certainty evidence), duration of supplemental oxygen (MD -7.52 days, 95% CI -20.83 to 5.78; very low-certainty evidence), and duration of ventilatory support (MD -3.59 days, 95% CI -12.97 to 5.79; very low-certainty evidence). The certainty of the evidence for these outcomes was downgraded due to risk of bias, imprecision, and inconsistency. Whilst these studies contributed data to four of our primary outcomes, we were unable to identify any studies that reported our other primary outcomes: duration of continuous positive airway pressure therapy, duration of neonatal intensive care unit stay, and duration of hospital stay.  The third study that contributed data to the review enrolled 12 participants on CMV for respiratory and non-respiratory causes, and compared two different LRMs applied after endotracheal tube suctioning to routine care. It was determined that both LRMs may slightly improve end-expiratory lung volume at 120 minutes' post-suctioning, when compared to routine care (incremental PEEP LRM versus routine care: MD -0.21, 95% CI -0.37 to -0.06; double PEEP LRM versus routine care: MD -0.18, 95% CI -0.35 to -0.02). It was also demonstrated that a double PEEP LRM may slightly reduce mean arterial pressure at 30 minutes' post-suctioning, when compared with routine care (MD -16.00, 95% CI -29.35 to -2.65).  AUTHORS' CONCLUSIONS: There is insufficient evidence to guide the use of LRMs in mechanically ventilated neonates. Well-designed randomised trials with larger sample sizes are needed to further evaluate the potential benefits and risks of LRM application in this population.


Asunto(s)
Displasia Broncopulmonar/epidemiología , Respiración Artificial/efectos adversos , Síndrome de Dificultad Respiratoria del Recién Nacido/terapia , Lesión Pulmonar Inducida por Ventilación Mecánica/mortalidad , Sesgo , Intervalos de Confianza , Humanos , Incidencia , Recién Nacido , Recien Nacido Prematuro , Oxígeno/administración & dosificación , Respiración con Presión Positiva/efectos adversos , Respiración con Presión Positiva/métodos , Respiración Artificial/métodos , Respiración Artificial/estadística & datos numéricos , Lesión Pulmonar Inducida por Ventilación Mecánica/prevención & control
20.
Subcell Biochem ; 97: 455-482, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33779928

RESUMEN

Preeclampsia (PE) is associated with long-term morbidity in mothers and lifelong morbidities for their children, ranging from cerebral palsy and cognitive delay in preterm infants, to hypertension, diabetes and obesity in adolescents and young adults. There are several processes that are critical for development of materno-fetal exchange, including establishing adequate perfusion of the placenta by maternal blood, and the formation of the placental villous vascular tree. Recent studies provide persuasive evidence that placenta-derived extracellular vesicles (EVs) represent a significant intercellular communication pathway, and that they may play an important role in placental and endothelial cell (both fetal and maternal) function. These functions are known to be altered in PE. EVs can carry and transport a wide range of bioactive molescules that have potential to be used as biomarkers and therapeutic delivery tools for PE. EV content is often parent cell specific, thus providing an insight or "thumbprint" of the intracellular environment of the originating cell (e.g., human placenta). EV have been identified in plasma under both normal and pathological conditions, including PE. The concentration of EVs and their content in plasma has been reported to increase in association with disease severity and/or progression. Placenta-derived EVs have been identified in maternal plasma during normal pregnancy and PE pregnancies. They contain placenta-specific proteins and miRNAs and, as such, may be differentiated from maternally-derived EVs. The aim of this review, thus, is to describe the potential roles of EVs in preecmpatic pregnancies, focussing on EVs secreted from placental cells. The biogenesis, specificity of placental EVs, and methods used to characterise EVs in the context of PE pregnancies will be also discussed.


Asunto(s)
Vesículas Extracelulares , Preeclampsia , Adolescente , Biomarcadores , Niño , Femenino , Humanos , Recién Nacido , Recien Nacido Prematuro , Placenta , Embarazo
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