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.

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.

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.

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.

The Effect of Human Immunodeficiency Virus-1 Infection on Low Birth Weight, Mother to Child HIV Transmission and Infants’ Death in African Area

Background: It is yet a controversy subject whether low birth weight and infant death are associated to human immunodeficiency virus-1 infection. Objective: To appreciate association between low birth weights, mother to child HIV transmission and infant mortality in HIV-1 infected pregnant women delivering between 2011 and 2016. Materials: We conducted 6 years cohort study in urban Mali. Outcome included preterm delivery, small for gestational age, infant survival status and HIV transmission. Comparison concerned women clinical WHO stage, mother viro-immunological status, and newborn anthropometric parameters. Results: HIV-1 infected women who delivered low birth weight newborn were 20.9% (111/531) versus 16.5% (1910/11.546) in HIV negative patients (p = 0.016). CD4 T cell counts low than 350 T cells count were strongly associated to LBW (p = 0.000;RR = 3.03;95% CI [1.89 - 3.16]). There is no significant association between ART that was initiated during pregnancy (p = 0.061, RR = 0.02;CI 95% (1.02 - 1.99)) or during delivery (p = 0.571;RR = 1.01;CI 95% (0.10 - 3.02)) and LBW delivery. In multivariate analysis ART regimens containing protease inhibitor (PI) were lone regimens associated with LBW ((p = 0.030;RR = 1.001;95% confidence interval [1.28 - 3.80]). Very low birth weight was statistically associated to women HIV infection (adjusted relative risk, 2.02;p = 0.000;95% confidence interval (2.17 - 4.10)). There is no significant difference between mother to child HIV transmission rate in the two HIV-infected pregnant women (10 infected children in group 2: MTCT rate 4.5%) and 3 infected children in group 1 (MTCT rate: 2.7%) (p = 0.56;RR, 0.59;CI 95% (0.18 - 4.39)). In multivariate analysis, LBW was associated with infant death (p = 0.001;RR = 2.04;CI 95% [1.04 - 5.05]). The median weight of infant at the moment of death in group 1 was 851 g (IQR: 520 - 1833 g). Significant relationship was found between infant death among LBW newborn with mother WHO stage 2 (p = 0.004;adjusted RR = 3.22;CI 95% [2.25 - 6.00]), CD4 T cells count 3 (p = 0.005;RR = 2.81;CI 95% [1.20 - 4.11]), PI regimens (p = 0.030;RR = 1.00;CI 95% [1.28 - 3.80]). Conclusion: We confirm increased risk of low birth weight and mother HIV-1 infection and we identified strongest association between mortality in infant born to HIV-1 infected mother and LBW.

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。

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。

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。

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.

2021年河北省新生儿低体重发生率及影响因素

目的了解河北省2021年新生儿低出生体重的发生率,并分析其影响因素,为制定妇幼健康工作政策和规划提供可靠依据。方法回顾性分析2021年1月1日至12月31日河北省危重孕产妇监测的22所医院出院的妊娠满28周及以上分娩的所有单胎活产儿的孕产妇及新生儿数据,包括院内所有科室死亡的孕产妇,最后共纳入52504例,孕妇年龄14~46岁,分娩孕周28~43周。22家危重孕产妇监测医院分布在全省15个县(市、区),分析新生儿低出生体重发生率及其影响因素。结果本研究共纳入单胎活产儿52504例,低出生体重发生率为3.6%。多因素Logistic回归分析显示,分娩医院为三级医院、年龄<20岁、有合并症/并发症、胎盘早剥、妊娠期高血压疾病、早产是新生儿发生低出生体重的危险因素;母亲受教育程度为本科及以上、经产妇、糖尿病和贫血是新生儿发生低出生体重的保护因素。结论应识别高危人群,规范管理,开展针对性防治工作,切实减少新生儿低出生体重的发生风险。

2021年河南省低出生体重发生影响因素分析

目的:了解2021年河南省低出生体重发生情况,筛选其影响因素。方法:选择河南妇幼健康管理平台中出生日期为2021年1月1日至2021年12月31日的妊娠满28周的225984名活产新生儿及其母亲的信息。比较不同特征新生儿和不同特征母亲低出生体重发生率,采用Logistic回归分析筛选低出生体重的影响因素。结果:2021年河南省低出生体重发生率为4.40%。Logistic回归分析结果显示,母亲孕前BMI≥24.0 kg/m^(2)、受教育程度为初中及以上,新生儿出生季节为冬季是低出生体重发生的保护因素,OR(95%CI)分别为0.853(0.801~0.909)、0.604(0.517~0.705)和0.906(0.841~0.975)。新生儿为女婴、双胎及以上、早产,母亲孕前BMI<18.5 kg/m^(2)、剖宫产、年龄<25岁或≥35岁、初产、产前检查次数<5次、妊娠风险分级为橙色或红色是低出生体重发生的危险因素,OR(95%CI)分别为1.457(1.385~1.533)、6.233(5.757~6.748)、46.460(44.096~48.950),1.446(1.325~1.577)、1.462(1.380~1.548)、1.086(1.008~1.170)或1.178(1.080~1.286)、1.598(1.505~1.695)、1.230(1.168~1.296)、1.218(1.116~1.328)或2.461(1.846~3.281)。结论:低出生体重的发生与多种母亲因素有关;应加强对重点孕妇的健康宣教和指导,有针对性地开展低出生体重防治工作。

辅助生殖技术孕产妇早产、新生儿低体质量影响因素

目的:探讨辅助生殖技术(ART)孕产妇早产、新生儿低体质量影响因素。方法:选取2018年10月-2022年2月在本院分娩的ART孕产妇150例,统计早产、新生儿低体质量发生情况,收集不同结局孕产妇基线资料、卵巢刺激情况、移植情况,应用logistic多因素回归分析ART孕产妇早产、新生儿低体质量影响因素。结果:早产与非早产孕产妇体质指数(BMI)、妊娠胎数、妊娠期高血压、胎膜早破占比有差异,新生儿低体质量与非新生儿低体质量孕产妇BMI、妊娠胎数、胎膜早破占比有差异(均P<0.05);logistic多因素回归分析显示,ART孕产妇BMI、妊娠胎数、妊娠期高血压、胎膜早破为发生早产的影响因素,ART孕产妇BMI、妊娠胎数、胎膜早破为新生儿低体质量发生影响因素(P<0.05)。结论:ART孕产妇早产、新生儿低体质量发生受多种因素影响,临床应依据影响因素制定合理干预措施,减少新生儿不良结局发生。

口腔感觉运动刺激疗法协同非营养性吸吮对极低出生体质量早产儿吸吮吞咽功能障碍的影响

目的:探讨口腔感觉运动刺激疗法协同非营养性吸吮对极低出生体质量早产儿吸吮吞咽功能障碍的影响。方法:将90例极低出生体质量早产儿随机分成A组、B组、C组各30例。A组采用非营养性吸吮,B组采用口腔感觉运动刺激疗法,C组采用口腔感觉运动刺激疗法协同非营养性吸吮。观察并记录两组早产儿开始经口喂养时间、达到完全经口喂养时间、留置胃管时间、静脉营养时间、住院天数。结果:C组早产儿开始经口喂养时间、达到完全经口喂养时间、留置胃管时间、静脉营养时间及平均住院天数均短于A组(P<0.05),B组以上方面与A组比较有统计学意义(P<0.05),B组以上方面与C组比较无统计学意义(P>0.05)。结论:口腔感觉运动刺激疗法协同非营养性吸吮可以改善极低出生体质量早产儿吸吮吞咽功能障碍,使之尽快达到经口喂养,早期出院。

极低出生体重儿生长与PICC尖端位置改变的相关性研究

目的探讨极低出生体重儿PICC导管尖端位置改变和体质量、身长、上肢长以及胸围等增长的相关性,建立导管位置预测方法。方法纳入极低出生体重儿42例,置管当天以及置管后1个月测量体质量、身长、上肢长、上臂围以及胸围等数据,置管后1个月通过胸部X线摄片判断导管尖端位置,采用多元线性回归分析方法分析尖端位置的影响因素。结果 95.2%患儿PICC尖端发生移位;不同穿刺位置的尖端位置改变比较,差异无统计学意义(P>0.05);回归分析显示尖端位置改变情况与上肢长增长率显著相关(P<0.01),上肢长增长1%,尖端位置向远离心脏方向移动0.15个椎体。结论上肢长增长率是PICC尖端位置改变的影响因素,可以作为位置预测的良好指标。

经鼻双水平正压通气模式联合咖啡因治疗极低出生体重儿呼吸暂停的临床研究

目的探讨经鼻双水平正压通气(duo positive airway pressure,Duo PAP)联合咖啡因治疗极低出生体重儿反复呼吸暂停的治疗效果。方法 2014年1月至2015年12月,在佛山市高明区人民医院新生儿科住院的患儿中,纳入胎龄<32周、出生体重<1 500 g、生后24小时内入院的反复呼吸暂停患儿,排除先天性心脏病、遗传代谢性疾病等疾病,共90例纳入本研究。随机分为Duo PAP联合咖啡因组(46例)与经鼻持续气道正压通气(nasal continuous positive airway pressure,NCPAP)联合咖啡因组(44例)。两组患儿均给予保暖、营养支持治疗,以及枸橼酸咖啡因静脉输注。Duo PAP组使用瑞士菲萍新生儿及小儿呼吸机(型号CE0124),NCPAP组使用美国Stephan CPAP无创呼吸机。比较两组治疗显效、有效、无效的比例,以及脑室内出血(intraventricular hemorrhage,IVH)、支气管肺发育不良(bronchopulmonary dysplasia,BPD)、坏死性小肠结肠炎(necrotizing enterocolitis,NEC)等并发症的比例。结果 Duo PAP组与NCPAP组患儿的性别比例、胎龄、出生体重比较,差异均无统计学意义(P﹥0.05)。DuoPAP联合咖啡因组与NCPAP联合咖啡因组显效的比例分别为50.0%(23/46)与29.5%(13/44),有效的比例分别为41.3%(19/46)与20.5%(9/44),DuoPAP联合咖啡因组较高(P﹤0.05)。两组BPD[4.3%(2/46)与6.8%(3/44)]、NEC[4.3%(2/46)与4.5%(2/44)]及IVH[4.3%(2/46)与4.5%(2/44)]的比例比较,差异均无统计学意义(P﹥0.05)。结论经鼻Duo PAP联合咖啡因能有效缓解极低出生体重儿的反复呼吸暂停,且不增加并发症的发生风险。

早期持续微量喂养对低出生体重儿营养状况的影响

目的探讨早期持续微量喂养与常规及间断喂养对治疗低出生体重儿营养状况的影响。方法选取2013年1月至2014年5月间山东省菜芜市人民医院新生儿科收治的108例低出生体重儿,随机盲取法将其分为A、B、C三组,每组36例,A组采用常规营养方式,B组采用早期间断微量喂养,C组采用早期持续微量喂养,观察三组患儿喂养不耐受及体重、头围、身长生长速度、达完全喂养时间、恢复出生体重时间等。结果 A组喂养不耐受16(44.44%)例,B组4(11.11%)例,C组2(5.56%)例,3组间发生率差异有统计学意义(x^2=19.64,P<0.001);3组间呕吐、潴留物、腹胀及潴留量间对比,差异具有统计学意义(x^2值分别为12.96、10.69、11.61和19.64,均P<0.01)。3组出院时肠内能量供给量无统计学差异(P>0.05)。在胎便排尽时间、体重增长速度、头围增长速度、身长增加速度、达完全喂养时间及恢复出生体重时间方面,A、B、C组间比较,具有统计学差异(F值分别为40.05、14.25、5.30、17.74、8.00和27.91,均P<0.01)。结论早期持续微量喂养可完全满足低出生体重儿营养需求,降低喂养不耐受等并发症发生率,促进身高及体重恢复。

吸入麻醉药对低出生体质量新生儿血液动力学的影响

目的:分析安氟烷、异氟烷、七氟烷对低出生体质量新生儿的血液动力学的影响。方法:收集新生儿外科2000年1月—2007年5月收治的低出生体质量新生儿131例。分析所有病例的疾病构成、一般情况、麻醉方法以及手术期间心率(HR)、无创血压(BP)、脉搏血氧饱和度(SpO2)和呼气末二氧化碳分压(PETCO2)情况。结果:共105例入选本次回顾研究,根据吸入麻醉药不同分为3组:安氟烷组(Enf)、异氟烷组(Iso)和七氟烷组(Sev)。3组患儿日龄、体质量、手术时间、性别和ASA评分构成比差异均无统计学意义。Enf组心率(148±15)次.min-1明显快于Iso组心率(138±12)次.min-1和Sev组心率(137±14)次.min-1(P<0.01)。3组BP、SpO2、PETCO2值差异均无统计学意义。结论:低出生体质量新生儿吸入安氟烷或异氟烷或七氟烷维持麻醉时,控制呼气末麻醉气体浓度在1.0～1.5MAC(最低肺泡气有效浓度,参考成人吸入麻醉药的MAC值计算)较合适。

新生儿硬肿症并发肺出血41例临床分析

研究目的 探讨新生儿硬肿症并发肺出血的临床特点和防治。 研究方法 新生儿硬肿症并发肺出血患儿41例。用凝固法测定血浆凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)和纤维蛋白原(Fg)定量,用APTT方法测定血浆凝血因子Ⅷ(Ⅷ:c),用发色底物方法测定血浆抗凝血酶Ⅲ(ATⅢ:a)活性。 研究结果 硬肿症合并肺出血患者和无出血患者PT分别为27.2±7.4s和17.7±4.8s(P<0.01);APTT分别为65.8±27.8s和60.9v35.8s(P>0.05);Fg分别为165±43.9mg％和177.5±104.1mg％(P>0.05);FⅧ:c分别为28.9± 8.7％和 43.9± 11.4％(P<0.01);ATⅢ:a分别为24.3±7.9％和47.5±19.0％(P<0.01)。 结论 新生儿硬肿症并发肺出血发病者多为早产儿和低体重儿。新生儿硬肿症合并肺出血患者较无出血患者PT明显延长,而FⅧ:c和ATⅢ:a明显降低。

不同血药质量浓度氨茶碱对低出生体质量儿喂养不耐受的影响

目的探讨不同血药质量浓度氨茶碱对低出生体质量儿（LBWI）喂养不耐受的影响。方法对本院NICU住院的492例LBWI临床资料进行回顾分析。比较应用氨茶碱（105例,氨茶碱组）和未应用氨茶碱（387例,对照组）对LBWI喂养不耐受的影响。对因呼吸暂停综合征应用氨茶碱治疗的105例进行氨茶碱血药质量浓度测定,按血药质量浓度不同分3组：A组（28例）血药质量浓度〈10mg/L,B组（60例）10~20mg/L,C组（17例）〉20mg/L,对比A、B、C组喂养不耐受发生情况及胃肠功能好转的临床观察指标。结果氨茶碱组喂养不耐受发生率较对照组明显增高（P〈0.001）。A、B、C3组间患儿喂养不耐受发生率比较差异无统计学意义（P〉0.05）。至胃残余量≤10%天数、经胃肠摄取热卡达209.2kJ/（kg.d）日龄、经胃肠摄取热卡达418.4kJ/（kg.d）日龄、住院天数,A组与B组比较差异均无统计学意义（Pa〉0.05）,C组与A、B组分别比较差异均有统计学意义（Pa〈0.01）。结论应用氨茶碱可导致LBWI喂养不耐受发生率增高。较低水平的氨茶碱血药质量浓度在发挥治疗作用同时可影响LBWI喂养不耐受,随血药质量浓度增高喂养不耐受发生率变化不明显,但胃肠功能更难恢复。应用氨茶碱治疗时尽可能通过药物监测实现个体化给药。