Allergy march of Chinese children with infantile allergic symptoms: a prospective multi-center study

Background:Allergy march refers to progression of allergic diseases from infantile food allergy to the development of asthma and allergic rhinitis (AR).Evidence come mostly from studies in European countries.This study aimed to investigate allergy march in Chinese children with infantile food protein allergy (FPA) with a special focus on the effect of different formula interventions.Methods:From 2008 to 2010,153 infants diagnosed with FPA were recruited in five tertiary hospitals across China.They were randomly treated with amino-acid-based formula or soy-protein-based formula for a period of 3 months.Long-term follow-up was performed when they reached early school age,using questionnaires,physical examinations,and serum-specific immunoglobulin E.Results:The overall follow-up rate was 73.20%.In patients who reached their early school years,the prevalence of physician-diagnosed AR and asthma were 43.75% and 23.21%,respectively.Only 40% of the subjects remained positive for food sensitizations upon follow-up.Twenty-six subjects receiving aeroallergen screening tests in infancy all proved negative,but upon follow-up,65.57% were sensitized to aeroallergens (P=0.005).No significant difference between the effects of amino-acid-based formula and soy-protein-based formula on children's allergy march was observed.Conclusions:A high proportion (47.32%) of Chinese infants with early allergic symptoms developed respiratory allergies by their early school years.Most food-sensitized infants outgrew their condition several years later,but then aeroallergen sensitization often occurred.Amino-acid-based formula showed no advantages over soy protein-based formula with respect to arresting the allergy march.

Delivery room resuscitation and short-term outcomes of extremely preterm and extremely low birth weight infants: a multicenter survey in North China

Background:Delivery room resuscitation assists preterm infants,especially extremely preterm infants(EPI)and extremely low birth weight infants(ELBWI),in breathing support,while it potentially exerts a negative impact on the lungs and outcomes of preterm infants.This study aimed to assess delivery room resuscitation and discharge outcomes of EPI and ELBWI in China.Methods:The clinical data of EPI(gestational age[GA]<28 weeks)and ELBWI(birth weight[BW]<1000 g),admitted within 72 h of birth in 33 neonatal intensive care units from five provinces and cities in North China between 2017 and 2018,were analyzed.The primary outcomes were delivery room resuscitation and risk factors for delivery room intubation(DRI).The secondary outcomes were survival rates,incidence of bronchopulmonary dysplasia(BPD),and risk factors for BPD.Results:A cohort of 952 preterm infants were enrolled.The incidence of DRI,chest compressions,and administration of epinephrine was 55.9%(532/952),12.5%(119/952),and 7.0%(67/952),respectively.Multivariate analysis revealed that the risk factors for DRI were GA<28 weeks(odds ratio[OR],3.147;95%confidence interval[CI],2.082–4.755),BW<1000 g(OR,2.240;95%CI,1.606–3.125),and antepartum infection(OR,1.429;95%CI,1.044–1.956).The survival rate was 65.9%(627/952)and was dependent on GA.The rate of BPD was 29.3%(181/627).Multivariate analysis showed that the risk factors for BPD were male(OR,1.603;95% CI,1.061–2.424),DRI(OR,2.094;95% CI,1.328–3.303),respiratory distress syndrome exposed to≥2 doses of pulmonary surfactants(PS;OR,2.700;95%CI,1.679–4.343),and mechanical ventilation≥7 days(OR,4.358;95% CI,2.777–6.837).However,a larger BW(OR,0.998;95% CI,0.996–0.999),antenatal steroid(OR,0.577;95%CI,0.379–0.880),and PS use in the delivery room(OR,0.273;95%CI,0.160–0.467)were preventive factors for BPD(all P<0.05).Conclusion:Improving delivery room resuscitation and management of respiratory complications are imperative during early management of the health of EPI and ELBWI.