Introduction: Anthropometry applied to newborns is a reliable indicator of the quality of fetal growth. The latter is influenced by genetic, racial and nutritional factors varying from one population to another, expla...Introduction: Anthropometry applied to newborns is a reliable indicator of the quality of fetal growth. The latter is influenced by genetic, racial and nutritional factors varying from one population to another, explaining why a standard cannot be applied to all populations. Research question: should the Caucasian frame of reference be dogmatically applied in our African context? Multicenter studies are therefore necessary;hence the interest of this work, the main objective of which was to describe the anthropometric profile of full-term newborns in the city of Douala. Methodology: We carried out a cross-sectional study with an analytical aim and prospective data collection in the maternity wards of the Douala General Hospital, Laquintinie Hospital, District hospitals of Deido, Nylon and Bonassama over a period of 4 months (January to April 2020). We were interested in any newborn, born alive, vaginally or by cesarean section, seen in the first 24 hours from a full-term single-fetal pregnancy whose mother had given consent. We excluded newborns whose term was unclear and those with congenital malformations or signs of embryo-foetopathy. Data collection was done using structured and pre-tested survey sheets. The study variables were obstetric and anthropometric. Statistical analyzes were carried out with CS Pro 7.3 and SPSS version 25.0 software. The Student, Chi-square and Fischer tests were used to compare the means of the variables, the percentages with a significance threshold P value Results: During the study period, 305 full-term newborns were included, divided into 172 boys and 133 girls. The average anthropometric parameters of the full-term newborn in the city of Douala were: average weight: 3305 grams, average height: 49.8 centimeters, average head circumference: 34.6 centimeters, average upper arm circumference: 11.3 centimeters, circumference average thoracic: 32.8 centimeters. The percentile distribution showed a 10th percentile at 2656 grams and a 90th percentile at 3966 grams for weight defining the limits for small-for-gestational-age neonates and macrosomes. Conclusion: The anthropometric data of the full-term newborn in the city of Douala were: an average weight of 3305.4 grams, an average height of 49.8 centimeters, an average head circumference of 34.2 centimeters, an average upper arm circumference of 11.3 centimeters, and an average thoracic circumference of 32.8 centimeters with higher valuesin male newborns.展开更多
AIM: To investigate the possible relationship between the influencing factors occurring before and during birth in full-term infants and the outcome of retinopathy. METHODS: Totally 816 full-term infants admitted in t...AIM: To investigate the possible relationship between the influencing factors occurring before and during birth in full-term infants and the outcome of retinopathy. METHODS: Totally 816 full-term infants admitted in the neonate intensive unit of Boai Hospital of Zhongshan between 1 May, 2008 and 30 June, 2011 were included in the study. Fundus examination was performed and evaluated individually on them at the age of 48 hours after delivery, 2 weeks and 1 month. Some possible risk factors happening prenatally or during delivery such as pregnant related hypertension, placenta previa, placental abruption etc, as well as some neonatal risk factors such as neonatal asphyxia, hypoxic-ischemic encephalopathy (HIE), low birth weight etc, were recorded and evacuated. Then the effect of the risk factors of full-term infants on retinopathy was studied. RESULTS: The incidence of retinal hemorrhage of full-term infants with prenatal pregnant related hypertension (PRH) of the mother (43.6%) was significantly higher than that of full-term infants without (8.0%). (P<0.001). The incidence of retinal hemorrhage of full-term infants with neonatal asphyxia and /or hypoxic-ischemic encephalopathy (HIE)(29.3%) was significantly higher than that of those without (15.7%), but correlation was not found between the severity of retina hemorrhage and the degree of hypoxic disease. A pale color of optic disc was associated with a low birth weight of full-term infant. Full-term infants with birth weigh-less than 2500g had a significant higher incidence of retinopathy than those with birth weight equal or more than 2500g( P<0.001). CONCLUSION: The main influencing factors which lead to retinopathy of high risk full-term infants are prenatal factors such as PRH, and some neonatal risk factors such as asphyxia, hypoxic-ischemic encephalopathy, and low birth weight.展开更多
Objective:To investigate the predictive value of of serum NSE,umbilical cord blood albumin levels in hyperbilirubinemia full-term neonates with brain injury.Methods:300 cases of hyperbilirubinemia full-term neonates i...Objective:To investigate the predictive value of of serum NSE,umbilical cord blood albumin levels in hyperbilirubinemia full-term neonates with brain injury.Methods:300 cases of hyperbilirubinemia full-term neonates in our hospital during January 2018 to November 2019 were chosen as hyperbilirubinemia group,200 cases of healthy full-term neonates who were delivered in our hospital during the same period and whose general information matched were chosen as normal control group.According to whether the hyperbilirubinemia group had brain injury,they were further divided into bilirubin encephalopathy group(n=34)and non-bilirubin encephalopathy group(n=266).NSE,umbilical cord blood albumin levels in hyperbilirubinemia group and normal control group were compared.Clinical data,NSE and umbilical cord blood albumin levels between bilirubin encephalopathy group,non-bilirubin encephalopathy group were compared.Risk factors associated with brain injury in full-term newborn with hyperbilirubinemia were analyzed by logistics regression,predictive value of NSE and umbilical cord blood albumin on brain injury in full-term newborn with hyperbilirubinemia were evaluated by ROC curve.Results:NSE level in hyperbilirubinemia group was higher than that in normal control group(P<0.05).There was no significant difference in umbilical cord blood albumin between two groups(P>0.05).Incidence of jaundice,anemia,indirect bilirubin peak,total bilirubin peak and NSE level in bilirubin encephalopathy group were higher than those in non-bilirubin encephalopathy group,level of umbilical cord blood albumin was lower than that in non-bilirubin encephalopathy group(P<0.05).Logistic regression analysis showed that jaundice,anemia,indirect bilirubin peak,total bilirubin peak,NSE and umbilical cord blood albumin within 24h after birth were risk factors for hyperbilirubinemia with brain injury(P<0.05).When NSE was 67.09 ng/mL,the yoden index was the highest,with sensitivity and specificity of 79.70%,55.88%respectively.When the umbilical cord blood albumin was 4.20mg/mL,the jorden index was the highest,sensitivity and specificity were 76.32%,82.35%respectively.Conclusion:Abnormal changes in serum NSE,umbilical cord blood albumin levels are observed in full-term neonates with hyperbilirubinemia,moreover they have value of early prediction for subsequent brain injury.展开更多
目的基于T1加权MR结构成像探究足月新生儿大脑87脑区体积偏侧性的分布特征及脑区体积偏侧性与新生儿行为神经测查法评分之间的相关性。材料与方法回顾性分析2010年11月至2017年9月在西安交通大学第一附属医院行头颅磁共振检查(三维T1WI...目的基于T1加权MR结构成像探究足月新生儿大脑87脑区体积偏侧性的分布特征及脑区体积偏侧性与新生儿行为神经测查法评分之间的相关性。材料与方法回顾性分析2010年11月至2017年9月在西安交通大学第一附属医院行头颅磁共振检查(三维T1WI)的健康足月新生儿64例[胎龄:(39.46±1.17)孕周;男43例,女21例;生后日龄:(10.94±6.90)天],基于Developing Human Connectome Project(dHCP)87脑区分割模板,在联影智能科研平台(uAI Research Portal)利用深度学习分割技术获得新生儿大脑87脑区体积,进而计算偏侧性系数(lateralization index,LI)=100×(V_(L)-V_(R))/(V_(L)+V_(R)),(V:脑区体积),运用t检验及Pearson偏相关探究大脑区域体积偏侧性特征及LI与行为神经测查法评分之间的相关性。结果新生儿期大脑区域体积左侧偏向性(LI>0)主要分布在枕叶、丘脑、尾状核、侧脑室及小脑等区域;右侧偏向性(LI<0)主要分布在海马、扣带回、颞叶及岛叶白质等区域。其中,枕叶白质(r=-0.303,P=0.015)、枕叶灰质(r=-0.315,P=0.012)、海马(r=-0.332,P<0.01)及扣带回后部白质(r=-0.263,P=0.035)的LI与主动肌张力评分之间存在相关性;此外并未发现各脑区的LI与行为能力评分之间存在相关性。结论新生儿期大脑区域体积已呈现出显著的偏侧性特征,脑区体积偏侧性分布范围广泛,且以右侧偏向性为主;主动肌张力在枕叶灰、白质、海马及扣带回后部白质呈右半球优势分布。展开更多
Background Respiratory distress syndrome （RDS） is one of the most common causes of neonatal respiratory failure and neonatal death, however, its clinical characteristics are very different from premature RDS, and th...Background Respiratory distress syndrome （RDS） is one of the most common causes of neonatal respiratory failure and neonatal death, however, its clinical characteristics are very different from premature RDS, and these characteristics have not been well documented as yet. This study was to investigate the pathogenesis, clinical characteristics and management strategies of RDS in full-term neonates, with the aim of developing a working protocol for improving the outcome in full-term neonates with RDS. Methods A total of 125 full-term infants with RDS were enrolled in this study. Their clinical and laboratory data were collected for analyzing the characteristics of full-term neonatal RDS. Results （1） The 125 cases included 94 male and 31 female infants, vaginal delivery occurred in 80 cases and cesarean section in 45 cases. （2） The onset time of RDS was （3.11±3.59） hours after birth. （3）The possible reasons included severe perinatal infections in 63 patients, elective cesarean section in 34 cases, severe birth asphyxia in 12 patients, meconium aspiration syndrome in 9 patients, pulmonary hemorrhage in 4 patients and maternal diabetes in 3 patients. （4） Complications included multiple organ system failure （MOSF） in 49 patients, persistent pulmonary hypertension of newborn （PPHN） in 25 patients, acute renal failure in 18 patients, severe hyperkalemia in 25 patients, severe metabolic acidosis in 6 cases, severe myocardial injury in 9 cases, pulmonary hemorrhage in 3 cases, disseminated intravascular coagulation in 14 patients and shock in 12 patients.（5） Four patients died, the mortality was therefore 3.2% with the main cause of septicemia complicating of MOSF, but their prognosis was improved while comprehensive treatment measures including early mechanical ventilation and broad spectrum antibiotics were taken into account. Conclusions RDS is not an uncommon disease in full-term infants and is associated with a higher mortality, its clinical characteristics are very different from premature RDS, and its onset is earlier and is more likely to develop into PPHN and/or MOSE The main cause of death is severe infection complicating of MOSF and most patients require prolonged mechanical ventilation. Comprehensive management strategies will help to improve patient＇s prognosis.展开更多
文摘Introduction: Anthropometry applied to newborns is a reliable indicator of the quality of fetal growth. The latter is influenced by genetic, racial and nutritional factors varying from one population to another, explaining why a standard cannot be applied to all populations. Research question: should the Caucasian frame of reference be dogmatically applied in our African context? Multicenter studies are therefore necessary;hence the interest of this work, the main objective of which was to describe the anthropometric profile of full-term newborns in the city of Douala. Methodology: We carried out a cross-sectional study with an analytical aim and prospective data collection in the maternity wards of the Douala General Hospital, Laquintinie Hospital, District hospitals of Deido, Nylon and Bonassama over a period of 4 months (January to April 2020). We were interested in any newborn, born alive, vaginally or by cesarean section, seen in the first 24 hours from a full-term single-fetal pregnancy whose mother had given consent. We excluded newborns whose term was unclear and those with congenital malformations or signs of embryo-foetopathy. Data collection was done using structured and pre-tested survey sheets. The study variables were obstetric and anthropometric. Statistical analyzes were carried out with CS Pro 7.3 and SPSS version 25.0 software. The Student, Chi-square and Fischer tests were used to compare the means of the variables, the percentages with a significance threshold P value Results: During the study period, 305 full-term newborns were included, divided into 172 boys and 133 girls. The average anthropometric parameters of the full-term newborn in the city of Douala were: average weight: 3305 grams, average height: 49.8 centimeters, average head circumference: 34.6 centimeters, average upper arm circumference: 11.3 centimeters, circumference average thoracic: 32.8 centimeters. The percentile distribution showed a 10th percentile at 2656 grams and a 90th percentile at 3966 grams for weight defining the limits for small-for-gestational-age neonates and macrosomes. Conclusion: The anthropometric data of the full-term newborn in the city of Douala were: an average weight of 3305.4 grams, an average height of 49.8 centimeters, an average head circumference of 34.2 centimeters, an average upper arm circumference of 11.3 centimeters, and an average thoracic circumference of 32.8 centimeters with higher valuesin male newborns.
基金Supported by Science Council Grant of Zhongshan City, China (No. 20082A091)
文摘AIM: To investigate the possible relationship between the influencing factors occurring before and during birth in full-term infants and the outcome of retinopathy. METHODS: Totally 816 full-term infants admitted in the neonate intensive unit of Boai Hospital of Zhongshan between 1 May, 2008 and 30 June, 2011 were included in the study. Fundus examination was performed and evaluated individually on them at the age of 48 hours after delivery, 2 weeks and 1 month. Some possible risk factors happening prenatally or during delivery such as pregnant related hypertension, placenta previa, placental abruption etc, as well as some neonatal risk factors such as neonatal asphyxia, hypoxic-ischemic encephalopathy (HIE), low birth weight etc, were recorded and evacuated. Then the effect of the risk factors of full-term infants on retinopathy was studied. RESULTS: The incidence of retinal hemorrhage of full-term infants with prenatal pregnant related hypertension (PRH) of the mother (43.6%) was significantly higher than that of full-term infants without (8.0%). (P<0.001). The incidence of retinal hemorrhage of full-term infants with neonatal asphyxia and /or hypoxic-ischemic encephalopathy (HIE)(29.3%) was significantly higher than that of those without (15.7%), but correlation was not found between the severity of retina hemorrhage and the degree of hypoxic disease. A pale color of optic disc was associated with a low birth weight of full-term infant. Full-term infants with birth weigh-less than 2500g had a significant higher incidence of retinopathy than those with birth weight equal or more than 2500g( P<0.001). CONCLUSION: The main influencing factors which lead to retinopathy of high risk full-term infants are prenatal factors such as PRH, and some neonatal risk factors such as asphyxia, hypoxic-ischemic encephalopathy, and low birth weight.
基金Guilin Scientific Research and Technology Development Project(No.20150403-6-1)Project to improve the basic scientific research ability of young and middle-aged teachers in Guangxi Universities(No.KY2016LX247)Young and middle-aged faculty research capacity Enhancement project of Guilin Medical College(No.2018glmcy096)
文摘Objective:To investigate the predictive value of of serum NSE,umbilical cord blood albumin levels in hyperbilirubinemia full-term neonates with brain injury.Methods:300 cases of hyperbilirubinemia full-term neonates in our hospital during January 2018 to November 2019 were chosen as hyperbilirubinemia group,200 cases of healthy full-term neonates who were delivered in our hospital during the same period and whose general information matched were chosen as normal control group.According to whether the hyperbilirubinemia group had brain injury,they were further divided into bilirubin encephalopathy group(n=34)and non-bilirubin encephalopathy group(n=266).NSE,umbilical cord blood albumin levels in hyperbilirubinemia group and normal control group were compared.Clinical data,NSE and umbilical cord blood albumin levels between bilirubin encephalopathy group,non-bilirubin encephalopathy group were compared.Risk factors associated with brain injury in full-term newborn with hyperbilirubinemia were analyzed by logistics regression,predictive value of NSE and umbilical cord blood albumin on brain injury in full-term newborn with hyperbilirubinemia were evaluated by ROC curve.Results:NSE level in hyperbilirubinemia group was higher than that in normal control group(P<0.05).There was no significant difference in umbilical cord blood albumin between two groups(P>0.05).Incidence of jaundice,anemia,indirect bilirubin peak,total bilirubin peak and NSE level in bilirubin encephalopathy group were higher than those in non-bilirubin encephalopathy group,level of umbilical cord blood albumin was lower than that in non-bilirubin encephalopathy group(P<0.05).Logistic regression analysis showed that jaundice,anemia,indirect bilirubin peak,total bilirubin peak,NSE and umbilical cord blood albumin within 24h after birth were risk factors for hyperbilirubinemia with brain injury(P<0.05).When NSE was 67.09 ng/mL,the yoden index was the highest,with sensitivity and specificity of 79.70%,55.88%respectively.When the umbilical cord blood albumin was 4.20mg/mL,the jorden index was the highest,sensitivity and specificity were 76.32%,82.35%respectively.Conclusion:Abnormal changes in serum NSE,umbilical cord blood albumin levels are observed in full-term neonates with hyperbilirubinemia,moreover they have value of early prediction for subsequent brain injury.
文摘目的基于T1加权MR结构成像探究足月新生儿大脑87脑区体积偏侧性的分布特征及脑区体积偏侧性与新生儿行为神经测查法评分之间的相关性。材料与方法回顾性分析2010年11月至2017年9月在西安交通大学第一附属医院行头颅磁共振检查(三维T1WI)的健康足月新生儿64例[胎龄:(39.46±1.17)孕周;男43例,女21例;生后日龄:(10.94±6.90)天],基于Developing Human Connectome Project(dHCP)87脑区分割模板,在联影智能科研平台(uAI Research Portal)利用深度学习分割技术获得新生儿大脑87脑区体积,进而计算偏侧性系数(lateralization index,LI)=100×(V_(L)-V_(R))/(V_(L)+V_(R)),(V:脑区体积),运用t检验及Pearson偏相关探究大脑区域体积偏侧性特征及LI与行为神经测查法评分之间的相关性。结果新生儿期大脑区域体积左侧偏向性(LI>0)主要分布在枕叶、丘脑、尾状核、侧脑室及小脑等区域;右侧偏向性(LI<0)主要分布在海马、扣带回、颞叶及岛叶白质等区域。其中,枕叶白质(r=-0.303,P=0.015)、枕叶灰质(r=-0.315,P=0.012)、海马(r=-0.332,P<0.01)及扣带回后部白质(r=-0.263,P=0.035)的LI与主动肌张力评分之间存在相关性;此外并未发现各脑区的LI与行为能力评分之间存在相关性。结论新生儿期大脑区域体积已呈现出显著的偏侧性特征,脑区体积偏侧性分布范围广泛,且以右侧偏向性为主;主动肌张力在枕叶灰、白质、海马及扣带回后部白质呈右半球优势分布。
基金This work was supported by the grants from China Postdoctoral Science Foundation （No. 20080431405＆ No. 200801041）.
文摘Background Respiratory distress syndrome （RDS） is one of the most common causes of neonatal respiratory failure and neonatal death, however, its clinical characteristics are very different from premature RDS, and these characteristics have not been well documented as yet. This study was to investigate the pathogenesis, clinical characteristics and management strategies of RDS in full-term neonates, with the aim of developing a working protocol for improving the outcome in full-term neonates with RDS. Methods A total of 125 full-term infants with RDS were enrolled in this study. Their clinical and laboratory data were collected for analyzing the characteristics of full-term neonatal RDS. Results （1） The 125 cases included 94 male and 31 female infants, vaginal delivery occurred in 80 cases and cesarean section in 45 cases. （2） The onset time of RDS was （3.11±3.59） hours after birth. （3）The possible reasons included severe perinatal infections in 63 patients, elective cesarean section in 34 cases, severe birth asphyxia in 12 patients, meconium aspiration syndrome in 9 patients, pulmonary hemorrhage in 4 patients and maternal diabetes in 3 patients. （4） Complications included multiple organ system failure （MOSF） in 49 patients, persistent pulmonary hypertension of newborn （PPHN） in 25 patients, acute renal failure in 18 patients, severe hyperkalemia in 25 patients, severe metabolic acidosis in 6 cases, severe myocardial injury in 9 cases, pulmonary hemorrhage in 3 cases, disseminated intravascular coagulation in 14 patients and shock in 12 patients.（5） Four patients died, the mortality was therefore 3.2% with the main cause of septicemia complicating of MOSF, but their prognosis was improved while comprehensive treatment measures including early mechanical ventilation and broad spectrum antibiotics were taken into account. Conclusions RDS is not an uncommon disease in full-term infants and is associated with a higher mortality, its clinical characteristics are very different from premature RDS, and its onset is earlier and is more likely to develop into PPHN and/or MOSE The main cause of death is severe infection complicating of MOSF and most patients require prolonged mechanical ventilation. Comprehensive management strategies will help to improve patient＇s prognosis.
