Background High-risk infants refer to newborns exposed to high-risk factors in the prenatal, natal or postnatal period. High-risk infants are at high risk of developmental retardation, and early identification of deve...Background High-risk infants refer to newborns exposed to high-risk factors in the prenatal, natal or postnatal period. High-risk infants are at high risk of developmental retardation, and early identification of developmental abnormalities plays a vital role in improving high-risk infants' quality of life.Aims To describe the neurodevelopment of high-risk infants aged less than 1 year old, and to analyse the incidences and influencing factors of neurodevelopmental abnormalities in order to provide a basis for neurodevelopment monitoring and management of highrisk infants.Methods High-risk infants born between January 2016 and December 2016 in the maternity and infant health hospitals of three districts in Shanghai were followed up.The Gesell Developmental Scale was used to assess the neurodevelopmental level at the time of recruitment(0-2 months) and at 9 months. Univariate and multivariate analyses of the influencing factors were conducted.Results 484 high-risk infants(male 51 %, female 49%)with an average gestation age of 36.5±2.2 weeks were recruited. At the time of recruitment, the average age was2.1(0.8) months, and the developmental quotient(DQ)scores of full-term high-risk infants in motor(t=3.542,p=0.001), cognitive(t=3.125, p=0.002), language(t=3.189, p=0.002) and social(t=3.316, p=0.001) areas were higher than those of preterm infants. The incidences of developmental abnormalities of full-term high-risk infants in motor(χ~2 =9.452, p=0.002), cognitive(χ~2=6.258, p=0.012), language(χ~2 =12.319, p =0.001) and social(χ~2 =6.811, p=0.009) areas were lower than the preterm infants. At 9 months, there was no difference in the DQ scores and incidences of developmental abnormalities in four areas between full-term and preterm high-risk infants, and the incidence of developmental abnormalities was around 10%.Conclusion The incidence of neurodevelopmental abnormalities in high-risk infants aged less than 1 year old is high. Preterm birth and parental bad habits are significant factors affecting the neurodevelopment.Monitoring and early interventions help to improve highrisk infants' neurodevelopment.展开更多
Objective To know the growth of the cerebellum in newborn infants. Methods The centraivermian area (CVA) of the cerebellum was measured by head ultrasonography in 90 newborns including 65full - terms, 14 preterms and ...Objective To know the growth of the cerebellum in newborn infants. Methods The centraivermian area (CVA) of the cerebellum was measured by head ultrasonography in 90 newborns including 65full - terms, 14 preterms and 11 small for gestational age infants (SGA). Results The average age of the newborninfants were 4.7d (3~7d). The mean CVA in full-terms was 5.81±0.8cm2, which was significantly greater thanthat in preterms (3.7±1.0cm2), and SGA (5.1±0.8cm2), respectively. However, when corrected for birth weight(BW), the ratio of CVA/BW in term SGA was 2.07, being signoficantly higher than the ratio of 1.72 in normalfull- term newborns. There was no dillerence between male and female infants. Statistically significantrelationships were lound between CVA and BW (r=0.8129, P<0.01) and between CVA and gestational age(r=0.7450, P<0.01). Conclusion The study provide some understanding on the grouth of the cerebellum, and thecerebellar measurement by cranial ultrasound is helpful for the assessment of neurological maturation in newborninfants.展开更多
Objective: To observe the effect of super-early comprehensive rehabilitation intervention on neurodevelopmental prognosis of premature high-risk infants;Methods: Premature high-risk infantsmet the inclusion criteria w...Objective: To observe the effect of super-early comprehensive rehabilitation intervention on neurodevelopmental prognosis of premature high-risk infants;Methods: Premature high-risk infantsmet the inclusion criteria were divided into control group (n=30) and treatment group (n=30) according to parental willingness. The control group was given routine treatment, while the treatment group was treated with comprehensive rehabilitationon the basis of the control group. The course of treatment for both groups was 10 d. The changes of body weight, milk consumption, NBNA score, GMFM score and Gesell score were observed. Results:After treatment, the body weight and milk consumption of the treatment group increased significantly compared with those before treatment (P<0.01), which was significantly better than that of the control group (P<0.01);the NBNA score of the treatment group was higher than that of the control group at 40 weeks of gestational age (P<0.05), and the abnormal rate of NBNA was lower than that of the control group (P<0.01). The GMFM scores of A-energy and B-energy areas and the five dimensions of social adaptation, big exercise, fine exercise, language and personal social interaction in the treatment group increased significantly in 1 month, 2 months and 3 months after birth,which were significantly better than those in the control group (P<0.05 or P<0.01). Conclusion: Super-early comprehensive rehabilitation can improve the physical quality of high-risk infants and promote the development of the nervous system, with remarkable effect.展开更多
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 ...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.展开更多
AIM:To evaluate the incidence of regurgitation and other symptoms of gastroesophageal reflux in Indonesian infants. METHODS:In a cross-sectional study at the University Outpatient Clinic for vaccination in Jakarta,138...AIM:To evaluate the incidence of regurgitation and other symptoms of gastroesophageal reflux in Indonesian infants. METHODS:In a cross-sectional study at the University Outpatient Clinic for vaccination in Jakarta,138 mothers of healthy infants less than 12-mo old were prospectively asked to report the frequency of regurgitation. RESULTS:Whatever the age was,some infants did not regurgitate(from 10% during the first month of life to 67% in 1-year-old infants).Regurgitation of at least once a day was reported in 77% of infants younger than 3 too.Daily regurgitation decreased to 12% in the 9-12 mo old group. Reported peak prevalence was 81%(26/32)during the first month of life.Regurgitation decreased sharply between the 4-6 and 7-9 mo old groups(from 44% to 9%).The longer the regurgitation persisted,the more frequently the mother perceived regurgitation as a problem.Volume and frequency of regurgitation,back arching,irritability,crying and refusal of feeding were the symptoms causing maternal anxiety.The longer the regurgitation persisted,the more frequently the mothers viewed it as a health problem. CONCLUSION:Regurgitation occurs frequently in Indonesian infants,and is a frequent cause of concern to mothers.展开更多
The prefrontal cortex of a human full termnewborn infant just after accidental death was studies by mcans of immunocytochemical technique with antibody directedagainst GABA(Immunonuclear Corp.)and ABC kit(Vector)。GAB...The prefrontal cortex of a human full termnewborn infant just after accidental death was studies by mcans of immunocytochemical technique with antibody directedagainst GABA(Immunonuclear Corp.)and ABC kit(Vector)。GABA-containing neurons were found over all layers and all were nonpyramidal cells.The laminar distribution of GABA-containing ne-urons was not even between different layers,density in laye Ⅱ was prominently higher than any other layers,density in layer Ⅲ and layer Ⅳ was higher than that in layer V and Ⅵ.展开更多
Nowadays metabolic syndrome represents a real outbreak affecting society. Paradoxically, pediatricians must feel involved in fighting this condition because of the latest evidences of developmental origins of adult di...Nowadays metabolic syndrome represents a real outbreak affecting society. Paradoxically, pediatricians must feel involved in fighting this condition because of the latest evidences of developmental origins of adult diseases. Fetal programming occurs when the normal fetal development is disrupted by an abnormal insult applied to a critical point in intrauterine life. Placenta assumes a pivotal role in programming the fetal experience in utero due to the adaptive changes in structure and function. Pregnancy complications such as diabetes, intrauterine growth restriction, preeclampsia, and hypoxia are associated with placental dysfunction and programming. Many experimental studies have been conducted to explain the phenotypic consequences of fetal-placental perturbations that predispose to the genesis of metabolic syndrome, obesity, diabetes, hyperinsulinemia, hypertension, and cardiovascular disease in adulthood. In recent years, elucidating the mechanisms involved in such kind of process has become the challenge of scientific research. Oxidative stress may be the general underlying mechanism that links altered placental function to fetal programming. Maternal diabetes, prenatal hypoxic/ischaemic events, inflammatory/infective insults are specific triggers for an acute increase in free radicals generation. Early identification of fetuses and newborns at high risk of oxidative damage may be crucial to decrease infant and adult morbidity.展开更多
BACKGROUND There have been few reports on level 3 difficult removal of peripherally inserted central catheter(PICC)in neonates.Here,we reported a case of an extremely preterm infant who underwent level 3 difficult rem...BACKGROUND There have been few reports on level 3 difficult removal of peripherally inserted central catheter(PICC)in neonates.Here,we reported a case of an extremely preterm infant who underwent level 3 difficult removal of a PICC.CASE SUMMARY Female baby A,weighing 1070 g at 27^(+1) wk of gestational age,was diagnosed with extremely preterm infant and neonatal respiratory distress syndrome.She underwent PICC insertion twice.The first PICC insertion went well;the second PICC was inserted in the right lower extremity,however,phlebitis occurred on the second day after the placement.On the third day of catheterization,phlebitis was aggravated,while the right leg circumference increased by 2.5 cm.On the fourth day of catheterization,more red swelling was found in the popliteal part,covering an area of about 1.5 cm×4 cm,which was diagnosed as phlebitis level 3;thus,we decided to remove the PICC.During tube removal,the catheter rebounded and could not be pulled out(several conventional methods were performed).Finally,we successfully removed the PICC using a new approach termed“AFGP”.On the 36th day of admission,the baby fully recovered and was discharged.CONCLUSION The“AFGP”bundle approach was effective for an extremely preterm infant,who underwent level 3 difficult removal of a PICC.展开更多
There are around 15 million preterm newborns(PT) eve ry year(Atienza-Navarro et al., 2020).With these figures in mind,prematurity represents a major health problem worldwide and it is a leading cause of infant mortali...There are around 15 million preterm newborns(PT) eve ry year(Atienza-Navarro et al., 2020).With these figures in mind,prematurity represents a major health problem worldwide and it is a leading cause of infant mortality,accounting for up to 35%of all deaths among newborns(Atienza-Navarro et al.,2020) and up to 18% of the deaths among children under 5 years of age.展开更多
Free radicals (FRs) generation is an unavoidable consequence of the life in an oxygen-rich atmosphere. FRs can be considered a double-edged sword. Beneficial effects of FRs occur at moderate concentrations and involve...Free radicals (FRs) generation is an unavoidable consequence of the life in an oxygen-rich atmosphere. FRs can be considered a double-edged sword. Beneficial effects of FRs occur at moderate concentrations and involve physiological roles in cellular responses to noxia, as in defense against infectious agents, in the function of a number of cellular signaling pathways and the induction of a mitogenic response. The over-production of FRs and the insufficiency of an antioxidant mechanism result in oxidative stress (OS), a deleterious process and important mediator of damage to cell structures and tissues. It occurs at birth in all newborns as a consequence of the hyperoxic challenge after the transition from the hypoxic intrauterine environment to extrauterine life. During the perinatal period, OS can be magnified by others predisposing conditions such as hyperoxia, hypoxia, ischemia, hypoxia-reperfusion, inflammation and high levels of non-protein bound iron. Epidemiological studies linked OS occurring during fetal stages and early infancy with adverse health outcomes later in life, indicating that OS is an early event in the etiology of these chronic diseases. Newborns, especially if preterm, are particularly susceptible to OS and damage due to the increased generation of FRs, the lack of adequate antioxidant protection, and the inability to induce antioxidant defenses during the hyperoxic challenge at birth. This impairment of the oxidative balance has been thought to be the common factor of pathologies grouped together as “free radical disease in the neonate” that include retinopathy of prematurity (which may lead to blindness in severe cases), bronchopulmonary dysplasia (a particularly debilitating pulmonary lesion of the preterm infant), periventricular leukomalacia (an important cause of severe neurodisability) and necrotizing enterocolitis. In this review we discuss in detail these perinatal diseases. Particularly, we analyze the current knowledge about the role of OS in their pathogenesis.展开更多
基金funded by the'Three-Year Action Plan for Strengthening the Public Health System in Shanghai(2015-2017)–Management of High-risk infants with Multidisciplinary Cooperation',project number:GWIV-19
文摘Background High-risk infants refer to newborns exposed to high-risk factors in the prenatal, natal or postnatal period. High-risk infants are at high risk of developmental retardation, and early identification of developmental abnormalities plays a vital role in improving high-risk infants' quality of life.Aims To describe the neurodevelopment of high-risk infants aged less than 1 year old, and to analyse the incidences and influencing factors of neurodevelopmental abnormalities in order to provide a basis for neurodevelopment monitoring and management of highrisk infants.Methods High-risk infants born between January 2016 and December 2016 in the maternity and infant health hospitals of three districts in Shanghai were followed up.The Gesell Developmental Scale was used to assess the neurodevelopmental level at the time of recruitment(0-2 months) and at 9 months. Univariate and multivariate analyses of the influencing factors were conducted.Results 484 high-risk infants(male 51 %, female 49%)with an average gestation age of 36.5±2.2 weeks were recruited. At the time of recruitment, the average age was2.1(0.8) months, and the developmental quotient(DQ)scores of full-term high-risk infants in motor(t=3.542,p=0.001), cognitive(t=3.125, p=0.002), language(t=3.189, p=0.002) and social(t=3.316, p=0.001) areas were higher than those of preterm infants. The incidences of developmental abnormalities of full-term high-risk infants in motor(χ~2 =9.452, p=0.002), cognitive(χ~2=6.258, p=0.012), language(χ~2 =12.319, p =0.001) and social(χ~2 =6.811, p=0.009) areas were lower than the preterm infants. At 9 months, there was no difference in the DQ scores and incidences of developmental abnormalities in four areas between full-term and preterm high-risk infants, and the incidence of developmental abnormalities was around 10%.Conclusion The incidence of neurodevelopmental abnormalities in high-risk infants aged less than 1 year old is high. Preterm birth and parental bad habits are significant factors affecting the neurodevelopment.Monitoring and early interventions help to improve highrisk infants' neurodevelopment.
文摘Objective To know the growth of the cerebellum in newborn infants. Methods The centraivermian area (CVA) of the cerebellum was measured by head ultrasonography in 90 newborns including 65full - terms, 14 preterms and 11 small for gestational age infants (SGA). Results The average age of the newborninfants were 4.7d (3~7d). The mean CVA in full-terms was 5.81±0.8cm2, which was significantly greater thanthat in preterms (3.7±1.0cm2), and SGA (5.1±0.8cm2), respectively. However, when corrected for birth weight(BW), the ratio of CVA/BW in term SGA was 2.07, being signoficantly higher than the ratio of 1.72 in normalfull- term newborns. There was no dillerence between male and female infants. Statistically significantrelationships were lound between CVA and BW (r=0.8129, P<0.01) and between CVA and gestational age(r=0.7450, P<0.01). Conclusion The study provide some understanding on the grouth of the cerebellum, and thecerebellar measurement by cranial ultrasound is helpful for the assessment of neurological maturation in newborninfants.
文摘Objective: To observe the effect of super-early comprehensive rehabilitation intervention on neurodevelopmental prognosis of premature high-risk infants;Methods: Premature high-risk infantsmet the inclusion criteria were divided into control group (n=30) and treatment group (n=30) according to parental willingness. The control group was given routine treatment, while the treatment group was treated with comprehensive rehabilitationon the basis of the control group. The course of treatment for both groups was 10 d. The changes of body weight, milk consumption, NBNA score, GMFM score and Gesell score were observed. Results:After treatment, the body weight and milk consumption of the treatment group increased significantly compared with those before treatment (P<0.01), which was significantly better than that of the control group (P<0.01);the NBNA score of the treatment group was higher than that of the control group at 40 weeks of gestational age (P<0.05), and the abnormal rate of NBNA was lower than that of the control group (P<0.01). The GMFM scores of A-energy and B-energy areas and the five dimensions of social adaptation, big exercise, fine exercise, language and personal social interaction in the treatment group increased significantly in 1 month, 2 months and 3 months after birth,which were significantly better than those in the control group (P<0.05 or P<0.01). Conclusion: Super-early comprehensive rehabilitation can improve the physical quality of high-risk infants and promote the development of the nervous system, with remarkable effect.
文摘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.
文摘AIM:To evaluate the incidence of regurgitation and other symptoms of gastroesophageal reflux in Indonesian infants. METHODS:In a cross-sectional study at the University Outpatient Clinic for vaccination in Jakarta,138 mothers of healthy infants less than 12-mo old were prospectively asked to report the frequency of regurgitation. RESULTS:Whatever the age was,some infants did not regurgitate(from 10% during the first month of life to 67% in 1-year-old infants).Regurgitation of at least once a day was reported in 77% of infants younger than 3 too.Daily regurgitation decreased to 12% in the 9-12 mo old group. Reported peak prevalence was 81%(26/32)during the first month of life.Regurgitation decreased sharply between the 4-6 and 7-9 mo old groups(from 44% to 9%).The longer the regurgitation persisted,the more frequently the mother perceived regurgitation as a problem.Volume and frequency of regurgitation,back arching,irritability,crying and refusal of feeding were the symptoms causing maternal anxiety.The longer the regurgitation persisted,the more frequently the mothers viewed it as a health problem. CONCLUSION:Regurgitation occurs frequently in Indonesian infants,and is a frequent cause of concern to mothers.
文摘The prefrontal cortex of a human full termnewborn infant just after accidental death was studies by mcans of immunocytochemical technique with antibody directedagainst GABA(Immunonuclear Corp.)and ABC kit(Vector)。GABA-containing neurons were found over all layers and all were nonpyramidal cells.The laminar distribution of GABA-containing ne-urons was not even between different layers,density in laye Ⅱ was prominently higher than any other layers,density in layer Ⅲ and layer Ⅳ was higher than that in layer V and Ⅵ.
文摘Nowadays metabolic syndrome represents a real outbreak affecting society. Paradoxically, pediatricians must feel involved in fighting this condition because of the latest evidences of developmental origins of adult diseases. Fetal programming occurs when the normal fetal development is disrupted by an abnormal insult applied to a critical point in intrauterine life. Placenta assumes a pivotal role in programming the fetal experience in utero due to the adaptive changes in structure and function. Pregnancy complications such as diabetes, intrauterine growth restriction, preeclampsia, and hypoxia are associated with placental dysfunction and programming. Many experimental studies have been conducted to explain the phenotypic consequences of fetal-placental perturbations that predispose to the genesis of metabolic syndrome, obesity, diabetes, hyperinsulinemia, hypertension, and cardiovascular disease in adulthood. In recent years, elucidating the mechanisms involved in such kind of process has become the challenge of scientific research. Oxidative stress may be the general underlying mechanism that links altered placental function to fetal programming. Maternal diabetes, prenatal hypoxic/ischaemic events, inflammatory/infective insults are specific triggers for an acute increase in free radicals generation. Early identification of fetuses and newborns at high risk of oxidative damage may be crucial to decrease infant and adult morbidity.
基金the 2017 Scientific Research Project of Sichuan Health and Family Planning Commission,No.18PJ215.
文摘BACKGROUND There have been few reports on level 3 difficult removal of peripherally inserted central catheter(PICC)in neonates.Here,we reported a case of an extremely preterm infant who underwent level 3 difficult removal of a PICC.CASE SUMMARY Female baby A,weighing 1070 g at 27^(+1) wk of gestational age,was diagnosed with extremely preterm infant and neonatal respiratory distress syndrome.She underwent PICC insertion twice.The first PICC insertion went well;the second PICC was inserted in the right lower extremity,however,phlebitis occurred on the second day after the placement.On the third day of catheterization,phlebitis was aggravated,while the right leg circumference increased by 2.5 cm.On the fourth day of catheterization,more red swelling was found in the popliteal part,covering an area of about 1.5 cm×4 cm,which was diagnosed as phlebitis level 3;thus,we decided to remove the PICC.During tube removal,the catheter rebounded and could not be pulled out(several conventional methods were performed).Finally,we successfully removed the PICC using a new approach termed“AFGP”.On the 36th day of admission,the baby fully recovered and was discharged.CONCLUSION The“AFGP”bundle approach was effective for an extremely preterm infant,who underwent level 3 difficult removal of a PICC.
基金supported by the following funds:To PAM:predoctoral fellowship.Instituto de Investigacion Biomedica de la Provincia de Cadiz (INIBICA)To MGA:Agencia Andaluza del Conocimiento.Proyectos I+D+I—Programa Operativo FEDER Andalucia 2014-2020 fondos FEDER (SOL2018001071 89-TRA)+1 种基金Agencia Estatal de Investigacion.Ministerio de Educacion y Ciencia.Programa Estatal de Generacion de Conocimiento y Fortalecimiento Cientifico y Tecnologico del Sistema de I+D+i y del Programa Estatal de I+D+i Orientada a los Retos de la Sociedaddel Plan Estatal de Investigacion Cientifica y Tecnica y de Innovacion 2017-2020 (PID2020-115499RB-I00/AEI/10.13039/501100011033)。
文摘There are around 15 million preterm newborns(PT) eve ry year(Atienza-Navarro et al., 2020).With these figures in mind,prematurity represents a major health problem worldwide and it is a leading cause of infant mortality,accounting for up to 35%of all deaths among newborns(Atienza-Navarro et al.,2020) and up to 18% of the deaths among children under 5 years of age.
文摘Free radicals (FRs) generation is an unavoidable consequence of the life in an oxygen-rich atmosphere. FRs can be considered a double-edged sword. Beneficial effects of FRs occur at moderate concentrations and involve physiological roles in cellular responses to noxia, as in defense against infectious agents, in the function of a number of cellular signaling pathways and the induction of a mitogenic response. The over-production of FRs and the insufficiency of an antioxidant mechanism result in oxidative stress (OS), a deleterious process and important mediator of damage to cell structures and tissues. It occurs at birth in all newborns as a consequence of the hyperoxic challenge after the transition from the hypoxic intrauterine environment to extrauterine life. During the perinatal period, OS can be magnified by others predisposing conditions such as hyperoxia, hypoxia, ischemia, hypoxia-reperfusion, inflammation and high levels of non-protein bound iron. Epidemiological studies linked OS occurring during fetal stages and early infancy with adverse health outcomes later in life, indicating that OS is an early event in the etiology of these chronic diseases. Newborns, especially if preterm, are particularly susceptible to OS and damage due to the increased generation of FRs, the lack of adequate antioxidant protection, and the inability to induce antioxidant defenses during the hyperoxic challenge at birth. This impairment of the oxidative balance has been thought to be the common factor of pathologies grouped together as “free radical disease in the neonate” that include retinopathy of prematurity (which may lead to blindness in severe cases), bronchopulmonary dysplasia (a particularly debilitating pulmonary lesion of the preterm infant), periventricular leukomalacia (an important cause of severe neurodisability) and necrotizing enterocolitis. In this review we discuss in detail these perinatal diseases. Particularly, we analyze the current knowledge about the role of OS in their pathogenesis.