Hypoglycaemia in screening oral glucose tolerance test in pregnancy with low birth weight fetus

Maternal hypoglycemia,a condition characterized by lower than normal blood glucose levels in pregnant women,has been increasingly associated with adverse pregnancy outcomes,including low birth weight(LBW)in neonates.LBW,defined as a birth weight of less than 2500 g,can result from various factors,including maternal nutrition,health status,and metabolic conditions like hypoglycemia.Maternal hypoglycemia may affect fetal growth by altering the supply of essential nutrients and oxygen to the fetus,leading to restricted fetal development and growth.This condition poses significant risks not only during pregnancy but also for the long-term health of the child,increasing the likelihood of developmental delays,health issues,and chronic conditions later in life.Research in this area has focused on understanding the mechanisms through which maternal hypoglycemia influences fetal development,with studies suggesting that alterations in placental blood flow and nutrient transport,as well as direct effects on fetal insulin levels and metabolism,may play a role.Given the potential impact of maternal hypoglycemia on neonatal health outcomes,early detection and management are crucial to minimize risks for LBW and its associated complications.Further investigations are needed to fully elucidate the complex interactions between maternal glucose levels and fetal growth,as well as to develop targeted interventions to support the health of both mother and child.Understanding these relationships is vital for improving prenatal care and outcomes for pregnancies complicated by hypoglycemia.

Neurodevelopmental Outcomes of Extremely Premature Infants with Extremely Low and Very Low Birth Weight at Three Years of Age: A Retrospective Study

Introduction: The purpose of this retrospective study is to identify medical conditions impacting neurodevelopmental outcomes of extremely low birth weight and very low birth weight preterm infants at three years of age. Methods: Infants born in Banner Diamond Children’s University Medical Center, receiving services in the Newborn Intensive Care Unit, and attending Neonatal Developmental Follow-Up Clinic were identified. Participants received developmental assessment and follow-up from August 2012 through December 2018. Relevant clinical conditions during initial hospital stay and up to three years of age were obtained by reviewing medical and developmental records. Bayley Scales of Infant Toddler Development (Bayley III) was used to evaluate skill development at 6, 9, 12, 18, 24, 30, 36 months. Results: Data analysis did not reveal significant p-values;it did demonstrate that some predictor variables impact neurodevelopmental outcomes in cognitive, language and motor skill development. Conclusion: This retrospective study reports significant association between birth weight and low cognitive scores. Correlations were also found between gestational age and Total Language, and the longer an infant stayed in the NICU, the poorer the Total Language Scaled Scores at 8 to 12 months, 15 to 18 months, and 24 to 36 months. Birth weight was found to be the greatest predictor of poor motor scores.

Neonatal Mortality Associated with the Referral of Low Birth Weight Newborns to the Institute of Child Nutrition and Health (INSE)

The objective of this study was to identify risk factors and study the causes of neonatal mortality of LBW newborns referred to the Institute of Nutrition and Child Health. Material and Methods: This is a prospective descriptive and analytical study from March 1 to August 31, 2015, involving 250 newborns referred to the Neonatology Department of the Institute of Child Nutrition and Health (INSE). Results: During our study period, we recorded 1169 newborns, 250 of whom were referred, representing a referral frequency of 21.38%. The overall mortality rate for transferring newborns was 46.8%. Risk factors associated with neonatal mortality were gravidity (p = 0.0019), parity (p = 0.0323), occupational activities requiring physical effort (p = 0.0257), birth weight (p = 0.0008) and prematurity (p = 0.0039). Conclusion: Neonatal mortality associated with referrals is a major health problem in developing countries. There is currently no doubt that it is possible to significantly reduce perinatal mortality and morbidity rates by organizing the identification of “mother-child” couples at risk, to refer them intently to centres better equipped with technical and human resources to care for them.

Study on the Relationship between Nursing Staffing and Nosocomial Infection in Very Low Birth Weight Infants

Background: At present, there is no domestic research on the relationship between nurse staffing and hospital infection in very low birth weight infants. In this paper, we will explore the relationship between nurses of very low birth weight (VLBW) infants in neonatal intensive care unit (NICU) and nosocomial infections. Methods: The clinical data of 280 very low birth weight infants born in our hospital from January 2010 to January 2020 were collected, and the chi-square test and multiple logistic regression analysis were used to study the nursing staff of each very low birth weight infant who was admitted to the NICU The relationship between the number of infections and hospital infections. Results: On average, each nurse needs to care for 4.3 very low birth weight infants (lowest to highest: 2.50 - 8.42). In the univariate analysis, the higher the incidence of urinary tract infection (P < 0.05), the multivariate logistic regression analysis of neonatal nosocomial infection showed that nurse staffing was significantly related to the incidence of urinary tract infection (OR = 1.78;95% confidence interval, 1.17 - 2.35, P < 0.05). However, there was no significant correlation between nurse staffing and bloodstream infection (OR = 0.91;95% confidence interval, 0.74 - 1.06, P > 0.05) or Ventilator associated pneumonia (VAP) infection (OR = 1.17;95% confidence interval, 0.94 - 1.47, P > 0.05). Conclusion: Our research shows that in the neonatal intensive care unit, the reasonable deployment of nursing staff is an important factor in preventing urinary tract infections in very low birth weight infants. It is important for improving the survival rate of very low birth weight infants and reducing the occurrence of sequelae.

Maternal Age, Low Birth Weight and Early Neonatal Death in Tertiary Hospital in the Volta Region of Ghana

Objectives: Current study sought to determine an association between Low Birth Weight (LBW) and early neonatal mortality at a resource limited country’s referral hospital and to determine relationship between maternal age and birth outcomes. Method: A retrospective study analyzing data on births in the Volta Regional Hospital, Ghana from the period of November 2011 to June 2016. A total of 8279 births were analyzed. Results: Results suggest that teenage mothers (8.60%) are more likely to give birth to pre-term babies than the elderly (6.60%) and the adult mothers (4.61%). LBW is highest among the teenage mothers (12.69%) followed by the elderly mothers (7.87%) and then the least among the adult mothers (6.48%). Extremely Low Birth Weight (ELBW) and Macrosomia births were more observed among the elderly mothers (0.90%;2.17%) than the teenage (0.28%;0.14%) and adult mothers (0.34%;1.61%) respectively. Data suggest that 100% of the ELBW were pre-term birth, 88.28% Very Low Birth Weight (VLBW), 34.56% LBW and only 1.06% of the pre-term birth were with Normal Birth Weight (NBW). Death rate ranges from 50% for ELBW, 33.59% for VLBW, 8.22% for LBW, 5.43% for Macrosomia and 1.5% for NBW. However, death rate distribution among the various age groups was statistically not significant (P 0.106). Conclusions: Our study suggests that early neonatal death, especially deaths among ELBW and VLBW is still high at the VRH of Ghana and therefore there is the need for further studies into interventions to reduce death among neonates born with VLBW and ELBW.

Anthropometric measurements at birth as predictor of low birth weight

In developing countries, low birth weight (BW < 2500 grams) accounts for 60% - 80% of neonatal deaths. Early identification and referral of LBW babies for extra essential newborn care is vital in preventing neonatal deaths. Studies carried out in different populations have suggested that the use of newborn anthropometric surrogates of birth weight may be a simple and reliable method to identify LBW babies. previous studies reported correlation between birth weight to several anthropometric measurements and their predictive value. We aimed to evaluate the correlation between birth length, head, chest, and mid arm circumferences to birth weight. Methods: A cross sectional study has been conducted in SHARIATI Hospital in Tehran, from September 2008 to February 2009. All Consecutive full-term. Single ton, live born babies were included and anthropometric measurements carried out within 48 hours after birth by authors. Birth weight was measured by digital scale within the first 24 hours after delivery. Birth length by somatometer and head, chest, mid arm circumferences were measured 2 times by using plastic measuring tape. Result: Out of 500 newborn studied. 52.2% were male and 47.8% were female. The mean birth weight was 3195.4 ± 399.9 gram and 3.8% of newborns were low birth weight. It was evident a positive correlation of birth weight to all such anthropometric measurements with the highest correlation coefficient for chest circumference (r: 0.74). By ROC- AUC analyses, chest circumference (AUC = 0.91, 95% CI 0.84 to 0.97) and arm circumference (AUC = 0.87, 95% CI 0.79 to 0.95) were identified as the optimal surrogate indicators of LBW babies. The optimal cut-points for chest circumference and arm circumference to identify LBW newborns were ≥31.2 cm and ≥10.2 cm respectively. Conclusions: Chest and mid arm circumferences were the best anthropometric surrogates of LBW among studied Iranian population. Further studies are needed in the field to cross-validate our results. anthropometric values are simple, practicable, quick and reliable indicator for predicting LBW newborns in the community and can be easily measured by paramedical workers in developing nation.

Food insecurity and other possible factors contributing to low birth weight: A case control study in Addis Ababa, Ethiopia

Objective: To determine the association between low birth weight and household food insecurity at government hospitals in Addis Ababa, Ethiopia.Methods: A case control study was carried out on 468 mothers with term neonates from February 1, 2017 to May 15, 2017. The cases were women who gave term babies weighing less than 2500 g and the controls were those having 2500 g or above. In the included hospitals, choices of cases were done as the cases found and the next three eligible newborns in the maternity room were the controls. Data were collected by using pretested and structured questionnaire. Standard beam balance was used to measure the neonatal weight by trained midwifery. The data were entered into a computer using Epi-Data 3.1 and exported to Stata version 14 for data management and analysis. Results: Mothers having food insecurity [adjusted odd ratio (AOR) 3.58;95% confidence interval (CI) (1.79-7.16)], mid-upper arm circumference [AOR 7.70;95% CI (4.39-13.60)], hypertension [AOR 4.81;95% CI (2.33-9.93)], and early age [AOR 3.88;95% CI (1.35-11.15)] showed statistically significant association with low birth weight. Conclusions: Household food insecurity, hypertension, mid-upper arm circumference and early age in women were significant predictors of low birth weight. The provision of adequate nutrient for pregnant mothers having household food insecurity should be assured in order to prevent adverse birth weight outcomes.

Maternal Anthropometric Study of Low Birth Weight Newborns in Saudi Arabia: A Hospital-Based Case-Control Study

Background: The aim of the study is to investigate the role of socio-demographic, life-style and clinical risk factors of low birth weight (LBW) among pregnant women in Saudi Arabia. It is a hospital-based, case-control study of mothers of 135 LBW and 65 normal birth weight neonates at the Obstetrics and Gynecology Unit of the Maternity and Children Hospital, KSA. Methods: On comparison by Duncan’s test, the gestational age of three LBW groups was found to be significantly different (P = 0.0026). The mean duration of hospital stay of the infants also increased for the LBW, very LBW and extreme LBW groups, and their difference was statistically significant (P = 0.0012). Results: A statistically significant, progressive decline was observed in the weight, length and circumference of the head of infants in the LBW to VLBW to ELBW groups. Conclusion: The present study has assessed the state of this significant public health problem of LBW in KSA, and identified several maternal modifiable risk factors. There is an urgent need for the development of reference charts using current data for the Middle Eastern population.

超早产儿获得性巨细胞病毒感染的临床检测及分析

目的探讨获得性巨细胞病毒感染在超早产儿中的临床应用价值。方法回顾性分析本院新生儿科2023年7月1日至9月15日送检的1072例新生儿血清样本的巨细胞病毒相关抗体检测结果。结果1072例样本中有2例患儿确诊获得性巨细胞病毒感染。该2例患儿均为超早产儿(胎龄24~27+6周)、超低出生体重儿(750~999 g),均以血小板降低为首发表现,1例为输血获得性巨细胞病毒感染,另1例为母乳获得性巨细胞病毒感染。结论在超早产儿这类特殊人群中,输血治疗时需警惕输血获得性巨细胞病毒感染,同时也要谨防母乳获得性巨细胞病毒感染,必要时经巴氏消毒后再喂养。

调整体位角度护理对极低出生体重儿胃食管反流和胃排空的影响

目的探讨不同体位角度下极低出生体重儿(VLBWI)的胃食管反流与胃排空情况,为规避VLBWI吸入风险提供参考。方法以2022年9月至2023年9月我院收治的120例VLBWI为研究对象,用随机数字表法分为3组,予以不同喂养体位护理方案。试验组40例,近似坐位(90°)喂养,喂养后近似坐位30 min+头高足低60°30 min+头高足低30°保持。对照1组40例,头高足低60°喂养,喂养后头高足低60°30 min+头高足低30°保持。对照2组40例,头高足低30°喂养,喂养后头高足低30°保持。喂养期间,统计3组溢乳/呕吐与呼吸暂停的发生例次,计算3组呼吸暂停与气管内呛咳的发生率,评价胃食管反流情况。统计3组胃残留、减量喂养与停喂的发生例次,评价胃排空情况。结果试验组溢乳/呕吐发生例次少于对照1组,溢乳/呕吐与呼吸暂停发生例次少于对照2组,呼吸暂停和气管内呛咳发生率低于对照2组(P<0.05)。试验组胃残留、减量喂养与停喂发生例次少于对照1组和对照2组,对照1组胃残留、减量喂养与停喂发生例次少于对照2组(P<0.05)。结论采用近似坐位喂养VLBWI,喂养后保持近似坐位30 min,再调至头高足低位60°保持30 min,最后降至头高足低30°并保持的体位护理方案,可以加快VLBWI胃排空,减少胃食管反流。

新生儿败血症的临床特征及其相关因素研究

目的分析新生儿败血症(NS)的临床特征,并探讨其影响因素。方法回顾性分析2018年6月至2022年6月商丘市第一人民医院5420例新生儿临床资料,将其中发生NS的52例患儿的临床资料纳入发生组,将未发生NS的5368例新生儿临床资料纳入未发生组。查阅资料记录新生儿围产期情况及实验室相关指标情况;收集并记录52例NS患儿的临床表现及病原菌分离鉴定结果。分析NS的临床特征及其相关因素。结果52例NS患儿临床表现主要以体温改变、反应差、黄疸等症状为主;NS患儿的致病菌以表皮葡萄球菌、肺炎克雷伯菌为主;两组新生儿胎龄、出生体重比较,差异有统计学意义(P<0.05);Logistic多因素分析发现,极早产儿(OR=3.594,95%CI:1.997-6.468)、极低出生体重儿(OR=3.724,95%CI:2.071-6.698)、超早产儿(OR=2.244,95%CI:1.158-4.346)、超低出生体重儿(OR=15.111,95%CI:8.286-27.557)是发生NS的影响因素(P<0.05)。结论NS患儿临床表现主要以体温改变、反应差、黄疸等症状为主,致病菌以表皮葡萄球菌、肺炎克雷伯菌为主;极早产儿、超早产儿、极低体重儿、超低出生体重儿是NS发生的影响因素。

1例超低出生体重儿经外周静脉置入中心静脉导管置管后并发心包填塞的护理

本文总结1例经外周静脉置入中心静脉导管(PICC)引起心包填塞的护理,以提高临床对本病的认识及预防。通过观察患儿局部与全身情况,采用胸部X线和心脏彩超进行检查,确诊患儿发生心包填塞及PICC异位,通过紧急行心包穿刺术,缓解心包填塞症状;及时拔除中心静脉置管,给予呼吸、循环、营养、重新置管等方面的支持治疗,并积极做好早产儿术后精细化护理。通过实施上述措施后,该患儿术后第7天心包腔无液性暗区、心影缩小,心率恢复正常,并在治疗68d后康复出院。积极预防深静脉导管并发症,在置管前应充分评估患儿,做好置管前准备。同时,置管及维护人员应具备丰富的临床经验,根据个体选择合适的置管方式、护理方案,才能降低不良事件发生率,保障置管的安全性。

新生儿序贯器官衰竭评分对极低出生体重儿晚发败血症死亡的预测价值

目的评价新生儿序贯器官衰竭评分(nSOFA)对极低出生体重儿晚发败血症死亡风险的预测价值。方法采用单中心、回顾性病例对照性研究。收集2018—2021年于南京医科大学附属苏州医院(苏州市立医院)新生儿科重症监护室住院的首次患有晚发败血症的95例极低出生体重儿确诊感染时及感染6 h后的nSOFA评分,上述患者以持续使用抗生素后发生的临床结局分为死亡组和存活组。采用受试者工作特征(ROC)曲线评估nSOFA评分对极低出生体重儿晚发败血症死亡风险的预测价值。结果感染后6 h晚发败血症死亡组nSOFA与存活组相比,差异有统计学意义(P<0.01),而在确诊感染时差异无统计学意义(P>0.05)。感染后6 h nSOFA评分预测模型ROC的AUC=0.873(95%CI 0.729~1.00,P=0.000),而确诊感染时AUC=0.541(95%CI 0.32~0.77,P=0.69)。感染后6 h nSOFA评分约登指数最大值为0.687,最佳截断值为6.5分。结论确诊败血症后6 h nSOFA能较好地预测极低出生体重儿的死亡风险。监测nSOFA对改善新生儿脓毒症预后有一定的临床价值。

一例超低出生体重儿脐动脉置管后并发肢体缺血性坏死的护理

总结2022年11月我院收治的1例超低出生体重儿(ELBWI)脐动脉置管后并发肢体缺血性坏死的护理经验。护理要点:组建多学科团队,制定精细化护理方案,肢体缺血性坏死的及时识别,予以个体化护理包括做好血管活性药物用药护理,避免药物不良反应,保证湿度与温度,维持有效外环境以及局部氧疗。经过精心的治疗及护理,患儿顺利出院,且未发现肢体生长异常等远期并发症。

极低/超低出生体质量儿晚发型败血症风险预测模型的构建与验证

目的:构建并验证极低/超低出生体质量儿(very/extremely low birth weight infants,VLBWI/ELBWI)发生晚发型败血症(late-onset sepsis,LOS)的风险预测模型。方法:选取2019年1月-2021年12月南京医科大学附属妇产医院新生儿重症监护室收治的579例VLBWI/ELBWI作为研究对象,其中发生LOS 93例为LOS组,未发生LOS 486例为对照组,分析两组发生LOS的影响因素,将单因素中P<0.05的因素纳入Logistic回归分析,建立风险预测模型,并应用ROC曲线检验模型的预测效果。结果:最终纳入出生体质量、外周静脉置管时间、禁食时间、早发型败血症(early-onset sepsis,EOS)发生史共4个因素构建出VLBWI/ELBWI发生LOS的风险预测模型,模型公式为Y=-2.349-0.003×出生体质量(g)+0.095×外周静脉置管时间(d)+0.198×禁食时间(d)-3.075×EOS发生史。预测模型ROC曲线下面积为0.860,约登指数最大值为0.597,预测敏感度为0.817,特异度为0.780,最佳临界值为0.159。结论:构建的模型预测性能良好,适用于临床VLBWI/ELBWI中LOS的筛查,可为医护人员尽早采取预防性措施提供理论依据。

俯卧位通气在超低出生体重儿机械通气中的应用研究

目的:探讨俯卧位通气在超低出生体重儿机械通气中的应用效果。方法:选取2019年4月—2022年6月某三级甲等医院新生儿重症监护室(NICU)收治的超低出生体重儿作为研究对象,将符合纳入标准的87例患儿采用随机数字表法分为观察组42例及对照组45例。对照组采用常规机械通气护理,患儿出生72 h后按照左侧卧位、右侧卧位、俯卧位、仰卧位,每2 h更换1次体位,每日俯卧位3次,时长6 h。观察组在常规机械通气护理基础上,患儿出生72 h后按照俯卧位、右侧卧位、俯卧位、左侧卧位、俯卧位、仰卧位顺序更换体位,4 h更换1次体位,每日俯卧位3次,时长12 h。出院时比较两组患儿机械通气时间、支气管肺发育不良(BPD)发生情况及住院时间。结果:两组患儿BPD发生率比较差异有统计学意义(P<0.05),两组机械通气时间、住院时间比较差异无统计学意义(P>0.05)。结论:俯卧位通气12 h可以降低超低出生体重儿BPD发生率,提高救治质量。

降低新生儿重症监护室极低出生体重早产儿抗生素使用时间的质量改进研究

目的应用质量改进的方法,制定降低新生儿重症监护室极低出生体重(very low birth weight,VLBW)早产儿抗生素使用时间的有效措施,以减少抗生素的使用。方法以住院VLBW早产儿为研究对象,以2020年11月—2021年6月VLBW早产儿住院期间抗生素使用时间占住院时间百分比作为基线值,以降低抗生素使用时间占住院时间百分比为具体质量改进目标。应用帕累托图分析影响早产儿抗生素使用时间的因素。根据抗生素使用的各个环节构建关键驱动图,确定质量改进的关键环节和具体的干预措施。通过运行图监测VLBW早产儿抗生素使用时间占住院时间百分比的变化直至达到质量改进目标。结果2020年11月—2021年6月VLBW早产儿抗生素使用时间占住院时间百分比在质量改进前为49%(基线值),设定质量改进目标为12个月内将该百分比降低10%。帕累托图分析显示影响早产儿的抗生素使用时间的主要因素为:抗生素使用不规范;无感染证据时未及时停用抗生素;中心静脉置管留置时间长;袋鼠式护理应用不足;肠内营养进程延迟。质量改进采取的干预措施包括:(1)制定败血症评估管理规范;(2)对医护人员进行关于早产儿抗生素合理使用的宣教;(3)查房时监督抗生素使用规范的执行性;(4)无明确感染表现且血培养阴性者,抗生素使用36 h后停止使用;(5)减少中心静脉置管及肠外营养时间,降低早产儿感染风险。控制图显示,随着干预措施的实施,VLBW早产儿抗生素使用时间占住院时间百分比由49%降低至32%,具有统计学意义。结论应用基于统计原理、过程控制的质量改进工具及质量改进措施后,VLBW早产儿的抗生素使用时间可得到显著降低。

超低出生体重新生儿医院感染特点及危险因素分析

目的:探究超低出生体重新生儿医院感染的特点和感染发生危险因素。方法:本院2020年1月-2023年12月分娩的体重≤1000g的新生儿232例作为研究对象,根据新生儿感染情况分为感染组(n=63)、未感染组(n=169)。分析体重≤1000g新生儿医院感染特点,多因素logistic回归分析医院感染的高危因素。结果:本次调查的232例新生儿出现医院感染63例,发生率为27.2%。主要感染部位为下呼吸道感染52.4%和呼吸机相关肺炎25.4%;共检出病原体48株,排名前3位分别为阴沟肠杆菌(14.6%)、肺炎克雷伯菌(14.6%)和大肠埃希菌(12.5%)。多因素logistic回归分析显示,进行手术、长时间住院、长时间呼吸机辅助呼吸、长时间放置中心静脉导管是医院感染发生的独立危险因素。结论:≤1000g体重新生儿医院感染以下呼吸道感染较常见,临床需重点关注进行过手术、住院时间久、长时间呼吸机辅助呼吸、长时间放置中心静脉导管的低出生体重新生儿。

极/超低出生体重儿出生后1周内并发高血糖的影响因素分析

目的:分析极/超低出生体重儿出生后1周内并发高血糖的影响因素。方法:回顾2016年8月—2023年8月在上饶市人民医院新生儿科出生的300例极/超低出生体重儿资料,根据出生后1周内是否并发高血糖(空腹血糖>7 mmol/L)分为正常组(n=220)和异常组(n=80),比较两组资料。结果:出生后1周内高血糖发生率26.67%(80/300),发生时间多在24 h内,平均高血糖持续时间(3.44±0.52)d,首发高血糖浓度平均(9.34±1.03)mmol/L;异常组体重<1500 g、5 min新生儿Apgar评分≤7分、胎龄<28周比例均高于正常组,差异均有统计学意义(P<0.05);异常组新生儿母亲年龄≥35岁、妊娠期糖尿病、妊娠期高血压疾病比例均高于正常组,差异均有统计学意义(P<0.05);异常组新生儿葡萄糖输注速度4~6 mg/(kg·min)、禁食时长≤1 d比例均低于正常组,机械通气、新生儿窒息比例均高于正常组,差异均有统计学意义(P<0.05);体重、胎龄、5 min新生儿Apgar评分、葡萄糖输注速度、新生儿窒息是极/超低出生体重儿出生后1周内并发高血糖的影响因素(P<0.05)。结论:极/超低出生体重儿出生后1周内高血糖发生率较高,体重、胎龄、5 min新生儿Apgar评分、葡萄糖输注速度、新生儿窒息是其影响因素,临床应针对上述指标针对性预防。

1例超低出生体重儿念珠菌血症伴烫伤样皮炎的护理体会

目的总结1例超低出生体重儿念珠菌血症伴烫伤样皮炎的治疗及护理经验。方法成立个案护理小组;制定预防皮肤感染策略,做好医院感染防控工作;梳理皮肤护理经验,培养预见性思维;充分进行皮肤护理评估,降低全身感染发生的风险;制定个性化围出院期居家护理指导;出院后继续做好延伸护理。结果患儿住院108 d出院,随访6个月,监测生长发育指标及神经系统发育均正常。结论成立个案小组、制定皮肤护理计划、严格执行消毒隔离制度、控制暖箱湿度等细节化管理,能够改善超低出生体重儿真菌感染的结局。