Impact of Delivery Mode on Morbidity in Preterm Infants with Very Low Birth Weights (<1500 Grams)

The mode of delivery and gestational age for very-low-birth-weight (VLBW) preterm infants are not yet well established and are constant topics of debate. Objective: To analyze the impact of delivery mode on morbidity in preterm infants weighing less than 1500 g. Results: Among 21,957 births, 81 were analyzed;53 were delivered vaginally, and 28 were delivered by cesarean section. The median maternal age, gestational age and body mass index among those delivered vaginally and by cesarean section were 20 years and 22.5 years, 27.6 weeks and 30.1 weeks, and 26.0 kg/m2 and 27.8 kg/m2, respectively. With respect to neonatal blood gas parameters, for those born vaginally and by cesarean section, the median pH was 7.32 and 7.24, the pCO2 was 41.5 mmHg and 51.1 mmHg, and the pO2 was 22.3 mmHg and 16 mmHg. The median fetal weight among those born by cesarean section and vaginally were 1180 g and 955 g, respectively. The median Apgar scores at the first and fifth minutes among those born by cesarean section and vaginally were 5.00 and 8.00 and 4.50 and 7.00, respectively. Conclusion: There was no significant difference between the results of vaginal and cesarean delivery for VLBW infants. Thus, further studies on this subject are needed.

Racial and Ethnic Analysis of Birth Weight Trends among Full-Term Singleton Newborns Delivered in a Prosperous Multicultural Society

Objectives: This study aims to describe birth weight and its variations concerning maternal characteristics as well as to standardize birth weight curves for Qatari and expatriate’s newborn population born in the state of Qatar. Methods: PEARL-Peristat registry is a National maternal-neonatal observation epidemiologic database project where both maternal and neonatal cohort data are collected to evaluate specified outcomes for a population defined by a disease, conditions, or exposures. Results: Out of 50,535 singleton deliveries, only 44,178 live-born infants were included in this study. The LBW rate has remained constant since 2011 and was reported as 2.4% in males and 3.5% in females. The average total LBW was 3%. The lowest incidence of LBW was seen in maternal age between 30 - 45 years. There was a marginal increase in the incidence of LBW among mothers less than 20 years of age. The incidence of LBW among Qatari mothers was reported as 2.6%, 2.2%, and 2.4% in years 2011, 2012, 2017 respectively with a significant difference when compared to expatriates’ newborns particularly in the year 2017 (p-value < 0.001). Moreover, among Qatari newborns, there is a significant rise in the rate of LBW from 2011 to 2017, 2.9% to 4.1% (p-value ≥ 0.007). The expatriate’s population received 69 % of all maternal hospital services offered in government hospitals. Conclusion: The birth weight of newborns delivered in the state of Qatar is to a large extent consistent with the international birth weight figures for both Qatari and expatriate newborns delivered in Qatar. Low birth weight is increasing particularly among young mothers. The lowest rate of LBW was reported among mothers aged above 29 years old. Large for the date was observed among mothers older than 29 years of age.

Low Birth Weight in Cameroon: Research and Analysis of Factors Associated with Their Occurrence in Douala Maternity Wards

Introduction: Low birth weight (LBW) is defined by the World Health Organization (WHO) as a birth weight strictly below 2500 g, whatever the term of pregnancy. It constitutes a major public health problem, both in developed and developing countries, due to its magnitude and its strong association with infant morbidity and mortality. Main objective was to study the factors associated with the occurrence of small-for-gestational-age newborns in Douala. Methodology: We carried out a cross-sectional analytical study with prospective data collection using a technical pretested sheet in the maternity wards of the Douala General Hospital, the Laquintinie Hospital, and the 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, of low weight, seen in the first 24 hours from a full-term single-fetal pregnancy whose mother had given her consent. Our sampling was consecutive and non-exhaustive. We excluded newborns whose term was unclear and those with congenital malformations or signs of embryo-foetopathy. Data collection was done using survey sheets. 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 percentage of small-for-gestational-age newborns was 9.8%;after multivariate analysis by logistic regression to eliminate confounding factors, we found maternal factors associated with small for gestational age newborns;maternal age less than 20 years, primiparity, gestational age (37 - 38), a delay in prenatal visits greater than 14 weeks, anemia in pregnancy, positive toxoplasmosis serology in pregnancy, a body mass index of Conclusion: Our study revealed the potential determinants of low birth weight at term in the Cameroonian urban context and specifically in Douala.

Risk Factors for Low Birth Weight and Preterm Birth：A Population-based Case-control Study in Wuhan,China

Low birth weight（LBW） and preterm birth（PB） are associated with newborn mortality and diseases in adulthood.We explored factors related to LBW and PB by conducting a population-based case-control study from January 2011 to December 2013 in Wuhan,China.A total of 337 LBW newborn babies,472 PB babies,and 708 babies with normal birth weights and born from term pregnancies were included in this study.Information of newborns and their parents was collected by trained investigators using questionnaires and referring to medical records.Univariate and logistic regression analyses with the stepwise selection method were used to determine the associations of related factors with LBW and PB.Results showed that maternal hypertension（OR=6.78,95% CI：2.27–20.29,P=0.001）,maternal high-risk pregnancy（OR=1.53,95% CI：1.06–2.21,P=0.022）,and maternal fruit intake ≥300 g per day during the first trimester（OR=1.70,95% CI：1.17–2.45,P=0.005） were associated with LBW.BMI ≥24 kg/m^2 of mother prior to delivery（OR=0.48,95% CI：0.32–0.74,P=0.001） and gestation ≥37 weeks（OR=0.01,95% CI：0.00–0.02,P〈0.034） were protective factors for LBW.Maternal hypertension（OR=3.36,95% CI：1.26–8.98,P=0.016）,maternal high-risk pregnancy（OR=4.38,95% CI：3.26–5.88,P〈0.001）,maternal meal intake of only twice per day（OR=1.88,95% CI：1.10–3.20,P=0.021）,and mother liking food with lots of aginomoto and salt（OR=1.60,95% CI：1.02–2.51,P=0.040） were risk factors for PB.BMI ≥24 kg/m^2 of mother prior to delivery（OR=0.66,95% CI：0.47–0.93,P=0.018）,distance of house from road ≥36 meters（OR=0.72,95% CI：0.53– 0.97,P=0.028）,and living in rural area（OR= 0.60,95% CI：0.37–0.99,P=0.047） were protective factors for PB.Our study demonstrated some risk factors and protective factors for LBW and PB,and provided valuable information for the prevention of the conditions among newborns.

Cut-Off Points of Head, Chest, and Arm Circumferences to Identify Low Birthweight: Meta-Analysis

Background: The cut-off points of newborn anthropometric variables to identify low birthweight (i.e., birthweight Methods: Meta-analysis was performed to summarize cut-off points in studies judged as good quality based on the Quality Assessment of Diagnostic Accuracy Studies tool (QUADAS). PubMed (MEDLINE) and nine other databases were searched (January, 2015). PubMed related-citations and references of potentially eligible articles and related reviews were also investigated. The Egger test was used to assess publication bias. Results: With respect to head, chest, and arm circumferences, the cut-off points that involved no publication bias could be summarized based on the data from large numbers of newborns (=21,793, 8917, and 12,912, respectively) in relatively sufficient numbers of studies (=17, 15, and 19, respectively). The optimal cut-off points to identify low birthweight were 33.0 cm (95% confidence interval [CI], 32.8 - 33.2), 30.4 cm (95% CI, 30.3 - 30.6), and 9.3 cm (95% CI, 9.1 - 9.4) for head circumference, chest circumference, and arm circumference, respectively. The summarized cut-off point of birth height, i.e., 47.2 cm (95% CI, 46.7 - 47.7), used to identify low birthweight involved publication bias (n = 13). Conclusion: The cut-off points were determined to identify low birthweight using head, chest, and arm circumferences.

Factors of Low Birth Weight Risk in the Department of Gynecology-Obstetrics of the Ignace Deen National University Teaching Hospital in Conakry, Guinea

Introduction: The underweight at birth is recognized as a major cause of morbidity and mortality in childhood. Objective: To identify maternal and obstetric sociodemographic factors associated with low birth weight. Patients and Methods: This is a retrospective study of analytical type that examined the records of women who gave birth in the Obstetrics and Gynecology department of Ignace Deen National University Teaching Hospital from 1st December 2016 to 30th April 2017. The analysis was made with the R version 3.3.1 software. We did a univariate and multivariate analysis. Outcomes: Out of the 1633 live births of single pregnancies that occurred during the study period, 109 children were born with a low weight (<2500 g) corresponding to a rate of 6.7%. In univariate analysis, we found a significant association between low birth weight and maternal single status (p = 0.019), maternal weight less than 60 kg (p = 0.038), primary parity (p = 0.018), maternal history of abortion (p = 0.001), history of preterm birth (p < 0.001), arterial hypertension (p < 0.001), anemia (p < 0.001) and malaria (p < 0.001). In multivariate analysis, the variables associated with low birth weight were: history of preterm delivery with OR of 8.5 [1.8 - 40.1], history of abortion (OR = 4.4 [1.4 - 13.9]), malaria (OR = 23.8 [6.1 - 92.5]), anemia (OR = 11.8 [3.7 - 38.2]) and high blood pressure (OR = 5.4 [1.6 - 17.9]). Conclusion: The decrease in frequency of low birth weight in Guinea will be done by improving the quality of prenatal care with an emphasis on screening, prevention and treatment of malaria, anemia and high blood pressure during pregnancy, prevention of abortion and premature birth.

Clinical Application of Newborn Umbilical Vein Catheterization Combining with PICC

Purpose: Research on clinical application effect of combining very low birth weight newborn (VLBWN) umbilical vein catheterization (UVC) with peripherally inserted central catheter (PICC). Method: 60 cases of VLBWN checked in our hospital’s ICU are selected and divided into combination group (n = 30) and PICC group (n = 30) according to the random number table. Combination of UVC and PICC is applied on newborn of combination group while only PICC is applied on newborn of PICC group. These two groups’ newborn’s PICC catheterization operation time, PICC indwelling time, weight gain, hospital stays, hospital infection, planned extubation, successful single puncture, adverse events and other indexes are observed. Result: Newborns in combination group have less PICC catheterization operation time and less hospital stays than newborns in PICC group while newborns in combination group have longer PICC indwelling time and greater weight gain than newborns in PICC group. The difference here has statistical significance (p < 0.05). Combination group’s hospital infection ratio (3.33%) is lower than that of PICC group (23.33%). The difference here has statistical significance (p < 0.05). Newborns in combination group have a planned extubation rate of 93.33% and a successful single puncture rate of 93.33%, which are greater than those of newborn in PICC group (respectively 73.33% and 70.00%). The difference here has statistical significance (p < 0.05). Newborns in combination group have an adverse event occurrence rate of 43.33%, lower than that of PICC group (70.00%). The difference here has statistical significance (p < 0.05). Conclusion: Application of combination of UVC and PICC on VLBWN can greatly improve PICC catheterization efficiency and newborn patients’ nutriture and reduce rate of complications, thus, it is worthy of clinical application.

Maternal Thyroid Hormones as Mediators between Phthalate Exposure and Neonatal Birth Weight:A Cross-Sectional Study from the Zunyi Birth Cohort

Studies have shown that exposure to phthalates can affect neonatal birth weight.However,epidemiological evidence on the mediating role of maternal thyroid hormones is limited.Therefore,this study,based on the Compliance Birth Cohort,aimed to reveal the potential mediating function of maternal thyroid hormones during pregnancy between phthalic acid ester(PAE)exposure and neonatal birth weight.The study included 1274 mother−infant pairs.Linear regression analysis revealed a negative association between MIBP and neonatal birth weight(β=−62.236;95%CI:−118.842,−5.631).Bayesian kernel-machine regression(BKMR)indicated a nonlinear negative association between PAE metabolites(PAEs)and birth weight.Linear regression analysis revealed a positive association between neonatal birth weight and FT3(β=41.605;95%CI:2.631,80.380).The BKMR model also found a positive association between thyroid hormones and birth weight but in a nonlinear manner.Additionally,linear regression analyses showed that TSH,TT3,TT4,FT3,and FT4 were associated with PAEs.The BKMR model revealed an inverted U-shaped association of PAEs with TT3 and FT3 and a nonlinear association with TSH,TT4,and FT4.Structural equation modeling revealed that MMP,MIBP,MBP,MEHP,MOP,MBZP,and MEOHP contributed to a net reduction in neonatal birth weight of 32 g through the TT3,FT3,TT4,and FT4 pathways.The findings suggest that exposure to PAEs during pregnancy leads to a reduction in neonatal birth weight,possibly due to the involvement of maternal thyroid hormones as mediators.Controlling maternal thyroid hormone levels during pregnancy may be a viable method to reduce the harmful effects of phthalate exposure on the developing fetus.

新生儿低出生体重的影响因素分析

目的分析新生儿低出生体重的影响因素,为预防和干预提供科学依据。方法选取434例低出生体重新生儿作为低出生体重组,另选择841例正常出生体重的健康新生儿作为对照组。收集两组新生儿及孕产妇的一般资料、孕期血脂指标,采用单因素及Logistic多因素回归分析新生儿低出生体重的影响因素。结果低出生体重组的新生儿胎龄(34.79±2.06)周小于对照组的(37.09±2.59)周,剖宫产分娩占比62.7%、试管婴儿占比15.9%高于对照组的49.6%、10.0%,孕产妇体质量指数(BMI)(21.78±3.40)kg/m^(2)及孕期甘油三酯(TG)(2.62±1.27)mmol/L、总胆固醇(TC)(4.99±1.20)mmol/L均高于对照组的(21.32±3.23)kg/m^(2)、(2.35±1.23)mmol/L、(4.74±1.15)mmol/L(P<0.05);两组新生儿性别、民族及孕产妇年龄、HDL-C、LDL-C比较,差异无统计学意义(P>0.05)。Logistic多因素回归分析结果显示:胎龄、剖宫产分娩、试管婴儿及孕产妇BMI、孕期血脂(TG、TC)是导致新生儿低出生体重的影响因素(P<0.05)。结论胎龄、剖宫产分娩、试管婴儿、孕产妇BMI、孕期血脂(TG、TC)是影响新生儿低出生体重的重要因素,因此临床应重视孕妇的孕期管理,以便及时识别和干预可能影响新生儿低出生体重的因素,保障母婴健康。

锌指蛋白A20在低出生体重儿胎盘组织中的表达及其对滋养细胞炎症的影响

目的探讨胎盘组织锌指蛋白A20(A20)的表达水平与低出生体重儿(LBW)新生儿体重及胎盘体重的相关性及其在LBW发病机制中的作用。方法选取2021年9月—2022年5月在本院住院分娩的LBW孕妇30例为LBW组,同期健康妊娠分娩的孕妇30例为健康对照组(NP组);qRT-PCR和Western blot检测两组胎盘组织A20的表达,采用免疫组化检测胎盘组织中A20表达水平;然后分别将A20的表达水平与LBW组新生儿体重及胎盘体重做相关性分析。同时体外培养人源胎盘滋养细胞株(HTR-8/SVneo),分为对照组(NC组)和单纯LPS刺激组(100 ng/mL),转染A20基因腺病毒过表达后,Western blot检测各组胎盘滋养细胞A20蛋白、NF-κB结合蛋白p65、NF-κB亚单位磷酸化p65(p-p65)和TNF-α和IL-1β蛋白的表达,双抗体夹心酶联免疫吸附测定(ELISA)方法检测上清液TNF-α、IL-1β的表达。结果与NP组比较,LBW组年龄、孕周差异无统计学意义(P>0.05),而新生儿体重、胎盘重量、Apgar评分1 min,5 min差异均有统计学意义(P<0.05);A20在LWB组中明显低表达(P<0.01),免疫组化显示A20在LBW组胎盘组织中降低,且与新生儿体重及胎盘重量呈正相关(P<0.05);与NC组比较,单纯LPS刺激组细胞A20蛋白表达降低(P<0.05),而p-p65和TNF-α和IL-1β蛋白表达降低(P<0.05);转染A20基因腺病毒过表达后,A20表达增加(P<0.05),p-p65和TNF-α和IL-1β蛋白表达降低(P<0.05)。结论A20与LBW的发生发展密切相关,其过表达可有效抑制LPS诱导的滋养细胞炎症因子的产生,有望成为预测LWB的分子标记物和治疗靶点。

妊娠期补锌对新生儿出生体重影响的meta分析

目的系统评价妊娠期补锌对新生儿出生体重的影响,为妊娠期合理补锌提供循证依据。方法计算机检索CNKI、CBM、WanFang Data、PubMed、Web of Science、EMbase、The Cochrane Library、Ebsco等数据库,搜集妊娠期补锌对新生儿出生体重影响的随机对照试验(RCT),检索时限为建库至2022年5月。两位研究者独立背对背进行文献筛选,资料提取并对文献质量进行偏倚风险评估,使用RevMan 5.3软件进行meta分析。结果共10个RCT纳入研究,包括研究对象4267例。meta分析结果显示:与对照组相比,妊娠期补锌对新生儿出生体重的影响并不显著(MD=6.87,95%CI:-18.47~32.21,P=0.60)。亚组分析结果显示,锌基础水平低的人群妊娠期补锌(MD=-7.61,95%CI:-69.90~54.68,P=0.81)和锌基础水平正常人群妊娠期补锌(MD=16.83,95%CI:-28.17~61.84,P=0.46)比较,差异无统计学意义(P>0.05);妊娠期单独补充锌(MD=-3.09,95%CI:-55.19~49.00,P=0.91)和含锌的多种微量营养素联合补充(MD=20.95,95%CI:-40.95~82.36,P=0.50)比较,差异无统计学意义(P>0.05)。结论当前证据显示,妊娠期补锌对新生儿出生体重没有显著影响。因纳入文献的质量和数量有所限制,所以本结论有待更多高质量研究给予验证。

基于家庭支持的中介效应探讨妊娠期糖尿病自我管理能力与新生儿出生体质量、Apgar评分的关系

目的基于家庭支持的中介效应探讨妊娠期糖尿病(GDM)自我管理能力与新生儿出生体质量、Apgar评分的关系。方法选取许昌市中心医院2022年4月至2023年4月收治的92例GDM患者,采用GDM专用自我管理能力量表评价其自我管理能力,利用糖尿病专用家庭支持问卷评价其家庭支持情况,且均随访统计新生儿出生体质量、出生1 min Apgar评分。Pearson法分析自我管理能力与家庭支持、新生儿出生体质量、Apgar评分及家庭支持与新生儿出生体质量、Apgar评分的相关性;Mplus8.3软件分析家庭支持在GDM自我管理能力与新生儿出生体质量、Apgar评分间的中介效应,并经Bootstrap法验证。结果患者自我管理能力评分(72.08±13.03)分,家庭支持总分(20.33±4.21),新生儿出生体质量(3308.10±1005.31)g,Apgar评分(8.23±1.69)分;患者自我管理能力总分与家庭支持总分、Apgar评分均呈正相关,差异有统计学意义(P<0.05),与新生儿出生体质量呈负相关,差异有统计学意义(P<0.05);患者家庭支持总分与新生儿出生体质量呈负相关,差异有统计学意义(P<0.05),与Apgar评分呈正相关,差异有统计学意义(P<0.05);患者自我管理能力可影响新生儿出生体质量、Apgar评分,差异均有统计学意义(P<0.05),患者自我管理能力可影响家庭支持,差异有统计学意义(P<0.05),家庭支持在患者自我管理能力与新生儿出生体质量、Apgar评分间呈部分中介效应,差异有统计学意义(P<0.05);自我管理能力对新生儿出生体质量、Apgar评分的直接效应为0.65、0.68,家庭支持对新生儿出生体质量、Apgar评分的间接效应为0.24、0.22,总效应为0.89、0.90。结论GDM自我管理能力待提升、家庭支持水平低,且二者均与新生儿出生体质量、Apgar评分有关,家庭支持在自我管理能力与新生儿出生体质量、Apgar评分间起中介效应。

焦虑抑郁孕妇的孕晚期唾液皮质醇水平与新生儿出生体重的相关性

目的评估焦虑抑郁母亲对新生儿出生体重的影响,探究孕晚期唾液皮质醇水平与新生儿出生体重的相关性。方法2021年1—12月期间在深圳市光明区人民医院产科门诊就诊的早孕期单胎妊娠孕妇,对其进行焦虑抑郁评估。有40例焦虑抑郁孕妇作为观察组和同期就诊的50例正常孕妇作为对照组,在孕晚期检测唾液皮质醇水平和睡眠情绪测评。比较两组的唾液皮质醇水平和分娩结局,并分析唾液皮质醇水平和新生儿出生体重的相关性。结果观察组抑郁孕妇的唾液皮质醇水平显著高于正常孕妇,差异有统计学意义(P<0.001),两组间的新生儿出生孕周和体重差异无统计学意义(P>0.05),但观察组的剖宫产率显著高于对照组,差异有统计学意义(57.5%vs.24.0%)。孕晚期的唾液皮质醇水平和出生体重呈负相关,但无统计学意义(P>0.05)。结论焦虑抑郁孕妇在妊娠晚期的唾液皮质醇呈现高水平,他们有更高的剖宫产率,未发现唾液皮质醇水平与新生儿出生体重的相关性。

西藏高海拔牧区市新生儿出生体重调查分析——以那曲市为例

以2016年1月至12月那曲市某医院妇产科接生登记表为依据,对新生儿及产妇的情况进行回顾性分析。结果显示,2016年该市某医院共登记新生儿总数为2500例,其中男婴1293例,女婴1207例,性别比为1.07∶1.00;95.5%的新生儿自然分娩出生;新生儿平均出生体重为2943.19±532.93 g,1.7%为极低出生体重儿,12.6%为低体重儿,巨大儿为1.1%。用Apgar评分评估新生儿,4.0%的新生儿轻度窒息,4.4%的重度窒息。单因素分析显示新生儿出生体重与其性别、出生季节、产妇年龄及孕次因素有关。那曲市新生儿出生体重低于全国平均水平,低于西藏其他地市水平,低体重儿比例较高;新生儿出生体重受多因素影响,应采取不同措施加以干预,从而使西藏高海拔牧区市新生儿体重合理增长。

2020-2022年20564例活产新生儿出生情况资料分析

目的:探讨2020-2022年各年活产新生儿相关情况,为政策干预提供理论依据。方法:本文为回顾性研究,分析北京市海淀区妇幼保健院院出生日期为2019年10月1日-2022年9月30日的20564例新生儿相关资料,比较各年份差异。结果:各年新生儿出生孕周、出生身长、出生体重、巨大儿的发生率未见统计学差异,剖宫产发生情况有所下降(χ^(2)=249.30,P=0.000);母亲高龄略有上升(χ^(2)=8.63,P=0.013);母亲文化程度在本科及以上的比例逐年升高(χ^(2)=58.73,P=0.000)。低出生体重儿的独立危险因素为产妇高龄(OR=1.373,95%CI 1.107~1.703)。结论:加强健康宣教关注母婴安全,尤其是早产儿及低体重儿,全方位保障新生儿的健康成长。

新生儿重症监护室不同出生体重儿PICC的现状分析

目的分析新生儿重症监护室(neonatal intensive care unit,NICU)不同出生体重儿经外周置入中心静脉导管(peripherally inserted central catheter,PICC)的现状,为后续护理质量改进提供依据。方法回顾性分析2017年1月1日至2021年12月31日某三级甲等医院NICU 908例PICC病例的临床资料,按出生体重(birth weight,BW)分为4组,比较各组间置管过程、维护过程、并发症和拔管原因。结果82.7%的患儿PICC经右下肢大隐静脉置管,不同出生体重组间穿刺部位存在差异,其中BW<1 kg和BW≥2.5 kg组经股静脉置管比例高于其他两组。总体一次性穿刺成功率84.8%,不同出生体重组间存在差异,BW≥2.5 kg组一次性穿刺成功率最低,为65.9%。总体一次性到位率为61.8%,过深率为31.9%,不同出生体重组导管尖端首次定位分布未见差异。总体并发症发生率为13.3%,非计划性拔管率为1.9%,不同出生体重组间总并发症发生率和非计划性拔管率未见差异。结论PICC并发症发生率和非计划性拔管率控制得较为理想,但在一次性穿刺成功率和一次性到位率方面仍有较大的提升空间,未来护理质量改进方向应以提高一次性置管成功率为主。

仔猪均匀度与初生重的营养影响因素研究进展

仔猪初生重和均匀度是影响产房成活率的关键指标,而产房成活率是衡量现代养殖企业生产成绩的重要指标之一。随着遗传选育技术的持续突破,母猪窝均产仔数及断奶头数呈现出逐年增长的趋势,但这一进步也伴随着仔猪初生重和均匀度的降低。初生重和均匀度降低与仔猪的存活及其后续的生长发育密切相关,目前影响仔猪出生重和均匀度的因素主要有窝产仔数、品种、营养因素、胚胎在子宫中的位置、胎次、季节等。文章综述了采食量、蛋白质、功能性纤维、功能性氨基酸等营养因素对仔猪初生重和均匀度的影响及其可能的调控机理,并给出了合理的推荐值,以期通过营养调控手段改善仔猪初生重和均匀度,为饲料配方的优化设计提供参考。

改良俯卧位通气联合按摩抚触在低出生体重儿机械通气中的应用

目的:探究改良俯卧位通气干预联合按摩抚触对低出生体重儿呼吸机相关性肺炎的预防效果。方法:选取2021年1月—2023年6月泉州市妇幼保健院•儿童医院收治的80例接受机械通气的低出生体重儿作为研究对象,按照双盲法将其分为对照组和观察组,每组各40例。两组均行常规机械通气护理以及按摩抚触,对照组给予俯卧位通气,观察组给予改良俯卧位通气。比较两组呼吸频率(RI)、二氧化碳分压(PaCO_(2))、平均动脉压(MAP)、呼吸机相关性肺炎发生率和并发症发生情况、住院时间、机械通气时间以及家属满意度。结果:干预后,观察组RI、PaCO_(2)、MAP水平较对照组更低,差异有统计学意义(P<0.05);与对照组相比,观察组住院时间以及机械通气时间更短,低出生体重儿的并发症发生情况和呼吸机相关性肺炎发生率更少,家属满意度更高,差异有统计学意义(P﹤0.05)。结论:改良俯卧位通气干预联合按摩抚触能够预防低出生体重儿呼吸机相关性肺炎的发生,减少患儿相关并发症的发生,改善患儿的血气指标和生命体征,有助于缩短患儿的住院时间。

妊娠期糖尿病患者脂代谢异常对新生儿出生体质量的影响

目的:研究妊娠期糖尿病(GDM)患者脂代谢异常对新生儿出生体质量的影响,为合理管理妊娠期糖尿病孕妇提供临床参考。方法:106例妊娠女性分为妊娠期糖尿病(GDM组,n=50)组、妊娠期糖耐量受损(GIGT组,n=24)组及糖耐量正常(NGT组,n=32)。比较3组孕妇血脂水平、孕期体质量增加及相关围产资料。结果:GDM组总胆固醇(TC)及三酰甘油(TG)水平均高于GIGT和NGT组,差异有统计学意义(P<0.05)。3组孕妇分娩前体质量差异有统计意义(P<0.01),且GDM组明显高于其他2组。GDM组新生儿出生体质量、孕妇术中羊水粪染及新生儿转入重症监护病房(NICU)的概率高于其他2组,差异有统计学意义(P<0.05);GDM组孕妇空腹血糖、TG水平及孕妇孕期体质量增加与新生儿出生体质量间存在正相关(r分别为0.528、0.632、0.585,P<0.05)。结论:在控制血糖的基础上,积极控制血脂水平,可减少巨大儿的发生及围产期并发症,保障母婴安全。

新生儿期体重变化趋势分析

目的:了解新生儿体重增长趋势与一般规律。方法:整群抽取合肥市2个妇幼保健站3年新生儿访视资料,内容包括新生儿出生时胎龄、体重和新生儿期各阶段体重以及母乳喂养情况,共获取完整资料1 023例。结果:整个新生儿期体重平均增加(1 091.6±329.8)g,男婴各阶段体重均高于女婴,但第1周的体重增量男女间无显著性差异。纯母乳喂养组第1周体重增量低于非纯母乳喂养组,1周后的体重增量两组间无显著性差异。广义线性模型分析显示新生儿各阶段体重均呈增加趋势,出生时体重和胎龄作为协变量具有统计学意义。结论:新生儿期各阶段体重增长具有一定的规律性,新生儿体重增长速度与出生体重、胎龄及喂养方式有关。