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.

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.

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.

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.

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.

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.

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

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.

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.

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

目的:系统回顾家庭参与式护理模式对早产儿生长发育的影响。方法:在PubMed、EMBASE、Cochrane Library、Web of Science、中国生物医学文献数据库、中国期刊全文数据库、万方医学和维普数据库中系统检索相关随机对照试验或半随机对照试验,探讨家庭参与式护理模式对新生儿重症监护室早产儿生长发育的影响。由两名独立研究者对文献进行筛选,提取数据,并评估所有纳入研究的偏倚风险后,采用RevMan 5.3进行Meta分析。结果:研究共纳入14篇文章,早产儿及其家属共3120例。Meta分析显示与传统的管理模式相比,FICare模式能有效地提高早产儿的体重增长速度(WMD=4.02,95%CI(2.47,5.56),P<0.001),增加睡眠时间(WMD=3.25,95%CI(2.05,4.44),P<0.001),提高母乳喂养率(RR=1.38,95%CI(1.15,1.64),P<0.001),降低再入院率(RR=0.49,95%CI(0.33,0.71),P<0.001),促进神经系统的发展(WMD=3.96,95%CI(3.18,4.74),P<0.001),提高早产儿父母的护理技能[WMD=17.40,95%CI(13.64,21.1),P<0.001],减少母婴分离对父母情绪的影响。结论:家庭参与式护理模式能有效促进早产儿的生长发育,减轻母婴分离带来的危害。受纳入研究的质量和地区的限制,上诉结论还需要更多高质量研究进行验证。

Influencing factors of the neurodevelopment of high-risk infants

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.

The trajectories of physical growth in 4 months postnatal corrected age among preterm infants discharged from neonatal intensive care units and associated factors: A prospective study

Objectives Growth retardation is a risk for premature infants.In addition to demographic and perinatal factors,preterm infants’physical growth may be affected by neonatal intensive care unit(NICU)stress,maternal postpartum depression,and mother-infant interaction.This study aimed to investigate the trajectories of physical growth in 4 months corrected age among preterm infants discharged from the NICU and the impactors on these trajectories.Methods A prospective study was conducted among 318 preterm infants from September 2019 to April 2021 in Shanghai,China.Latent growth modeling was applied to identify the weight,length,and head circumference growth trajectories in 4 months corrected age and explore the effects of demographic and medical characteristics,infant stress during NICU stay,maternal postpartum depression,and mother-infant interaction on each trajectory.Results Unconditional latent growth models showed curve trajectories with increasingly slower growth in weight,length,and head circumference until 4 months of corrected age.Conditional latent growth models showed that a longer length of stay in the NICU and more skin punctures were negatively associated with weight at 40 weeks corrected gestational age(β=−0.43 and−0.19,respectively,P<0.05).The maternal postpartum depression between 40 weeks corrected gestational age and 1 month corrected postnatal age was associated with a lower growth rate of length(β=−0.17,P=0.040),while between 2 and 3 months corrected postnatal age,there were lower growth rates of weight and head circumference(β=−0.15 and−0.19,respectively,P<0.05).The mother-infant interaction scores between 40 weeks corrected gestational age and 1 month corrected postnatal age negatively predicted the growth rate of weight(β=−0.19,P=0.020).Conclusion The physical growth trajectories of preterm infants discharged from the NICU were influenced by infant stress during the NICU stay,maternal postpartum depression and mother-infant interaction.

The Indonesian version of the Premature Infant Pain Profile-Revised:Translation and adaptation of a neonatal pain assessment

Purpose: Pain assessment is a key component of good pain management in hospitalized infants.This study aimed to translate and adapt a version of pain measurement in infants,the Premature Infant Pain Profile Revised (PIPP-R) into Indonesian.Method: The adaptation process of the measuring instrument used a modified Brislin method which included forward translation,back translation 1,group discussion 1,back translation 2,group discussion 2,and pilot testing on neonatal nurses: feasibility test,inter-rater reliability using intraclass correlation (ICC),and internal consistency using Cronbach's α coefficient.Results: The PIPP-R version in English has been translated into Indonesian.In general,nurses assessed this measuring instrument as feasible.The inter-rater reliability showed a high agreement (ICC =0.968,P=0.001) and this measuring instrument had good internal consistency (Cronbach's α=0.856).Conclusion: The Indonesian version of PIPP-R is easy to use and shows good psychometric properties.The use of this measuring instrument will help nurses and researchers obtain accurate infant pain intensity measurement values.

Eeffect of super early comprehensive rehabilitationon neurodevelopmental prognosis of high-risk infants

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.

Efficacy of Danshen Injection Combined with Phosphocreatine Disodium in Treating Frequent Premature Contractions during Pregnancy and Its Effects on Maternal and Infant Outcomes

[Objectives]To explore the efficacy of Danshen Injection combined with phosphocreatine disodium in treating frequent premature contractions during pregnancy and its effect on maternal and infant outcomes.[Methods]A total of 200 pregnant women with normal pregnancy and frequent premature contractions who were treated in the outpatient department of internal medicine in Women and Children's Hospital of Hubei Province and Xinzhou District People's Hospital of Wuhan Central Hospital during September 2015 and October 2018 were selected and randomly divided into the control group and observation group,100 cases for each group.The observation group was treated with Danshen Injection combined with phosphocreatine disodium,and the control group was treated with phosphocreatine disodium alone.The course of treatment in both groups was one week.During the treatment,the changes of heart rate,heart rhythm,electrocardiogram and 24-h dynamic electrocardiogram(DCG)of both groups were observed.[Results]After treatment,the clinical efficacy of the observation group was better than that of the control group,and the difference was statistically significant(P<0.01).There were no adverse drug reactions in both groups.However,in the control group,non-sustained ventricular tachycardia(NSVT)was found in 24-h dynamic electrocardiogram(DCG)of 2 pregnant women with premature ventricular contraction.The pregnancy process was smooth,with full-term natural delivery and no fetal malformation.There was no significant difference in gestational age and neonatal weight between the two groups(P>0.05).However,there was a statistically significant difference in Apgar score between the two groups(P<0.05).During the 6-month postpartum follow-up,the mother and child were unharmed,and examination of repeated electrocardiograms showed that the conditions were normal.[Conclusions]Danshen Injection combined with phosphocreatine disodium has better efficacy in the treatment of frequent premature contractions during pregnancy and the maternal and infant outcomes than the treatment with phosphocreatine disodium alone,and it has good safety and can prevent premature contractions from progressing to tachyarrhythmias.

The effect of an early oral stimulation program on oral feeding of preterm infants

Purpose:To evaluate the effect of an oral stimulation program on preterm infants.Methods:Preterm infants(n=72)were randomly assigned to experimental and control groups.Controls(n=36)received routine care while the experimental group(n=36)received oral stimulation in addition to routine care.Postmenstrual age,total intake volume,body weight,the transition time from initiation of oral feeding to full oral feeding and feeding efficiency were calculated.Results:Postmenstrual age and full oral feeding weight were significantly lower in the experimental group(p<0.05).The time from initiation of oral feeding to full oral feeding was significantly shorter in the experimental group(p<0.05)while feeding efficiency was higher in the experimental group(p<0.05)compared to controls.No significant differences existed in hospital stay length or weight gain rate.Conclusions:An early oral stimulation program is beneficial in preterm infants.

The evolution of refractive status in Chinese infants during the first year of life and its affected factors

AIM： To study the evolution of the refractive status and examine the affected factors in infants during the first year of life in a large sample size in China. METHODS： A total of 1258 babies （2516 eyes） aged 32wk gestational age to ty participated in the study, including 766 premature and 492 full-term infants. First, each baby received an orthoptic examination, slit-lamp checking and fundus imaging. Patients with diseases which might affect refractive status were excluded from the cohort. The cycloplegia retinoscopy was performed. Their neonatal histories were reviewed. Each measurement contained the refractive status and calculation of the spherical equivalent （SE）. RESULTS： Refractive state showed an average hyperopia of ＋0.94_＋1.63 D at early ages, followed by a trend toward more hyperopia. The refractive state reached the top （＋2.431.46 D） at the age of one to two months. Then gliding till one year old when the refractive state reached ＋0.59：1.41 D. The prevalence of astigmatism was 42.17% in the study, being 2.82% myopic astigmatism and 39.35% hyperopic astigmatism. The 94.1% of hyperopic astigmatism was with-the-rule astigmatism and 71.83% of myopic astigmatism was with-the-rule astigmatism. Refractive state between boys and girls was different. The mean SE of boys was ＋1.97＋1.57 D, while that of girls was ＋1.79＋1.46 D, and the difference was significant. CONCLUSION： Before one year old, the change of refractive status is associated with checking age and sex. At the age of one to two months, the degree of hyperopia reaches the top. Boys have more hyperopic degree than girls, and with- the-rule astigmatism is predominant. Excluding premature infants with advanced retinopathy of prematurity, premature and full-term children have same refraction status.