Prevalence, Aetiology, Maternal and Neonatal Outcome of Term Mothers with Anaemia, Presenting to a Tertiary Care Unit for Confinement in Sri Lanka

Objective: To describe the proportion of women presenting with undiagnosed anaemia at confinement and to explore associations between anaemia and socio economic factors, dietary pattern and compare maternal and neonatal outcome among term mothers with anaemia compared to non-anaemic pregnant women at a tertiary care centre in Sri Lanka. Method: A comparative cross-sectional study was performed by recruiting anaemic and non-anaemic term mothers who delivered at the Teaching Hospital Peradeniya during the period March 2018-March 2019. Pregnant mothers whose haemoglobin level was less than 10.5 g/dl were considered as anaemic and compared with the mothers whose haemoglobin level was above this level. With written consent, demographic data, etiological factors, maternal and neonatal outcomes of term mothers were evaluated by an interview and blood samples were withdrawn to carry out anaemia related investigations. Results: Among 2854 pregnancies, a total of 234 (8.19%) term pregnant mothers were anaemic and they were and compared with 199 non-anaemic mothers. Out of the anaemic mothers (Hb < 105 g/l), 133 (56.76%) had moderate anaemia, 100 (42.79%) had mild anaemia and 1 mother (0.45%) had severe anaemia. Low monthly family income was significantly associated with the incidence of anaemia. Anaemia was also associated with low weekly consumption of red meat (OR 8.994;95% CI, 5.74 - 14.09, p < 0.05) and high weekly tea intake (OR 0.217;95% CI 0.144 - 0.327, p < 0.05). Among anaemic mothers, 215 (67.44%) had low serum ferritin (<30 ng/mL) while most of them were diagnosed with iron deficiency anaemia (58.24%) (n = 113) based on haemoglobin. Most anaemic mothers had undergone elective caesarean section (46.26%) while vaginal deliveries (33.33%) were common among non-anamic group. Conclusions: A moderate prevalence of anaemia among term pregnant women in Peradeniya, Sri Lanka was observed and was associated with low socio economic status, low consumption of tea and poor nutrition lacking in red meat.

Correlation between Transcutaneous Bilirubinemia and Blood Bilirubinemia in Screening Term Newborn for Neonatal Jaundice at the Essos Hospital Centre (EHC), Yaoundé, Cameroon

Background: Early and non-invasive diagnosis of neonatal hyperbilirubinemia remains critical in dark skinned babies of low resource settings. Objective: To assess correlation/agreement between transcutaneous bilirubin (Tcb) and serum bilirubin (Tsb) values in full term neonates with jaundice. Methodology: An analytical cross-sectional study was conducted at the neonatology unit of the Essos Hospital Centre (EHC) from January to June 2019. All full-term neonates aged 0 to 7 days with suspected jaundice who did not receive phototherapy were eligible for the study. The enrolled neonates in the study were assessed clinically, then with the MBJ20 transcutaneous bilirubinometer (TcB). The MBJ20 transcutaneous bilirubinometer highest measurement over the forehead and the sternum were compared to TsB. Data were entered and then analysed with the CsPro7.2 and R (version 3.6.0) software. Correlation was captured by Bland & Alman plots and Concordance Correlation Coefficient (CCC) estimates. The Pearson correlation coefficient and Student test for paired data were used for descriptions purposes, and the significance level was 5%. Results: We recruited 88 neonates. The sex ratio of the babies included was 1.25 favouring males. Median Post-natal age was 3 days with 62% aged 72 hours or more. The mean TcB corresponding to the maximum average between frontal and sternal measurement was 153 mg/dl ± 48 and the average Tsb was 123.80 mg/dl ± 50.48. A good linear correlation was found between TcB and total serum bilirubin level r = 0.86 [0.80;0.91]. Positive correlation was noted between both (forehead and sternum) TcB measurements sites, namely r = 0.78 and r = 0.86. The Bland & Altman plot measured the bias at -29.68 mg/l (confidence interval at 95%, 21.14 - 80.50). The CCC estimate was 0.2 varying from -0.22 to 0.76 according to TcB measurement threshold and post-natal age. The ROC area under the curve value for a threshold < 100 mg/l equals 90% proving to be a good predictor for this threshold. Conclusion: A good linear correlation was found despite a poor agreement between TcB and Tsb. TcB method systematically overestimated the value of TsB.

Respiratory Distress in Full and Post Term Neonates: Prevalence, Etiologies and Outcomes in a Tertiary Health Center in Yaoundé

Introduction: Respiratory pathologies are top listed amongst neonatal morbidities. Our objective was to describe the clinical features, causes and treatment of respiratory distress (RD) in full and post term neonates in a tertiary health center in Yaoundé, the Essos Hospital Centre (EHC). Patients and Method: This was a retrospective study. Full/post term neonates with RD from January 2017-December 2018 were included. Main parameters: incidence of RD, etiologies, risk factors for severity and mortality. Results: We included 186 neonates among 2312 newborn babies. The RD prevalence rate was 8%. Sex ratio of 2.15 was favoring male, median gestational age of 38 weeks. Clinical signs of RD were dominated by a Silverman score above 4/10 in 64%. Main etiologies were pneumonia (44%), followed by transient tachypnea (35.4). Perinatal asphyxia (OR = 9.412, P = 0.005) and cyanosis (OR = 6.509;P < 0.001) were worsening RD, while caesarian section was protective (OR = 0.412;P = 0.050). Mortality rate (MR) was 10.4%. Therapeutic measures briefly consisted in oxygen therapy for 98.9% of patients and probabilistic antibiotic therapy. Conclusion: Neonatal pneumonia was the preeminent etiology of RD in this population;the MR was high.

Significant variations in nutritional supplementation amongst neonates in the United Kingdom

AIM:To ascertain United Kingdom adherence to European society of Paediatric Gastroenterology,Hepatology and Nutrition guidance(ESPGHAN).METHODS:A national cross sectional questionnaire study of neonatal units across England was completed between January and March 2014.All 174 units in the country were attempted to be contacted to complete a telephone survey.This included all level 1,2 and 3 units.They were initially contacted by phone and asking any senior member of the team about their current practice and procedures.The first ten telephone interviews were completed with two researchers present to ensure consistency of approach.If no response was received or no details were available,one further attempt was made to contact the unit.The results were recorded in a proforma and then collated and entered into a spreadsheet for analysis.Comparison to United Kingdom adherence to ESPGHAN guidance was completed.RESULTS:Response rate was 53%.There was variation in use of all supplements.The survey collected data from 91 neonatal units(53%response rate).It was found that 10%of neonatal units had no fixed policy on supplements.The protocols regarding supplementation involved predominantly folic acid,vitamin A,vitamin D and iron,with much variation in doses and regimens.The criteria for prescribing supplements was largely based on age(47%) with only 7%using a weight targets to initiate supplements.Summary data regarding the appropriateness of each nutritional supplement for a variety of different weights are presented,as well as comparison to ESPGHAN guidance which suggests issues with both underdoing of Breast Fed infants and overdosing of infants on several artificial formulas which already contain significant amounts of these nutritional elements.CONCLUSION:There is significant heterogeneity in neonatal policies when prescribing supplements to neonates.National policies which take international guidance into account are recommended.

Risk Factors for Perinatal Asphyxia in Newborns Delivered at Term

Perinatal asphyxia is defined as harm to the fetus or the newborn caused by hypoxia and/or ischemia of various organs with intensity to produce biochemical and/or functional changes. Understanding the risk factors for this clinical condition allows the identification of vulnerable groups, enabling an improvement in care planning in the perinatal period in neonatal intensive care units. In this sense, this research aimed to identify risk factors for perinatal asphyxia present in newborns term that showed record for this clinical condition. This was a cross-sectional, retrospective documentary, quantitative and descriptive, conducted from data from medical records of 55 infants admitted to a neonatal intensive care unit. As for maternal characteristics (78.0%) had between 16 and 35 years, only one child (53.0%) and (76.0%) had no prior history of miscarriage. As for pre-existing diseases or pregnancy (38.0%) developed by Hypertensive Pregnancy Specific disease (02.0%) were suffering from Hypertension and (02.0%) of Diabetes Mellitus. As for newborns, most infants had birth weight (43.6%) and correlation with gestational age (78.2%) compatible for good conditions of birth. Only (20.0%) of the infants had a difficult labor. It stood out although there was a slight predominance of severe asphyxia (50.9%) in the first minute and (45.5%) of the infants had record release intrauterine meconium. It was concluded that most mothers and newborns did not have risk factors for perinatal asphyxia, thus, this fact could be attributed to the structural conditions of service, especially in the care during labor, delivery and immediate assistance newborn.

尿素氮肌酐和胱抑素c对足月窒息新生儿发生急性肾损伤的预测价值分析

目的:分析尿素氮(BUN)、肌酐(SCr)和胱抑素c(CysC)对足月窒息新生儿发生急性肾损伤(AKI)的预测价值。方法:回顾性收集2020年1月至2023年6月85例于我院分娩的足月窒息新生儿的临床资料,根据新生儿是否发生AKI分为AKI组(n=30)与非AKI组(n=55)。收集两组新生儿性别、胎龄等临床资料及BUN、SCr和CysC等资料并比较,采用Logistic多因素回归分析明确影响足月窒息新生儿发生AKI的危险因素,并采用受试者工作特征(ROC)曲线分析BUN、SCr和CysC对足月窒息新生儿发生AKI的预测价值。结果:两组新生儿性别、胎龄、出生体质量、分娩方式及胎数差异无统计学意义(P>0.05);AKI组新生儿重度窒息比例、BUN、SCr、CysC水平同非AKI组相比较均更高(P<0.05);经Logistic回归分析显示,窒息程度越严重及BUN、SCr、CysC水平异常升高均为预测足月窒息新生儿发生AKI的独立因素(P<0.05);经ROC曲线分析显示,血BUN、SCr、CysC对足月窒息新生儿发生AKI均有一定预测价值,其中血CysC预测足月窒息新生儿发生AKI的曲线下面积(AUC)及敏感度较血BUN、SCr高,预测价值相对最好(P<0.05)。结论:BUN、SCr、CysC水平检测对于足月窒息新生儿是否发生AKI均具有重用指导价值,且以血清CysC指导价值最好。

足月新生儿区域脑体积与生后日龄及神经行为发育的相关性研究

目的分析足月新生儿87个脑区体积与生后日龄及神经行为发育水平之间的相关性。方法回顾性收集2010年11月至2017年9月于西安交通大学第一附属医院行头颅磁共振成像检查(三维T1加权成像)表现正常的足月新生儿75例,胎龄(39.38±1.22)孕周,男/女(51/24);生后日龄(11.11±6.67)d。基于87脑区分割模板,利用VB-Net(V-shape Bottleneck network)深度学习分割技术将新生儿大脑划分为87个脑区并计算各脑区体积,通过Pearson偏相关与线性回归分析各脑区体积与生后日龄以及神经行为学之间的相关性。结果校正胎龄、出生体质量、头围、身长及性别后,足月新生儿全脑66.7%(58/87脑区)脑区体积随生后日龄增加逐渐增大(相关系数r:0.2~0.7,P<0.05)。其中,双侧豆状核、左侧尾状核、右侧枕叶灰质、右侧颞下叶灰质、双侧颞前叶灰质体积与生后日龄呈强相关(r>0.50,P<0.05)。右侧枕叶灰质体积随生后日龄线性增长斜率最大(斜率:100.67),且与行为能力呈正相关(r=0.324,P<0.01)。结论新生儿期全脑多数脑区体积随生后日龄增加而增大,以初级感觉运动相关脑区增长最快,呈空间异质性。部分脑区体积在增长过程中伴随行为能力形成。

足月新生儿大脑体积偏侧性分布及与神经行为学的相关性研究

目的基于T1加权MR结构成像探究足月新生儿大脑87脑区体积偏侧性的分布特征及脑区体积偏侧性与新生儿行为神经测查法评分之间的相关性。材料与方法回顾性分析2010年11月至2017年9月在西安交通大学第一附属医院行头颅磁共振检查(三维T1WI)的健康足月新生儿64例[胎龄:(39.46±1.17)孕周;男43例,女21例;生后日龄:(10.94±6.90)天],基于Developing Human Connectome Project(dHCP)87脑区分割模板,在联影智能科研平台(uAI Research Portal)利用深度学习分割技术获得新生儿大脑87脑区体积,进而计算偏侧性系数(lateralization index,LI)=100×(V_(L)-V_(R))/(V_(L)+V_(R)),(V:脑区体积),运用t检验及Pearson偏相关探究大脑区域体积偏侧性特征及LI与行为神经测查法评分之间的相关性。结果新生儿期大脑区域体积左侧偏向性(LI>0)主要分布在枕叶、丘脑、尾状核、侧脑室及小脑等区域;右侧偏向性(LI<0)主要分布在海马、扣带回、颞叶及岛叶白质等区域。其中,枕叶白质(r=-0.303,P=0.015)、枕叶灰质(r=-0.315,P=0.012)、海马(r=-0.332,P<0.01)及扣带回后部白质(r=-0.263,P=0.035)的LI与主动肌张力评分之间存在相关性;此外并未发现各脑区的LI与行为能力评分之间存在相关性。结论新生儿期大脑区域体积已呈现出显著的偏侧性特征,脑区体积偏侧性分布范围广泛,且以右侧偏向性为主;主动肌张力在枕叶灰、白质、海马及扣带回后部白质呈右半球优势分布。

不同蓝光照射频率在新生儿高胆红素血症的应用效果

目的:研究不同蓝光照射频率治疗新生儿高胆红素血症(高胆)的疗效。方法:研究对象为2019年12至2022年2月本院收治的高胆患儿126例,按照随机单双号法分为对照组(63例)和观察组(63例)。两组患儿均接受常规药物治疗,再此基础上对照组患儿给予蓝光长时间照射,观察组则采用蓝光间歇照射。观察比较两组患儿治疗前和治疗第5 d的血清间接胆红素(Serum indirect bilirubin,IBiL)、血清总胆红素(Serum total bilirubin,TBiL)水平,及血清中血胱抑素C(Cystatin C,CysC)、α-谷胱甘肽-S转移酶(Glutathione S transferases-α,α-GST)、谷氨酸脱氢酶(Glutamic dehydrogenase,GLDH)三项水平及观察期间发生的不良反应发生情况。结果:两组患儿经不同蓝光照射频率治疗5 d后,患儿血清中IBiL、TBiL、CysC、α-GST及GLDH水平较治疗前均有显著下降(P<0.05),且观察组上述各项指标明显低于对照组(P<0.05);治疗期间,观察组患儿总不良反应发生率为11.11%,明显低于对照组的26.98%,差异比较具有统计学意义(P<0.05)。结论:采用蓝光间歇照射法治疗新生儿高胆红素血症,有明显疗效,且能显著降低新生儿血清胆红素水平及血清中各酶系水平,降低不良反应发生风险,更值得临床使用。

正常足月新生儿出生3个月内肠道菌群的定植规律分析

目的 探讨正常足月新生儿出生3个月内肠道菌群的定植规律。方法 收集20例正常足月新生儿及其孕母的临床资料,取新生儿出生后第1天(C0)、第3天(C1)、第1周(C2)、第1个月(C3)及第3个月(C4)的粪便标本,采用Illumina NovaSeq PE250进行16S核糖体RNA(16S rRNA)V3+V4区测序,采用生物信息学分析肠道菌群的定植规律。结果 正常足月新生儿粪便中肠道菌群的扩增子序列变异体(ASV)数目、Shannon指数于C0时最高;正常足月新生儿出生3个月内的肠道菌群以变形菌门(Proteobacteria)、厚壁菌门(Firmicutes)、放线菌门(Actinobacteriota)、拟杆菌门(Bacteroidota)为优势菌门,Proteobacteria相对丰度随日龄由高变低再逐渐增高,Firmicutes与之相反;正常足月新生儿生3个月内优势菌群在属水平的演变依次为罗尔斯通菌属(Ralstonia)、链球菌属(Streptococcus)、双歧杆菌属(Bifidobacterium),随日龄增加,Bifidobacterium相对丰度逐渐升高,C4时达44.18%且为优势菌属。结论 正常足月新生儿生3个月内肠道菌群的多样性、组成结构及相对丰度出现变化。

血清心肌酶谱联合胆红素对足月新生儿心肌损害的诊断价值

目的:探讨血清心肌酶谱联合胆红素对足月新生儿心肌损害的临床诊断效果。方法:选取收治的足月心肌损害新生儿50例作为心肌损害组,另选取50例同期健康新生儿作为无损害组,对所有新生儿行血清心肌酶谱各指标水平检测及胆红素水平检查,并分析其联合检测对新生儿心肌损害的诊断效能。结果:心肌损害组血清肌酸激酶(CK)、乳酸脱氢酶(LDH)、谷草转氨酶(AST)、肌酸激酶同工酶(CK-MB)以及总胆红素(TBIL)水平均明显高于对照组(P<0.05);多因素Logistic回归分析结果显示,LDH、AST以及TBIL为新生足月婴儿发生心肌损害的独立危险因素;血清LDH水平预测足月新生儿心肌损害的AUC值为0.904,曲线下面积为0.828~0.954,血清AST水平预测足月新生儿心肌损害的AUC值为0.881,曲线下面积为0.801~0.937,血清TBIL水平预测新生足月幼儿心肌损害的AUC值为0.882,曲线下面积为0.802~0.938,联合预测足月新生儿心肌损害的AUC值为0.994,曲线下面积为0.952~1.000。结论:血清心肌酶谱相关指标联合胆红素对足月新生儿心肌损害的诊断更加准确,可为临床尽早发现及制定防治方案提供依据。

枸橼酸咖啡因治疗新生儿呼吸暂停疗效分析

目的研究枸橼酸咖啡因治疗新生儿呼吸暂停的效果及对临床症状改善、近期预后的影响。方法选取2019年5月~2021年5月我院收治的108例新生儿呼吸暂停患儿为研究对象,根据随机数字表法,将其分为观察组和对照组,每组各54例。观察组患儿接受枸橼酸咖啡因治疗,对照组患儿接受氨茶碱治疗。比较两组患儿的治疗总有效率、临床症状改善时间及用药后3d内呼吸暂停发作次数;比较治疗前和治疗3d后两组患儿血气指标[动脉血二氧化碳分压(PaCO_(2))、血氧分压(PaO_(2))]及血清β-内啡肽(β-EP)水平变化;观察两组患儿治疗期间不良反应发生情况。结果观察组患儿治疗总有效率显著高于对照组,不良反应总发生率显著低于对照组,差异均有统计学意义(P<0.05);观察组患儿意识好转、原始反射好转、肌张力好转时间均短于对照组,用药后3d内呼吸暂停发作次数低于对照组,差异均有统计学意义(P<0.05);治疗3d后,观察组患儿PaCO_(2)和血清β-EP水平低于对照组,PaO_(2)水平高于对照组,差异均有统计学意义(P<0.05)。结论枸橼酸咖啡因治疗新生儿呼吸暂停的效果显著,能有效改善临床症状,降低患儿呼吸暂停发作次数,且不良反应小,用药安全性高。

脑损伤足月新生儿aEEG特点与新生儿神经功能的关系研究

目的:研究脑损伤足月新生儿振幅整合脑电图(aEEG)特点与新生儿神经功能的关系。方法:选取在黄河三门峡医院2020年1月至2021年12月治疗的43例脑损伤足月患儿作为观察组,另选同期出生的43例无脑损伤但存在高危因素患儿作为对照组。对两组患儿均进行aEEG检查,并使用新生儿神经行为测定(NBNA)和贝利婴幼儿发育量表(BSID)评定患儿神经功能。结果:观察组新生儿a EEG总体异常率显著高于对照组,差异具有统计学意义(P <0.05);观察组新生儿NBNA、智能发育指数(MDI)、心理运动发育指数(PDI)评分均低于对照组,差异具有统计学意义(P <0.05);轻度异常组、重度异常组新生儿的NBNA、MDI、PDI评分均低于正常组,且重度异常组的NBNA、MDI、PDI评分均低于轻度异常组,差异具有统计学意义(P <0.05);经Spearman秩相关分析,a EEG与NBNA评分呈正相关(r_(s)=0.415,P <0.05),aEEG与MDI评分呈正相关(r_(s)=0.462,P <0.05),a EEG与PDI评分呈正相关(r_(s)=0.502,P <0.05)。结论:脑损伤足月新生儿aEEG异常率更高,主要表现为振幅异常、睡眠周期缺失、出现异常放电,且与患儿神经功能密切相关。

妊娠期孕妇学校课程参与频次对单胎足月妊娠孕妇自我护理能力及新生儿结局的影响

目的探讨妊娠期孕妇学校课程参与频次对单胎足月妊娠孕妇自我护理能力及新生儿结局的影响。方法选取2019年1月—2023年6月本院的100例待产单胎足月妊娠女性作为研究目标,使用简单化随机表法将100例目标受试群体随机划分成研究组和对照组,每组50例孕妇,这两组准妈妈均参加过不同频次的学习,其中对照组孕妇参加学校课程的频次≤3次。研究组孕妇参加妊娠期学校课程的频次>3次。评估她们的自我护理能力及新生儿结局。结果相比于对照组,研究组的自我保健水平和婴幼儿的健康状况都有显著改善(P<0.05)。结论随着受试者的课程参与度的增加,其自我护理能力和婴幼儿的健康状况也会相应地改善。

米索前列醇经口服和阴道后穹隆给药对足月妊娠孕妇促宫颈成熟疗效和母婴结局的影响

目的:探讨米索前列醇经口服和阴道后穹隆给药对足月妊娠孕妇促宫颈成熟疗效和母婴结局的影响。方法:选取2020年1月—2023年12月上饶市立医院产科收治的80例宫颈条件不成熟的足月妊娠孕妇,按随机数字表法分为A组和B组,各40例。A组口服米索前列醇,B组经阴道后穹隆给药米索前列醇。比较两组足月妊娠孕妇促宫颈成熟有效率、引产相关指标、母婴结局、引产期间并发症发生率和用药期间不良反应发生率。结果:A组足月妊娠孕妇促宫颈成熟总有效率与B组比较,差异无统计学意义(P>0.05)。两组足月妊娠孕妇引产至临产时间、总产程时间和用药次数比较,差异均无统计学意义(P>0.05)。A组足月妊娠孕妇宫缩过强、急产发生率分别为5.00%和0,均明显低于B组的20.00%和15.00%,差异均有统计学意义(P<0.05)。A组足月妊娠孕妇用药期间总不良反应发生率为7.50%,明显低于B组的25.00%,差异有统计学意义(P<0.05)。结论:米索前列醇口服和经阴道后穹隆给药方式对足月妊娠孕妇促宫颈成熟疗效相当,但口服给药方式可提高阴道分娩成功率,改善母婴结局,安全性更高。

不同断脐时间对新生儿窒息影响的Meta分析

目的:分析不同断脐时间对新生儿窒息的影响。方法:检索PubMed、Web of science、Embase、the Cochrane Library、中国知网、维普数据库、万方数据库、中国生物医学文献服务系统(SinoMed)。由2名研究人员根据纳入和排除标准分别对文献进行筛选和质量评价,使用RevMan 5.4软件进行分析。结果:最终纳入9篇随机对照试验(RCT)文献。Meta分析表明,延迟断脐提高了新生儿氧分压(PO_(2)),不同断脐时间对新生儿窒息率,血气分析pH值、碱剩余、二氧化碳分压(PaCO_(2)),新生儿1 min Apgar评分、5 min Apgar评分的影响差异均无统计学意义(P<0.05)。结论:正常足月新生儿延迟30 s至3 min断脐可以提高新生儿PO_(2)含量,不会对新生儿窒息率,血气分析中的pH值、碱剩余、PaCO_(2)以及Apgar评分造成影响。

孕妇孕期增重、胰岛素抵抗代谢评分异常与足月新生儿超重关系及其临床预测价值

目的:探讨孕妇孕期增重、胰岛素抵抗代谢评分(Mets-IR)与足月新生儿超重及其临床评估价值。方法:收集2019年1月-2023年7月本院入住的493名单胎孕妇临床资料,记录分娩方式、年龄、文化程度、孕前体质指数(BMI)、孕次、孕期不同阶段增重及增重程度、孕晚期Mets-IR,新生儿体质量、性别、身高。采用logistic回归分析影响新生儿超重的因素,采用受试者工作特征曲线(ROC)评估各个指标预测新生儿超重效能。结果:493名孕妇均顺利生产,新生儿出生时体质量≥4000g 133例(27.0%)纳入超重组(体质量4025~4896g),<4000g 360例(73.0%)纳入对照组(体质量2501~3978g)。超重组新生儿出生时体质量、孕妇孕期总增重、孕早期增重、孕中期增重、孕晚期增重、Mets-IR均高于对照组(P<0.05)。logistic回归分析显示,孕期增重(孕期总增重、孕早期增重、孕中期增重、孕晚期增重、孕期总增重程度、孕早期增重程度、孕中期增重程度、孕晚期增重程度)、孕晚期Mets-IR升高均可影响新生儿超重(P<0.05)。孕期增重、Mets-IR预测新生儿超重均有一定价值,曲线下面积(AUC)均≥0.56、灵敏度均≥42.5%、特异性均≥24.1%,孕期增重联合Mets-IR预测新生儿超重的AUC(0.838)和灵敏度(87.2%)均升高(P<0.05)。结论:孕期增重、孕晚期Mets-IR与足月新生儿超重相关,联合应用可用于预测新生儿超重。

ABO血型不合溶血病与G6PD缺乏症致正常体重足月新生儿高胆红素血症的临床特征比较分析

目的比较正常体重足月新生儿以葡萄糖-6-磷酸脱氢酶(G6PD)缺乏症和新生儿ABO血型不合溶血病(ABO-HDN)为致病因素导致新生儿高胆红素血症的临床特征的差异。方法选取2021年1月至2023年9月在我院因“新生儿高胆红素血症”住院治疗的正常体重足月新生儿148例为研究对象,根据诊断将其分为G6PD缺乏症组(96例)和ABO-HDN组(52例),对其性别、胎龄、出生体重、分娩方式、入院日龄、入院前黄疸出时间、生后24 h黄疸发生率、黄疸出现日龄、TBIL浓度峰值、IBIL浓度峰值、贫血发生率、住院治疗时间、急性胆红素脑病发生情况进行回顾性比较分析。结果ABO-HDN组比G6PD缺乏症组患儿出生后24 h黄疸率更高、出现黄疸的年龄更小、入院日龄更小、患儿入院前黄疸出现时间更短、贫血发生率更高(P<0.05);G6PD缺乏症组比ABO-HDN组患儿的TBIL浓度峰值、IBIL浓度峰值更高(P<0.05)。两组患儿住院治疗时间比较,差异无统计学意义(Z=-0.538,P>0.05)。G6PD缺乏症组有2例患儿出现急性胆红素脑病,ABO-HDN组未出现,患儿均治愈出院。结论G6PD缺乏症患儿发生黄疸时间与生理性黄疸时间重合,导致就诊延迟而发生更严重黄疸,甚至出现急性胆红素脑病;而ABO-HDN患儿黄疸出现时间早,治疗更及时,避免了不良后果的发生。

肺泡表面活性物质联合经鼻持续气道正压通气治疗足月新生儿呼吸窘迫综合征的效果

目的探讨肺泡表面活性物质(PS)联合经鼻持续气道正压通气(nCPAP)治疗足月新生儿呼吸窘迫综合征(RDS)的效果。方法回顾性分析2018年9月至2021年11月我院收治的104例足月新生儿RDS患儿临床资料,根据治疗方法不同将其分为参照组和研究组,各52例。参照组给予nCPAP治疗,研究组给予PS联合nCPAP治疗。比较两组的治疗效果。结果研究组的治疗总有效率高于参照组,并发症总发生率低于参照组(P<0.05);两组的死亡率比较,差异无统计学意义(P>0.05)。研究组的动脉血二氧化碳分压(PaCO_(2))低于参照组,动脉血氧分压(PaO_(2))与血氧饱和度(SaO_(2))高于参照组(P<0.05)。治疗后,研究组的呼气末正压通气(PEEP)、平均气道压(MAP)及气道峰压(PIP)低于参照组(P<0.05)。研究组的机械通气时间及住院时间短于参照组(P<0.05)。研究组的家长满意度高于参照组(P<0.05)。结论PS联合nCPAP治疗足月新生儿RDS可提高临床治疗效果,改善患儿氧合能力及肺通气功能,缩短机械通气时间及住院时间,降低并发症发生风险,且家属满意度较高。

足月胎膜早破孕妇分娩方式对妊娠结局的影响观察

目的分析足月胎膜早破孕妇分娩方式对妊娠结局的影响。方法选择2020年1月—2023年1月于榆林市横山区人民医院诊治的80例足月胎膜早破孕妇作为研究对象,根据孕妇的意愿选择不同的分娩方式,分为择期计划剖宫产组和自然临产组,每组40例。比较两组分娩方式对妊娠结局的影响。结果择期计划剖宫产组者的产后24 h内出血量、期待治疗时间均少于或短于自然临产组相应指标,差异有统计学意义(P<0.05);择期计划剖宫产组出生后1 min、出生后5 min、出生后10 min的Apgar评分均高于自然临产组相应评分,差异有统计学意义(P<0.05);择期计划剖宫产组不良妊娠结局发生率低于自然临产组,差异有统计学意义(P<0.05);择期计划剖宫产组新生儿不良事件发生率低于自然临产组,差异有统计学意义(P<0.05)。结论足月胎膜早破孕妇应尽早进行分娩,从而降低不良妊娠不良结局及新生儿不良结局发生率,减少胎儿病死率及孕妇感染率。