Changes of the peripapillary vascular parameters inpremature infants without retinopathy of prematurityusing U-net segmentation

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.

Analysis of the clinical characteristics and refraction state in premature infants: a 10-year retrospective analysis

AIM: To report the visual outcomes and refractive status in premature infants with and without retinopathy of prematurity(ROP) who were or not treated. METHODS: The clinical records of all premature infants with or without ROP and with or without treatment between 2007 and 2017 were retrospectively reviewed. Basic demographic data, serial changes in ROP incidence, treatment and outcomes, and the refractive states were analyzed. Correlations among myopia and astigmatism progression, birth weight, gestational age, and treatment methods were also analyzed.RESULTS: A total of 562 screened premature infants(all Chinese, 1124 eyes), were recruited with a 378:184 maleto-female ratio. Birth weight did not directly influence ROP incidence. The overall ROP incidence was 16.55%(93/562 cases). The incidences in boys and girls were 16.14%(33/378 cases) and 17.39%(32/184 cases), respectively, and this difference was not significant. However, all infants with serious ROP(stage IV and V) were male. Myopia combined with astigmatism was common in premature infants with and without ROP(30.99%, 172/555 cases), and myopic refraction(including myopia and myopia combined with astigmatism) was more common in premature infants with ROP(48.84%, 42/86 cases). In the >8.00 diopter group, there were significantly more ROP infants than without ROP. Myopic refraction(including myopia and myopia combined with astigmatism) was most common in infants with ROP after treatment(63.63%, 7/11 cases). CONCLUSION: The refractive state is different between premature infants and mature infants. Those treated for ROP had a higher chance of developing myopia, astigmatism, and higher diopter.

Early Intervention in the Neurodevelopment of Premature Infants during the First Six Months of Life

Objective: Measure the effects of Early Intervention ad modum Katona (EI-K) in high-risk premature infants by means of clinical, neurobehavioral, and neurophysiologic tests. Method: We used the Amiel-Tison neurologic examination, the Bayley Scale of Infant Behavior, and electroencephalography (EEG) recordings at 42 weeks of conceptional age, and after 6 months of treatment EI-K (n = 14) and compared these results with those of a group of infants without early intervention (nEI) (n = 11). Results: We found better performance of infants in EI-K than nEI group after 6 months of treatment in neurologic and behavioral examination measurements, but found no differences in EEG comparisons. Conclusion: Our data suggest significant benefit of the use of EI-K program over n-EI in the neurologic and neurobe-havior examinations of premature infants after 6 months of age.

Preventive Effect of Different Dosage of Recombinant Human Erythropoietin on Anemia of Premature Infants

To assess the efficacy and the optimum dose of recombinant human erythropoietin (rhEpo) on the anemia of premature, 45 preterm infants with a gestational age of less than 35 weeks and birth weight of less 1 800 g were randomly assigned to treatment group 1 (n = 15, receiving subcutaneous rhEpo 150 U/kg·time), treatment group 2 (n = 15, receiving 250 U/kg·time), three times a week for 6 weeks, and control group (n = 15, no treatment was given). All preterm infants received supplements of vitamin E (20 IU) and iron (20 mg) each day. Our results showed that postnatal decline of hemoglobin (Hb) and hematocrit (Hct) were lessened in the treatment groups, particularly in the group 2 and the differences were very significant (P<0. 0001 for all). Treated infants had significantly higher reticulocyte counts (Ret) (P<0. 000] for all), but there was no significant difference between the two treatment groups (P>0. 05). Serum iron dropped significantly in the treatment groups as compared with control group (P<0. 01 for all), but no dose-dependent relationship was observed in treated infants (P>0. 05). After treatment, serum levels of erythropoietin was higher in group 2 than those in group 1 and control group (P<0. 0001, P<0. 01 and P<0. 05, respectively). There was no significant difference between group 1 and control group (P>0. 05). No side effects related to rhEpo therapy were observed. Our study suggested that rhEpo therapy stimulates endogenous erythro-poiesis and enhances Ret, Hct and level of Hb in a dose-dependent manner in premature infants. The therapy is more efficient when given in higher dosages.

Application of FICare mode in premature infants of NICU:A meta-analysis

infants.Methods:Systematic searches in PubMed,EMBASE,The Cochrane Library,Web of Science,Chinese biomedical literature database,China National Knowledge Infrastructure,Wanfang medical and VIP database were performed for randomized controlled trials(RCTs)or quasi-RCTs which explored the effects of FICare mode on growth and development of premature infants in neonatal intensive care unit.Then,meta-analysis was performed by RevMan 5.3 after two independent investigators screened the literature,extracted the data and evaluated the risk of bias of all included studies.Results:A total of 14 articles were included,including 3120 preterm infants and their families.Meta-analysis showed that compared with the traditional management mode,FICare mode can effectively improve the growth rate of premature infants'weight[Weight mean difference(WMD)=4.02,95%CI(2.47,5.56),P<0.001],increase sleep time[WMD=3.25,95%CI(2.05,4.44),P<0.001],improve breastfeeding rate[RR=1.38,95%CI(1.15,1.64),P<0.001],reduce readmission rate[Relative risk(RR)=0.49,95%CI(0.33,0.71),P<0.001],promote the development of the nervous system[WMD=3.96,95%CI(3.18,4.74),P<0.001],improve nursing skills of Premature infants'parents[WMD=17.40,95%CI(13.64,21.1),P<0.001],reduce the influence of maternal and infant separation on parents'emotions.Conclusion:FICare mode can effectively promote the growth and development of premature infants and alleviate the harm caused by the separation of mother and infants.Limited by the quality and region of the included studies,the appeal conclusion still needs to be tested by more high-quality studies.

THE DEVELOPMENT OF A MANIKIN TO SIMULATE THE THERMAL PHYSIOLOGY OF PREMATURE INFANTS

This paper describes a manikin (also known as mannequin) to simulate the thermal physiology of premature infants and experiments performed on it.The performance of the manikin is shown to compare well with that a selection of premature infants in terms of their rate of heat loss.

PHENOBARBITAL FOR THE PREVENTION OF IVH INCHINESE PREMATURE INFANTS

Objectivs To evaluate the effect of phenobarbital in preventing intraventricular hemorrhage inpremature infants. Methods A randomized controlled trial for the prevention of neonatal intraventricularhemorrhage (IVH) was carried out in 57 Chinese premature infants with gestation of 34 weeks. These prematureinfants were randomly assigned to prevented (23 cases) or control (34 cases) groups. Results No statisticallysignificant differences in general data between the two groups were found. It was noticed that the average Apgarscore in prevented group was lower than that in the control group. The average age at the time of the loading dosesof phenobarbital was 8.9± 8.3 (0.5～25)h (outborn babies usually delay to receive phenobarbital), and the averageduration of the maintenance dose was 5d. The mean value of serum phenobarbital level obtained on day 4 was 20.9±5.2mg/L. The results demonstrated that the incidence of IVH and severe IVH decreased significantly inprevented group (74% vs 97%, P<0.05 and 13% vs 62%, P<0.01 respectively). NO severe IVH and hydrocephaluswere develOPed in the infants with IVH grade Ⅱ in the prevented group. While 7 infants with grade Ⅱ developedgrade Ⅲ during very short period, and 2 infants had to shunt for hydrocephalus in the control group. Infants onphenobarbital had not observed any side - effects. The duration of clinical symptoms was markedly shortened in theprevented group. Conclusion The study supports the use of phenobarbital for the prevention of IVH and severeIVH in Chinese premature infants. It is suggested that phenobarbital prophylaxis should be routinely carried outin all preterm infants with gestational age 34 weeks within 6h alter birth.

Toxicity and Viral Load in Urine during Valganciclovir Therapy in Premature Infants

Cytomegalovirus (CMV) infection is the most important cause of mental retardation and sensorineural hearing loss. Antiviral treatment with valganciclovir, a relatively new but potential toxic oral drug, is recommended to prevent further hearing deterioration. In this retrospective cohort study we evaluated the relation between the dose of valganciclovir and the reduction of CMV viral load, as well as the toxicity. All neonates with gestational

Effect of Transitional Care Model on Low Birth Weight Premature Infants: a meta-analysis

Objective: To systematically review the effect of Transitional Care model (TCM) on the growth and development of premature infants. Methods: Randomized controlled trials (RCTs) or quasi-RTCs regarding the effect of TCM in low birth weight premature infants were retrieved in electronic databases such as the Cochrane Library, PubMed, EMbase, Web of Science, CBM (Chinese Biomedicine Database), CNKI (China National Knowledge Infrastructure), VIP (Chinese Scientific Journals Database) and Wanfang Database. Then, we adopted RevMan 5.3 software to perform a meta-analysis. Results: A total of 11 articles were included, including 1282 preterm infants. The result showed that compared with the routine care model, TCM can effectively increase the weight when premature infants discharged one week [MD=225.57, 95%CI (171.78, 279.37), P<0.001], increase the weight after discharged one month [MD=0.89, 95%CI (0.72, 1.06), P<0.001], increase the weight after discharged three months [MD=670.44, 95%CI (527.65, 813.23), P<0.001], promote the height of newborns [MD=4.54, 95%CI (2.42, 6.65), P<0.001], reduce readmission rate [RR=0.38, 95%CI (0.25, 0.58), P<0.001], alleviate adverse skin reactions [RR=0.33, 95%CI (0.22, 0.50), P<0.001], increase nursing satisfaction of the families [RR=1.21, 95%CI (1.13, 1.31), P<0.001]. Conclusion: TCM can effectively promote the growth and development of the low birth weight premature infants, reduce the hospital readmission rate, alleviate adverse skin reactions of premature infants and improve the nursing satisfaction of the families. However, due to the limitation of the region and quality of the included studies, which the accuracy of the result still be treated with more caution. Further high-quality studies are needed to verify the conclusion.

Ultrasound measurement of the corpus callosum and neural development of premature infants

Length and thickness of 152 corpus callosa Using ultrasonic diagnostic equipment with a were measured in neonates within 24 hours ot b^rtn. neonatal brain-specific probe, corpus callosum length and thickness of the genu, body, and splenium were measured on the standard mid-sagittal plane, and the anteroposterior diameter of the genu was measured in the coronal plane. Results showed that corpus callosum length as well as thickness of the genu and splenium increased with gesta- tional age and birth weight, while other measures did not. These three factors on the standard mid-sagittal plane are therefore likely to be suitable for real-time evaluation of corpus callosum de- velopment in premature infants using cranial ultrasound. Further analysis revealed that thickness of the body and splenium and the anteroposterior diameter of the genu were greater in male infants than in female infants, suggesting that there are sex differences in corpus callosum size during the neonatal period. A second set of measurements were taken from 40 premature infants whose ges- tational age was 34 weeks or less. Corpus callosum measurements were corrected to a gestational age of 40 weeks, and infants were grouped for analysis depending on the outcome of a neonatal behavioral neurological assessment. Compared with infants with a normal neurological assessment, corpus callosum length and genu and splenium thicknesses were less in those with abnormalities, indicating that corpus callosum growth in premature infants is associated with neurobehavioral development during the early extrauterine stage.

Mental health of mothers and their premature infants for the prevention of child abuse and maltreatment

Birth of preterm infants is a stressful event for their parents, particularly for mothers. The mothers of preterm infants often feel hard to relate their infants because they have separated since their first days after delivery. Long term separation and less attractive, less responsive appearance of preterm infants also make it difficult to build mother-child relationships. In addition, the mothers of preterm infants are likely to have mood disorders such as depression, anxiety, and stress-related disorders. The mothers’ psychiatric illnesses affect the psychosocial development of preterm infants and are often regarded as a risk factor for child abuse and maltreatment in later life. Child abuse and maltreatment are also prevalent among preterm infants than the full term infants. Intervention from the early period of preterm birth is an important issue for both preterm infants and their mothers. Medical and co-medical professionals should pay attention to developmental outcome of preterm as well as psychosocial conditions of their mothers for the improvement of their mental health.

Need for oxygen therapy and ventilatory support in premature infants in a hospital in Southern Brazil

BACKGROUND Prematurity in newborns is a condition that is associated with worse hospital outcomes when compared to birth to term.A preterm infant(PI)is classified when gestational age(GA)<37 wk.AIM To analyze prognostic indicators related to the use of oxygen therapy,noninvasive ventilation(continuous positive airway pressure)and mechanical ventilation(MV)in PI.METHODS This is a retrospective cohort.The sample was composed of PIs from a private hospital in southern Brazil.We included neonates with GA<37 wk of gestation in the period of January 1,2018 to December 31,2018.For data collection,electronic records were used in the Tasy Philips^(TM)system,identifying the variables:maternal age,type of birth,prenatal information,GA,Apgar score,birth weight,neonatal morbidities,vital signs in the 1st hour at birth,need for oxygen therapy,continuous positive airway pressure and MV,hospitalization in the neonatal intensive care unit,length of stay and discharge or death.RESULTS In total,90 PI records were analyzed.The median(p25-p75)of GA was 34.0(31.9-35.4)wk,and there were 45(50%)males.The most common morbidity among PIs was the acute respiratory discomfort syndrome,requiring hospitalization in the neonatal intensive care unit in 76(84.4%)cases.The utilization rate of oxygen therapy,continuous positive airway pressure and MV was 12(13.3%),37(41.1%)and 13(14.4%),respectively.The median(p25-p75)length of stay was 12.0(5.0-22.2)d,with 10(11.1%)deaths.A statistical association was observed with the use of MV and GA<28 wk,lower maternal age,low birth weight,Apgar<8 and neonatal deaths.CONCLUSION The identification of factors related to the need for MV in prematurity may help in the indication of a qualified team and technologies to promptly meet the unforeseen events that may occur after birth.

Predictors of caring behaviors of mothers of premature infants based on the health belief model

Objective:To investigate predictors of caring behaviors of mothers of premature infants based on the health belief model.Methods:This cross-sectional study was conducted by using the structural equation modeling on 168 mothers of premature infants,who were selected by convenience sampling method from October 2017 to February 2018 in Iran.Data were collected by using a standard scale.Validity and reliability of all data collection tools were approved.Data were analyzed by using SPSS V.16 and Mplus6 software.Results:The structural equation modeling of the initial health belief model did not have a good fit,but the fitness of model 2 obtaining from the modified initial model was confirmed by changes in locations of constructs.None of constructs of model 2 had a significant positive association with the caring behavior of mothers of premature infants and only 2.8%of variance of caring behaviors in mothers could be predicted by the sum of variables of demographic characteristics and the modified health belief model constructs.Conclusions:Given that the findings do not approve the use of the health belief model in predicting determinants of caring behavior of mothers of premature infants,it is suggested to apply this model to investigate the effect of educational intervention based on the health belief model on the caring behavior of mothers.

The Issue of Care Given to Premature Infants in the Provincial Hospital Center of Missour

Background: Preterm birth is common in Morocco and it’s around 8%. Several management rules of taking care of preterm infants have been developed but have not been put into action. The geo-graphical inaccessibility to specialized hospitals and the weakness of the reception capacity of the care centers hinder the management of the complications associated with preterm birth. Purpose: The present study is designed to present some epidemiological data of preterm births within the Provincial Hospital Center of Missour during 2012 and to discuss the various problems emerging in the management of treatment and care. Materials and Methods: Retrospective study of preterm births in the maternity ward in the Hospital of Missour during 2012. Results: 37 preterm births among 1121 (3.3%) have been analyzed (51.3% severe premature infants, 45.9% late preterm infants and 2.7% extremely premature infants). 64.2% are originally from difficult areas to reach during winter. All mothers have received upon arrival at the maternity a corticosteroid and calcium antagonists (Adalate*) and an antibiotic treatment to those with a positive infectious anamnesis found in half of the women. We have recorded 3 twin pregnancies and 2 gravidic toxemias. Only 21 babies have been given back to their mothers (namely 56.7%). 5 premature infants (namely 13%) have been referred to the university hospital center of Fez (2 respiratory distress, a malformation and 2 severe premature births) given that there is an absence of a specialized care unit at the hospital, knowing that no baby has received neither surfactant nor caffeine at birth. 14 premature babies (namely 37.8%) have been transferred to the pediatric unit with a total death rate of 16.2% (6 premature) mainly related to neonatal infection and to suffering of the hyaline membranes disease. Conclusion: We emphasize the interest of prevention programs which demand an early diagnosis of preterm birth threats and monitoring high-risk pregnancies, improving the medical care given to low-weight premature by creating “Kangaroo” units at a regional level and the targeting of measures for rural and under-covered areas.

Bronchopulmonary Dysplasia in Premature Infants with Very Low Birth Weight: A Single Centre Retrospective Study in China

To investigate bronchopulmonary dysplasia (BPD) and its treatment with dexamethasone (DEX) in premature infants with birth weight (BW) < 1500 g. We retrospectively reviewed the records of preterm infants admitted to the Division of Neonatology, the Second Xiangya Hospital, Central South University between September 2011 and December 2014. Patients were excluded if they needed oxygen therapy but were lost to follow-up at ≤36 weeks post-menstrual age (PMA) or <56 days after birth, or they had severe congenital anomalies. The incidence of BPD was 18% (37/212). Gestational age (GA) was <32 weeks in all BPD patients. GA, BW, and Apgar scores were lower and hospitalization duration and pulmonary surfactant (PS) use were higher in the BPD group than in the non-BPD group (P < 0.05). Risk factors for BPD included neonatal respiratory distress syndrome, neonatal pneumonia, positive sputum culture, pulmonary hemorrhage, respiratory failure. Multivariate logistic regression revealed that GA (odds ratio [OR]: 0.479, P = 0.004) and neonatal respiratory distress syndrome (OR: 6.146, P = 0.043) were independent risk factors for BPD. DEX was administered to 26 patients after the diagnosis of BPD. After one and two weeks of DEX treatment, the oxygen requirement had significantly reduced compared to the week prior to treatment (P < 0.05), while during treatment, the weight gain rate and weight gain efficiency slower significantly than that during either of the two preceding weeks (P < 0.001). These results suggest that low GA was the most important risk factor for BPD, DEX reduced oxygen dependency but decreased weight gain.

Differentially expressed miRNAs in premature infants with retinopathy-a bioinformatics analysis

AIM：To reveal the role of miRNA in retinopathy of prematurity（ROP） by bioinformatics analysis.METHODS：The raw data of this study came from the researches of Wang et al and Zhao et al who analyzed the micro RNA（mi RNA） expression profile between ROP and controls.Based on the identified differentially expressed miRNA,the related target genes,lnc RNA and circ RNA were predicted.Then we performed functional enrichment analysis to further analyze the functions of target genes.RESULTS：Hsa-mi RNA-128-3 p and hsa-mi RNA-9-5 p showed significantly different expression in both studies.Lnc RNA of POLDIP2,GAS5,NEFL and UHRF1,circ RNA of ZNF280 C_hsa_circ_001211 and SIAE_hsa_circ_002083,tar get gene of QKI showed meaningful differential expression in ROP.Enrichment analysis showed that TGF-β signaling pathway,PI3 K-Akt signaling pathway and MAPK signaling pathway might play important roles in the prog ress of ROP.CONCLUSION：This research may provide a comprehensive bioinformatics analysis of differentially expressed miR NAs which are possibly involved in ROP.

Central corneal thickness measurements in premature infants

AIM:To evaluate the central corneal thickness(CCT)measurements of premature infantsMETHODS:The premature infants who were born between 25-34wk of gestational age(GA)were retrieved for the study.All CCT measurements were performed within the first 2d of their life under topical anesthesia by using an ultrasonic pachymeter.RESULTS:The mean CCT of 200 eyes was 647.79±63.94μm.The mean CCT of the right and left eyes were similar(647.30±64.72μm and 648.29±63.47μm consecutively).The mean CCT of the girls was 642.08±54.89μm and the boys was 653.07±71.14μm,with no statistically significant difference(P】0.05).But there was a negative correlation of the CCT with GA and birth weight(BW)(P【0.01).CONCLUSION:The CCT values of premature babies were negatively correlated with GA and BW.

Effects of diode laser photocoagulation treatment on ocular biometric parameters in premature infants with retinopathy of prematurity

AIM:To investigate the effects of diode laser treatment on ocular biometric parameters in premature infants with retinopathy of prematurity(ROP).METHODS:Premature infants who received diode laser treatment for ROP(n=68)and premature infants with spontaneous regressed ROP without treatment(n=50)were performed longitudinal ocular biometric measurements including anterior chamber depth,lens thickness and axial length as follows:1 d prior to laser treatment,and 3,6,9,and 12 mo after the laser treatment.RESULTS:The mean birth weight,gestational age and initial examination time values were 936.53±302.07 g,26.66±2.42 wk,36.26±2.73 wk in the treatment group and 959.78±260.08 g,27.28±2.10 wk,36.56±2.54 wk in the control group.There was no statistically significant difference in these demographic characteristics of the groups.Anterior chamber depth,lens thickness and axial length demonstrated statistically significant linear increases during the study period in the two groups(P<0.001 for each).There were no statistically significant differences between the two groups in terms of anterior chamber depth after laser treatment.Measurements of the lens thickness at 9 th and 12 th months(9 th month 3.70±0.22 vs 3.60±0.21 mm,P=0.017;12 th month 3.81±0.21 vs 3.69±0.22 mm,P=0.002)and the axial length at 12 th month(19.35±0.79 vs 19.13±0.54 mm,P=0.031)after laser treatment were statistically higher in the treatment group.CONCLUSION:Diode laser retinal photocoagulation treatment in premature infants seems to increase the lens thickness and axial length.

Evaluation of Parents’ Awareness and Knowledge about Problems and Issues Related to Their Premature Infants in an Iranian Hospital

Premature infant is an infant who was born before the end of 37th weeks of pregnancy. Approximately 9.6% of infants are premature and they can be at risk for hospitalization. This study has done for evaluation of awareness and knowledge of parents about problems of premature infants in Neonatal Intensive Care Unit (NICU). This was a descriptive study with 160 parents whose premature infants were admitted to NICU (Tehran-Iran, 2009-2011). Data were collected by a questionnaire for evaluation of awareness and knowledge of parents about problems of prematurity, and then analyzed by using descriptive analytic statistical methods and SPSS software. Based on the results, there was a significant relation between age and the total score of questionnaire (P = 0.022, R = 0.18). Mothers had higher awareness and knowledge than fathers (P < 0.05). The most awareness in parents was about doing of hygienic principle when they entered to NICU and about the importance of regularly and continuous attendance in ward. Awareness and knowledge of parents about problems of their premature infant were related to their age and being a mother or father. Parents had little knowledge about some NICU principles and premature infant’s needs and care.

Research Progress on the Prevention of Premature Infant Lung Injury and Neonatal Respiratory Support

In the past 40 years,advances in neonatal intensive care unit(NICU)technology have enabled premature infants with lower birth weight and younger gestational age to survive.But with it comes an increase in the incidence of long-term respiratory dysfunction,mainly in the form of bronchopulmonary dysplasia(BPD).Preventing lung injury is crucial for preventing BPD and improving the long-term prognosis of premature infants.Therefore,how to avoid ventilator-associated lung injury has become a focus of clinical and scientific research in premature infants in recent years.This article will elaborate on the susceptibility and pathophysiology of premature infant lung injury,ventilation strategies for preventing lung injury,and new advances in neonatal respiratory support.