Table of Content

10 February 2022, Volume 30 Issue 2

Previous Issue    Next Issue

Professional Forum

Perspective on nutrition support for high-risk infants

HU Yan

2022, 30(2):  117-119.  DOI: 10.11852/zgetbjzz2022-0099

Asbtract ( )   PDF (498KB) ( )  

References | Related Articles | Metrics

Nutritional support for high-risk infants is special and can be challenging.Regular monitoring with appropriate growth curves, body composition changes during catch-up growth, and individualized nutritional feeding support programs according to high-risk factors or disease characteristics are very important for nutritional support of high-risk infants and improving their prognosis.

Nutritional support and health management of high-risk infants

LIU Xi-hong

2022, 30(2):  120-123.  DOI: 10.11852/zgetbjzz2022-0058

Asbtract ( )   PDF (590KB) ( )  

References | Related Articles | Metrics

The incidence and survival rates of high-risk infants have been increasing. However, more and more high-risk infants have faced a series of growth and development problems after discharge, which require long-term, systematic, comprehensive and meticulous health management. The health management is recommended to start with nutritional support, combined with capacity promotion, disease management and prevention (including vaccination), implement a three-tier network management model to improve the follow-up rate and compliance, promote the all-round development of high-risk children, make it normal or as close to normal as possible, thereby reducing family anxiety, improving the quality of life and the long-term quality of the population and ultimately reducing the incidence of chronic diseases in adulthood.

Original Articles

Characteristics of intestinal flora in infants aged 0 to 36 months in Beijing

YU Xiao-ran^*, YAN Yin-kun^*, HUANG Yi-wen, CHENG Hong, YAN Qi, WAN Nai-jun, LI Li-hua, REN Xia, XIE Xiang-hui, MI Jie

2022, 30(2):  124-129.  DOI: 10.11852/zgetbjzz2021-1686

Asbtract ( )   PDF (1861KB) ( )  

References | Related Articles | Metrics

Objective To understand the changing characteristics of the intestinal flora of infants aged 0 to 36 months, and to explore the effect of exclusive breastfeeding on the colonization of intestinal flora from 0 to 36 months of age. Methods From January to April 2021, 291 healthy singleton infants and toddlers aged 0 to 36 months were enrolled in this study, and their fresh stools were collected in Haidian, Changping and Tongzhou districts of Beijing.The 77 infants aged 6 to 36 months were divided into the continuous breastfeeding group and the weaned group according to whether they were exclusive breastfeeding or not, then the effect of exclusive breastfeeding on the subsequent intestinal flora was analyzed.The 16S rRNA V4 region was sequenced using Illumina Novaseq 6000 sequencing platform. Results 1) The diversity and species composition of intestinal flora in infants changed with age, and Shannon index showed an increasing trend with age.At the phylum level, the intestinal flora was mainly composed of Proteobacteria, Firmicutes, Actinobacteria and Bacteroidetes.The abundance of Proteobacteria was the highest in newborns, but Firmicutes gradually replaced Proteobacteria as the dominant bacteria with the increase of age.2) If infants were exclusively breastfed before 6 months old, then the Shannon index and Observed-OTUs index after weaning of infants aged 6 to 36 months were higher than those continuously breastfed (Z=-2.400, P=0.015).Among weaned infants aged 6 to 36 months, the Shannon index of intestinal flora was higher in infants exclusively breastfed before 6 months old than that in infants mixed-fed before 6 months old (Z=-2.500, P=0.011). Conclusion The diversity and composition of the intestinal flora of infants vary significantly with age, and whether exclusive breastfeeding at 0 to 6 months old affects the diversity of intestinal flora in infants.

Prevalence and influencing factors of overweight and obesity among infants in four districts of Beijing

HUANG Yi-wen^*, YAN Yin-kun^*, YU Xiao-ran, CHENG Hong, YAN Qi, WAN Nai-jun, LI Li-hua, REN Xia, XIE Xiang-hui, MI Jie

2022, 30(2):  130-134.  DOI: 10.11852/zgetbjzz2021-1684

Asbtract ( )   PDF (570KB) ( )  

References | Related Articles | Metrics

Objective To describe the current prevalence of overweight and obesity among infants in Beijing, and to explore the influencing factors of overweight and obesity based on body composition analysis. Methods A multicenter cross-sectional survey was conducted in Haidian district, Changping district, Shijingshan district and Tongzhou district of Beijing from January to April 2021.Single fetus infants aged 0 to 2 years and without obvious malformations and genetic metabolic diseases were selected, and completed questionnaire survey (infant general demographic characteristics, maternal pregnancy and delivery, infant birth, etc.) and physical examination (infant length, weight and body composition measurement).Finally 896 infants with complete data of questionnaire survey and physical examination were enrolled in this study. Results The prevalence of overweight/obesity diagnosed by weight for height Z score (WHZ) in four districts of Beijing was 9.65% in boys and 4.42% in girls, whereas the prevalence of overweight/obesity diagnosed by body composition analysis was as high as 21.46% and 7.67% in boys and girls, respectively.Fat mass index (FMI) was significantly higher in infants whose mothers were overweight and obese before pregnancy (boys: β=0.222, 95%CI: 0.021 - 0.423; girls: β=0.237, 95% CI: 0.048-0.426) and infants who had larger for gestational age (boys:β=0.212, 95% CI: 0.014 - 0.411) and larger birth length (boys: β=0.037, 95%CI: 0.012 - 0.063; girls: β=0.027, 95% CI: 0.001 - 0.054,P<0.05). Conclusions The prevalence of overweight and obesity in infants in the four districts of Beijing is not optimistic, and the measurements of body composition can reduce the rates of missed diagnosis and inaccurate diagnosis of infant obesity.Therefore, effective intervention measurement should be taken to prevent and control overweight and obesity in the early stage of life.

Early development status of 4 656 preschool children and its correlation with learning support in Tongzhou district, Beijing

HOU Shan-shan^*, LI Xue-ying, MI Xiao-yi, GAO Ya-qing, ZOU Si-yu, MENG Zhao-xue, ZHOU Hong

2022, 30(2):  135-139.  DOI: 10.11852/zgetbjzz2021-0672

Asbtract ( )   PDF (556KB) ( )  

References | Related Articles | Metrics

Objective To evaluate the early development status of preschool children in Tongzhou district, Beijing, and to understand factors that affect the early development of preschool children and its relationship with family/father/mother learning support, so as to provide evidence for promoting the early comprehensive development of preschool children. Methods 4 656 children enrolled in kindergartens in Tongzhou district from December 1st to December 31st, 2020 were selected as the study objects.The questionnaires in this study included general characteristics of parents and children, whether father/mother/other caregiver accompanied the child in the seven learning support activities over the past 3 days and early childhood development situation.Logistic regression was used to analyze the factors affecting the early childhood development index and its influencing factors, focusing on the correlation with family/father/mother learning support. Results The early development index of preschool children was 98.5%, and the social and emotional compliance rate in the four modules was the lowest (86.6%, 4 032/4 056).Full-term birth increased the likelihood of reaching the standard for early childhood development.Obtaining learning support from family (OR=4.856, 95%CI:2.601 - 9.066), father (OR=2.183,95%CI:1.299 - 3.669) and mother (OR=4.150, 95%CI:2.517 - 6.844) promoted preschool children′s early development. Conclusions The early development index of preschool children in Tongzhou district, Beijing is relatively high, but the social and emotional compliance rate is still lower.So in order to promote the development of preschool children, it is necessary to carry out personalized health education for the parents of preschool children and their caregivers, and to raise family awareness of early childhood development, especially considering the role of parents.

Longitudinal study on neuropsychological and behavioral development of test-tube full-term infants with assisted reproduction technology

HU Dan, WANG Xiao-xia, CUI Yi-fan, LIU Pu, LIANG Qian, XIAO Xu-wu

2022, 30(2):  140-143.  DOI: 10.11852/zgetbjzz2021-0300

Asbtract ( )   PDF (470KB) ( )  

References | Related Articles | Metrics

Objective To compare the physical development and neuropsychological development level of test-tube full-term infants by assisted reproductive technology (ART) with that of naturally conceived (NC) healthy infants, so as to provide a scientific basis for the early comprehensive development of test-tube infants. Methods Totally 60 ART term infants and 60 NC term infants were enrolled and their relevant information was collected in this study from January 1st, 2019 to December 31st, 2020.Infants′ health check-up data were followed up at 6 and 12 months old.The Children′s Neuropsychological Behavioral Development Assessment (2016 version) was used to assess the neuropsychological behavioral development of infants. Results There were significant differences on parental age, the incidence of pregnancy complications and cesarean section and multiple fetus rate between ART infants and NC term infants(t=11.141, 15.392, χ²=23.008, 28.104,36.936,P<0.001), but the differences in the length and weight at birth and incidence of birth complications between the two groupswere not significant (P>0.05).ART term infants and NC term infants had the consistent trends on physical development levels at 6 months old and 12 months old (P>0.05).At 6 months old, the scores of fine motor development, language development and total development quotient of ART infants were significantly lower than those of NC infants (t=6.455,4.583,6.895,P＜0.05), but the neuropsychological and behavioral development levels of the two groups were similar at 12 months old (P>0.05). Conclusions Although assisted reproduction full-term test-tube infants face adverse high-risk factors during the fetal period, the physical development at birth and infancy reaches the level of naturally conceived infants.The early development of fine motor and language skills of ART infants is lower than that of naturally conceived infants, but they can catch up with the level of naturally conceived babies at the age of 12 months old, indicating the importance of promoting the early comprehensive development of ART infants.

Effects of parent-child music intervention on intellectual development and parent-child relationship of premature infants discharged from neonatal intensive care unit

LI Yang, YANG Mei-rong

2022, 30(2):  144-147.  DOI: 10.11852/zgetbjzz2021-0478

Asbtract ( )   PDF (488KB) ( )  

References | Related Articles | Metrics

Objective To analyze the effects of parent-child music intervention on intellectual development, maternal postpartum depression and parent-child relationship of premature infants discharged from neonatal intensive care unit (NICU), so as to provide clinical practice experience and evidence for promoting the intellectual development of premature infants and improving the mental health of their mothers. Methods A total of 61 premature infants at 40 - 44 weeks postmenstrual age (PMA), who were followed up in the Child Rehabilitation Department of Tangshan Maternal and Child Health Hospital from May to December 2020, were enrolled in this study and were divided into parent-child music intervention group(n=30) and control group(n=31).The control group received conventional family guidance, while the premature infants in the parent-child music intervention group were given parent-child music intervention additionally.The intervention lasted for 3 months with the frequency of 15 - 20 min/d.Premature infants were assessed with Gesell Development Scale (GDS) and their mothers were assessed with the Edinburgh Postpartum Depression Scale (EPDS) and the Mother′ Object Relationship Scale [MORS (child)] before and after intervention. Results After intervention, the development quotient of adaptability, gross motor function and language area were significantly higher in parent-child music intervention group than those in control group(t=3.139,3.113,3.612,P<0.05).After intervention, the scores of EPDS assessment in both groups were lower than those before intervention (t=12.286, 16.102, P<0.05), and the change was more significant in parent-child music intervention group (t=2.545, P<0.05).The scores of MORS(Child) in both groups after treatment were higher than those before intervention (t=13.871,9.046,P<0.05), and the score of parent-child music intervention group was significantly higher that those in the control group (t=3.292,P<0.05). Conclusion Parent-child music intervention can promote the intellectual development of premature infants discharged from NICU, and is beneficial to the improvement of maternal postpartum depression and parent-child relationship.

Differences of the Test of Infant Motor Performance between Chinese and American norms

QU Fu-xiang^*, HU Bin, WANG Cheng-ju, HUANG Tian-qi, WU Jie-ling, WANG Yu-mei, SUN Ke-xing, TIAN Yuan, ZENG Yu-dong, ZHANG Xue-jiao, GAO Yue, MENG Fan-ping, MU Li-juan, LU Ai-jie, LI Hai-wei, WU Ning, ZHANG Yu-ping

2022, 30(2):  148-152.  DOI: 10.11852/zgetbjzz2020-1909

Asbtract ( )   PDF (574KB) ( )  

References | Related Articles | Metrics

Objective To compare Chinese and American norms for the Test of Infant Motor Performance (TIMP), to understand the difference and clarify the importance of localization studies and revision, so as to provide evidence for guiding the promotion of TIMP in China. Methods After the manual of TIMP having been finished by using forward and backward translation and appraisers having been trained, Chinese norms for TIMP were established by sampling in 11 medical institutions in East China, North China, South China, Central China, Southwest, Northwest and Northeast China. Then the Chinese norms were compared with American norms through the sample, score, and subgroup classification. Results There were 13 week-age groups in Chinese norms for TIMP, and the total number of samples is 1 035, including 56% males and 44% females, 95% Han nationality and 5% ethnic minorities, of which 31% were premature infants and 69% were full-term infants. There were 12 week-age groups in American norms for TIMP with a total of 990 samples, including 52% males and 48% females, 58% whites and 25% blacks, of which high risk, medium risk, and low-risk infants accounted for 35%, 30% and 35%, respectively. The average score of each age group of Chinese norms for TIMP was lower than that of the same age group of American norms(P<0.001), and the 10th, 50th and 90th percentile curves of Chinese norms were lower than those of American norms. There were no significant differences in the scores of most week-age groups between full-term and premature subgroups in Chinese norms, but the score of the high-risk infants subgroup of American norms was significantly lower than those of the low-risk subgroup(P<0.001). Conclusions Based on the differences in the demographic characteristics and the development of child health in two countries, the sample population between Chinese and American norms for TIMP is different. The average scores in all week-age groups of Chinese norms are lower than those of the same week-age group of American norms, so American norms could not be directly used as the reference standard in Chinese clinical work.

Application research of joint attention and peer-mediated intervention in autism spectrum disorders

LI Hai-bei, GAO Chao, SHANG Qing

2022, 30(2):  153-156.  DOI: 10.11852/zgetbjzz2021-0242

Asbtract ( )   PDF (500KB) ( )  

References | Related Articles | Metrics

Objective To compare and analyze the effect of joint attention(JA)and peer-mediated intervention(PMI)on the treatment of children with autism spectrum disorders(ASD),in order to provide evidence for optimizing intervention programs. Methods Totally 60 ASD children who have typically developed siblings in Henan Children′s Hospital from January 2019 to June 2020 were recruited in this study,and were divided into JA group(n=30)and PMI group(n=30)according to their performance intellectual quotient.Childhood Autism Rating Scale(CARS),Early Social-Communication Scale(ESCS)and Infant-Junior Middle School Social Adaptive Capacity Scale(SM) were used to evaluate children′s performance before intervention,after intervention and 4 weeks in intervention.The differences in scores before and after intervention were compared. Results The differential value of the score in indication follow,fixation follow and eye change before and after intervention between JA group and PMI group were significantly different(t=2.25,2.12,2.33,P＜0.05),which was not significant in terms of finger indication and active display(P>0.05).In terms of the differential value of CARS score before and after treatment,there was no significant difference between the JA group and PMI group(P>0.05).In 4 weeks after intervention,there were no significant differences in indication follow,fixation follow and eye change before and after intervention between JA group and PMI group(P>0.05).At the end of intervention and 4 weeks after the intervention,the score difference of SM scale in PMI group was higher than that in JA group,and the difference was significant(t=2.56,2.29,P<0.05). Conclusions Both JA and PMI have positive effects on children with ASD.Compared with PMI,JA has a good immediate effect on the improvement of response joint attention ability,but the maintenance effect of the two methods is similar.However,PMI is superior than JA in improving social adaptation ability.

Recent trends and risk factors of low birth weight in Liuzhou from 2012 to 2018

HU Min^*, ZHANG Yu, ZENG Ting, LIU Liu, NONG Zheng, LIU Cheng-juan, QIN Hai-yan, ZENG Ding-yuan

2022, 30(2):  157-162.  DOI: 10.11852/zgetbjzz2021-0565

Asbtract ( )   PDF (559KB) ( )  

References | Related Articles | Metrics

Objective To describe and analyze the trends and risk factors of the incidence rate of low birth weight (LBW) infants, so as to provide evidence for reducing the incidence of LBW. Methods Birth data of 394 225 births born in Liuzhou between 2012 and 2018 were retrospectively analyzed. The χ² test for trend was used to test the difference of LBW among years. Logistic regression model was adopted to identify significant risk factors associated with LBW. Results The incidence rate of LBW in Liuzhou from 2012 to 2018 was decreasing, with the highest and lowest incidence rates of 6.04% and 6.66% in the year 2014 and 2018, respectively. The risk of LBW among mothers aged 40 to 55 years was 84% higher than that of the mothers aged 25 to 29 years.The risk of LBW among Zhuang mothers was 4% higher than that of Han mothers.The risk of LBW among mothers with education level of elementary school and below was 62% higher than that of mothers with bachelor degree or higher. The risk of LBW among non-resident mothers was 99% higher than that of resident mothers, and the risk of LBW among primiparous mothers was 56%higher than that of multiparous mothers. During the period 2012 - 2018, 12.31% of the singleton births at 28 - 42 weeks were SGA infants, including preterm SGA and term SGA. While all the preterm SGA infants were LBW, 47.95% of preterm AGA and 16.97% of term SGA infants were LBW. Conclusions The incidence of LBW in Liuzhou shows a decreasing trend from 2012 to 2018, but is higher than the national average level. The occurrence of LBW is influenced by multiple factors, and preventive and intervention measures should be taken to reduce the incidence of LBW by targeting relevant risk factors.

Review

Research advances on family nurture intervention in early intervention for infants in neonatal intensive care unit

MA Dan^*, CHEN Jun-lin, ZHANG Ling

2022, 30(2):  163-166.  DOI: 10.11852/zgetbjzz2020-2024

Asbtract ( )   PDF (564KB) ( )  

References | Related Articles | Metrics

This review summarizes the application of family nurture intervention (FNI) in early intervention of premature infants in neonatal intensive care unit(NICU) in order to promote neurodevelopment and relieve their mother′s stress, anxiety, depression and other bad emotions, thus providing reference for FNI treatment and related researches in NICU.

Research advances in the role of Toll-like receptor 4 in neonatal necrotizing enteroeolitis

CHEN Guo-ping, ZHAO Ying-xin

2022, 30(2):  167-171.  DOI: 10.11852/zgetbjzz2020-2148

Asbtract ( )   PDF (530KB) ( )  

References | Related Articles | Metrics

Neonatal necrotizing enterocolitis (NEC) is an inflammatory and necrotizing disease of the intestine in neonates, especially in premature infants. It is characterized by high incidence rate, complex pathogenesis, high mortality and serious sequelae. The incidence of NEC is related to preterm birth, intestinal microbial colonization, enteral feeding and genetics. In recent years, research on molecular-level mechanisms has become a hot topic, and Toll-like receptor 4 (TLR4) is found to play a key role in the pathogenesis of NEC. This article reviews the latest studies on the role of TLR4 in NEC, aiming to increase the understanding of NEC and to provide reference for the development of prevention and treatment strategies.

Progress on the application of Goal Attainment Scales in rehabilitation of cerebral palsy

ZHONG De-xiang^*, ZHAI Chun, CHEN Jian-ping

2022, 30(2):  172-175.  DOI: 10.11852/zgetbjzz2021-0017

Asbtract ( )   PDF (486KB) ( )  

References | Related Articles | Metrics

The Goal Attainment Scale (GAS) is a scoring method for recording the level of achievement of individual goals during rehabilitation interventions, with emphasis on individual differences, high sensitivity and multiple participants in goal setting. The therapist can closely combine the functional assessment results with family needs to develop a personalized Goal Attainment Scale for patients with cerebral palsy, so it can be widely used in the rehabilitation of children with cerebral palsy.

Research progress in biomarkers in the risk of bronchopulmonary dysplasia

CHEN Xiang-fei, QU Shu-qiang

2022, 30(2):  176-180.  DOI: 10.11852/zgetbjzz2021-0030

Asbtract ( )   PDF (556KB) ( )  

References | Related Articles | Metrics

Bronchopulmonary dysplasia (BPD) is mainly found in very low or extra-low birth weight infants, or newborns who take a long time on ventilator and have difficulty in removing ventilator. BPD is one of the causes of neonatal mortality, which seriously affects the health status of children and also causes a heavy economic burden to families and society. At present, there are no specific drugs and effective interventions at home and abroad, so prevention and assessment of the occurrence of this disease are crucial. The occurrence and risk assessment of BPD by molecular biomarkers is currently a hot topic of researches at home and abroad, which plays an important guiding role and has practical significance. This paper reviews the risk and assessment of molecular biomarkers for the development of BPD, in order to provide new ideas on how to predict and assess the occurrence of BPD.

Research advance in the early developmental motor interventions of preterm infants

MU Yu-hong^*, LI Jing, HU You-fang

2022, 30(2):  181-183.  DOI: 10.11852/zgetbjzz2021-0271

Asbtract ( )   PDF (436KB) ( )  

References | Related Articles | Metrics

The rapid development of medical technology largely increases the survival rate of preterm infants. However, preterm infants are at risk of adverse neurobehavioral outcomes, including cerebral palsy, motor and cognitive impairments, causing heavy burdens to families and society. The early period of life, when brain is growing fast and easily shaped, is a good time to commence early developmental motor interventions. This review discusses the early developmental motor interventions of preterm infants, in order to provide reference for clinical medical staff to carry out appropriate and effective motor interventions.

Meta Analysis

Meta-analysis of the risk factors for intracranial hemorrhage in very low and extremely low birth weight infants

LI Shang-bin, HAO Ling, LI Jiao, MENG Jin-feng, HUANG Jia-yu, YAN Wei-chen, WANG Jie, REN Chang-jun

2022, 30(2):  184-188.  DOI: 10.11852/zgetbjzz2020-2101

Asbtract ( )   PDF (591KB) ( )  

References | Related Articles | Metrics

Objective To systematically analyze of the risk factors of intracranial hemorrhage in very low birth weight infants(VLBWI) and extremely low birth weight infants(ELBWI), in order to provide reference for early prevention and clinical decision-making. Methods Literatures were searched in China National Knowledge Network, China Biomedical Literature Database (CBM), Wanfang Database, VIP Database, Cochrane Library, PubMed, Web of Science, EMBASE from the establishment of the database to to September 18, 2020. Literatures were retrieved and selected according to the inclusion and exclusion criteria. Finally RevMan 5.3 was used to conduct Meta-analysis. Results Totally 13 literatures met the inclusion criteria. The cumulative number of cases was 790, and the number of controls was 1 871. Meta-analysis showed that the risk factors for intracranial hemorrhage in VLBWI and ELBWI included intrauterine distress or asphyxia(OR=2.52,95%CI: 1.98 - 3.21), application of mechanical ventilation (OR=3.35,95%CI:2.56 - 4.38), mechanical ventilation time ＞3 days (OR=10.29,95%CI:3.69 - 28.66), coagulation mechanism disorder(OR=3.42,95%CI:1.80 - 6.48),neonatal necrotizing enterocolitis (OR=3.79, 95%CI:1.92 - 7.50) and gestational age ＜29 weeks (OR=2.45, 95%CI:1.65 - 3.64), and the protective factor is antenatal use of glucocorticoids (OR=0.35, 95%CI:0.22 - 0.56). It was found that vaginal delivery had no significant influence on ICH of VLBWI and ELBWI. Conclusions Intrauterine distress or asphyxia, application of mechanical ventilation, mechanical ventilation time ＞3 days, coagulation mechanism disorder, neonatal necrotizing enterocolitis and gestational age ＜29 weeks are closely related to intracranial hemorrhage in VLBWI and ELBWI. Prenatal glucocorticoids can reduce the incidence of intracranial hemorrhage in VLBWI and ELBWI.

Clinical Research

Analysis of factors affecting ultrasound bone mineral density in premature infants with gestational age less than 34 weeks

DENG Sha-sha, YE Kan, LU Xiao-ting, YAN Bo-qiu, KONG Rui

2022, 30(2):  189-193.  DOI: 10.11852/zgetbjzz2021-0244

Asbtract ( )   PDF (551KB) ( )  

References | Related Articles | Metrics

Objective To explore the factors affecting ultrasound bone mineral density (BMD) in premature infants, so as to provide reference for early prevention of metabolic bone disease. Methods Totally 224 premature infants with gestational age＜34 weeks were recruited in this study from May 2017 to December 2018 in Suzhou Municipal Hospital.Tibial BMD was measured at the corrected age of 3 months old.Data related to the early skeletal development of premature infants were collected by in-patient management information system and health records in child healthcare department. Results The Z scores of tibial BMD in 224 premature infants at the corrected age of 3 months were-1.4(-0.6,-2.0).Among them, tibial BMD Z scores of 79(35.27%) cases were normal, 43(19.20%) cases were mild BMD deficiency, 38(16.96%) cases were modest BMD deficiency, and 64 (28.57%) cases were severe BMD deficiency.Female gender(OR=4.184, 95%CI:1.876-9.329, P＜0.001), gestational age ≤ 31 weeks (OR=2.854, 95%CI:1.282-6.352, P=0.010), duration of intravenous nutrition ≥7 days (OR=3.180, 95%CI:1.480-6.832, P=0.003), duration of caffeine therapy ≥10 days (OR=5.673, 95%CI:1.820-17.686, P=0.003), the peaks of alkaline phosphatase (ALP)≥400 U/L during hospitalization (OR=2.796, 95%CI:1.065-7.341, P=0.037) were risk factors for BMD deficiency.However, the Z scores of tibial BMD was significantly higher in premature infants with maternal gestational diabetes (OR=0.312, 95%CI:0.139-0.698, P=0.005) or gestational hypertension (OR=0.191, 95%CI: 0.065-0.560, P=0.003).Compared with exclusively breastfeeding after discharge, common formula-feeding (OR=0.145, 95%CI:0.058-0.363, P＜0.001), nutrient-enriched formula-feeding (OR=0.168, 95%CI:0.062-0.455, P＜0.001) and human milk fortifier-feeding (OR=0.219, 95%CI:0.063-0.765,P=0.219) may reduce the risk of BMD deficiency.There were no significant difference in Z score among infants who had calcium supplementation and higher-dose vitamin D₃ (800 U/d) supplementation or not. Conclusions In the early health management, more attention should be paid to the infant with high risk indicators associated with BMD deficiency, such as gestational age ≤31 weeks, duration of intravenous nutrition≥7 days, duration of caffeine therapy ≥10 days, ALP ≥ 400 U/L during hospitalization.In addition, exclusively breastfed prematures are suggested to take adequate calcium and phosphorus supplementation, thus preventing bone disease in preterm infants.

Case-control study on the risk factors of autistic children during early life in Hefei

SHAO Na, ZHAO Mei, WEI Xiao-die, RONG Fan, SANG Ni, ZHANG Hu-ke-an

2022, 30(2):  194-198.  DOI: 10.11852/zgetbjzz2020-1824

Asbtract ( )   PDF (641KB) ( )  

References | Related Articles | Metrics

Objective To explore the risk factors of childhood autism in early life,in order to provide reference for early prevention of autism. Methods A total of 100 children newly diagnosed with autism in a tertiary hospital in Hefei from June to September,2019,were enrolled in the case group.And 198 typical developed children were selected as the control group,matched by gender and age in 1∶2 case control study.Basic information of the family,mother′s situation during pregnancy and delivery period,and the children′s situation within 2 years after birth were investigated. Results Logistic regression analysis showed that marriage between blood relatives within three generations(OR=13.154,95%CI:2.225-77.785),epilepsy,mental retardation,dyskinesia or mental illness within three generations(OR=8.245,95%CI:2.165-31.394),maternal introversion personality(OR=3.263,95%CI:1.345-7.919),taking broad-spectrum antibiotics during pregnancy(OR=4.967,95%CI:1.344-18.362),premature(OR=3.698,95%CI:1.543-8.858)were risk factors for autism.Neonatal performance(compared with abnormal quiet,crying OR=0.275,95% CI:0.097-0.782),outdoor activity for at least 1 hour/day within 2 years old(1-2 hours/day OR=0.203,95%CI:0.050-0.828,＞2 hours/day OR=0.189,95%CI:0.048-0.747)were the protective factors of autism. Conclusions The occurrence of autism is affected by genetic factors,mother′s personality type,antibiotic use during pregnancy,premature delivery,neonatal performance and outdoor activity time within 2 years old.It is suggested to strengthen the early prevention and treatment of autism from the perspectives of these aspects.

Study on risk factors of hypothermia at admission in very low birth weight infants and/or premature infants with gestational age less than 32 weeks

GAO Rui, LI Cong, GAO Ling-ling, HAN Mei-ying, XU Ping

2022, 30(2):  199-202.  DOI: 10.11852/zgetbjzz2021-0377

Asbtract ( )   PDF (474KB) ( )  

References | Related Articles | Metrics

Objective To describe the distribution of temperature at admission in very low birth weight infants (VLBWIs) and/or premature infants with a gestational age≤32 weeks, and to analyze the risk factors of hypothermia, in order to provide clinical evidence for reducing the incidence of admission hypothermia. Methods From 1st January, 2019 to 31st December, 2020, 248 VLBWIs (birth weight＜1 500 g) and/or premature infants with gestational age≤32 weeks admitted to Neonatal Intensive Care Unit(NICU) of Liaocheng People′s Hospital were enrolled in this study.Then the participants were divided into normothermia group(36.5℃-37.5℃,n=122),mild hypothermia group(36.0℃-36.4℃, n=98) and moderate hypothermia group(32.0℃-35.9℃, n=27).The admission temperature, general and perinatal conditions of the three groups were recorded and compared. Results The admission temperature ranged from 34.8℃ to 38.0℃ in 248 VLBWIs (birth weight＜1 500 g) and/or premature infants with gestational age≤32 weeks, and the average temperature is (36.37±0.44)℃.Univariate analysis showed that compared with the normothermia group, the gestational age and the proportion of cesarean section were lower in moderate hypothermia group (H=12.316, χ²=7.739,P<0.05), and the proportion of endotracheal intubation at birth was higher moderate hypothermia group (χ²=22.907, P<0.05).Compared with the normothermia group, the birth weight of infants in mild and moderate hypothermia group was lower (H=26.060,P<0.05), while the proportion of 5 min Apgar score ≤7 and resuscitation were higher (χ²=27.594,23.879, P<0.05).Multivariate Logistic regression analysis showed that higher birth weight was associated with lower risk of hypothermia (OR=0.997, 95%CI: 0.996-0.999), while multiple births and resuscitation were independently risk factors of hypothermia (OR=2.279, 95%CI:1.106-4.694; OR=3.265, 95%CI:1.209-8.819, P＜0.05). Conclusions The occurrence of hypothermia in VLBWIs and/or premature infants with gestational age≤32 weeks is associated with a number of factors, including birth weight, multiple births and resuscitation by asphyxia as independent risk factors for hypothermia, and the incidence of admission hypothermia can be reduced through continuous quality improvement programs.

Correlation analysis of the motor development assessment between Peabody Motor Development Scale-2 and Gesell Development Scale

CHEN Jun-lin, ZHOU Wen-zhi, YANG Xia

2022, 30(2):  203-206.  DOI: 10.11852/zgetbjzz2020-1785

Asbtract ( )   PDF (718KB) ( )  

References | Related Articles | Metrics

Objective To analyze the correlation of the motor development assessment between Peabody Motor Development Scale-2(PDMS-2) and Gesell Development Scale(GDS) in children with different birth conditions and different gestational ages. Methods A total of 900 infants, who were 3 to 12 months old and in the rehabilitation department of Chengdu Women′s and Children′s Central Hospital, were enrolled in this study and were assessed by PDMS-2 and GDS. The assessment results between PDMS-2 and GDS were described and their correlation was analyzed. Results The gross and fine motor assessment results between PDMS-2 and GDS were positively correlated among extremely low birth weight infants, low birth weight infants and full-term infants(r=0.386-0.530,P＜0.001).With the increasing of age, the correlation became stronger, and it was highest at the age of 12 months old(ELBWI: r=0.641, 0.601; LBWI: r=0.678, 0.647; full-term infants: r=0.896, 0.749).The correlation between PDMS-2 and GDS in terms of gross motor assessment and fine motor assessment of full-term infants(r=0.530, 0.483) were higher than those in LBWI(r=0.496, 0.459) and ELBWI(r=0.449, 0.386). Conclusions Children′s motor function should be assessed according to their birth condition and age, as well as the sensitivity of the assessment scale, so that the assessment results will be more scientific and accurate.

Blood lead level and its correlation with social functions in school-age children with attention deficit/hyperactivity disorder

DONG Shuang^*, JI Yi-ting^*, WANG Dan, MAO Guang-hui, YAN Chong-huai, CAI Shi-zhong, CHEN Yan

2022, 30(2):  207-211.  DOI: 10.11852/zgetbjzz2020-2006

Asbtract ( )   PDF (591KB) ( )  

References | Related Articles | Metrics

Objective To investigate the environmental lead exposure of school-age children with attention/deficit hyperactivity disorder(ADHD),and to further analyze the correlation between the lead exposure levels of ADHD children in different years and subtypes,as well as the social functions under different blood lead levels. Methods A total of 4 590 ADHD children were recruited as ADHD group from January 2016 to December 2019 in the Department of Child Health Care in Children′s Hospital of Soochow University. Meanwhile,2 264 children with inattention and/or impulsive hyperactivity symptoms but not meeting the diagnostic criteria were selected as non-ADHD group. Fasting venous blood was collected from all children in the morning,and the blood lead level was determined by atomic absorption spectrometry. All children′s social functions were evaluated by Weiss Functional Impairment Rating Scale-Parent Report(WFIRS-P). Results From 2016 to 2019,the overall blood lead level of ADHD children showed a downward trend year by year. The blood lead level of children in ADHD group was higher than that of children in non-ADHD group(t=2.659,P=0.008). The proportion of blood lead level ≥50 μg/L in children with combined ADHD was the highest. The blood lead level of children with combined ADHD was higher than that of predominantly inattentive ADHD group and predominantly hyperactive/impulsive ADHD group(H=14.629,P=0.001). There was no significant correlation between blood lead level and six dimensions of social functions in ADHD children, but the score of social activities was significanty higher in non-ADHD children with blood lead level<50 μg/L(t=2.016,P<0.05). Conclusions In recent years,the level of lead exposure in children shows a downward trend. For children with inattention and/or impulsive hyperactivity as the main symptoms,attention still should be paid to low level of lead exposure.

Clinical study on Subjective Global Nutritional Assessment method for children with cerebral palsy

CHEN Jing, TONG Guang-lei, SHI Lei, YE Fu-ling, FENG Chao, XU Xue-cui, LI Hong

2022, 30(2):  212-215.  DOI: 10.11852/zgetbjzz2021-1129

Asbtract ( )   PDF (489KB) ( )  

References | Related Articles | Metrics

Objective To study the consistency between the results of Subjective Global Nutritional Assessment (SGNA) and Z-score method for children when assessing the malnutrition of children with cerebral palsy (CP), so as to provide helpful reference for more general clinical applications of SGNA. Methods Totally 76 children with CP treated in the Department of Pediatric Rehabilitation of Anhui Children′s Hospital from January to July 2021 were enrolled in this study, and were assessed with SGNA and Z-score method simultaneously to evaluate their nutritional status. Weighted-Kappa coefficient was used to analyze their consistency on evaluating different nutritional levels for children with CP. There were two kinds of nutritional level division for the Z-score method. The traditional Z-score nutritional levels included three levels:well nourished (Z>—2), moderately malnourished (-3＜Z ≤-2) and severely malnourished(Z≤-3). Nutritional levels presented by consensus statement of the Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition (ASPEN) included four levels, among which slightly malnourished (-2＜Z ≤-1) was added, and this new level was merged with moderately malnourished as one level to compare with the three SGNA nutritional levels in this study. Results According to traditional Z-score levels (Z >-2 as well nourished), the weighted-Kappa coefficient of the two methods was 0.491 (95%CI: 0.336 - 0.645), and the consistency was moderate. According to ASPEN nutritional levels (Z >-1 as well nourished), the weighted-Kappa coefficient of the two methods was 0.709 (95%CI: 0.569 - 0.850), and the consistency was relatively strong. Conclusions For CP children′s nutritional status evaluation, the consistency between SGNA nutritional levels and Z-score levels is obviously affected by different divisions of Z-score levels. Compared with the traditional Z-score nutritional levels, higher consistency is observed between ASPEN Z-score nutritional levels and SGNA nutritional levels.

Experience Exchange

Association between vitamin D level at birth and clinical outcomes in very low birth weight infants

YOU Fang^*, KONG Qing-ping, QIANG Guang-feng, ZHAO Jing, REN Xue-yun

2022, 30(2):  216-220.  DOI: 10.11852/zgetbjzz2020-2068

Asbtract ( )   PDF (530KB) ( )  

References | Related Articles | Metrics

Objective To analyze the influence of serum 25-(OH) D level on the clinical outcomes of very low birth weight infants, in order to provide new orientation for the prevention and treatment of related disease in preterm infants. Methods From September 2019 and September 2020, a total of 105 very low birth weight infants hospitalized in Neonatal Intensive Care Unit (NICU) of Affiliated Hospital of Jining Medical College were selected as study subjects. According to the level of serum 25-(OH)D within 24 hours after birth, infants were divided into severe vitamin D deficiency group (group A), vitamin D deficiency group (group B) and control group. General characteristics, length of hospital stay, complications and clinical outcomes of infants in the three groups were compared. Results A total of 105 infants with very low birth weight were included.The mean serum 25-(OH)D was (14.33±3.60)ng/ml at birth.The incidence of vitamin D deficiency was 79.1%.The serum 25-(OH)D level of infants born in summer and autumn was significantly higher than that in winter and spring (t=2.71,P=0.01).The birth weight of the infants for group A and group B was lower than those of the control group(F=0.86,P<0.01;Z score: F=5.43,P=0.01).1- minute Apgar score of the infants for group A and group B were lower than those of the control group(F=9.05,P<0.01).The older the mother was, the higher the incidence of vitamin D deficiency was, and the difference between the three groups was statistically significant (F=8.40,P<0.01).The length of hospital stay, duration of oxygen use, duration of ventilation in infants with vitamin D deficiency were significantly higher than those in the control group, with statistically significant differences among the three groups (F=19.65,7.45,15.97,4.87,P<0.05).The incidence of RDS、BPD and ROP in infants with vitamin D deficiency was higher than control group, the difference between the three groups was statistically significant (χ²=17.37,P<0.05).Logistic regression analysis showed that vitamin D deficiency at birth was a risk factor for RDS(OR=6.604,95%CI:1.828 - 23.862,P=0.004)、BPD(OR=8.199,95%CI:1.428 - 47.067,P=0.018). Conclusions Serum 25-(OH) D deficiency is prevalent in very low birth weight infants. For very low birth weight infants, low serum 25-(OH)D level may increase the duration of oxygen therapy and respiratory support, increase the incidence of BPD, RDS and ROP, and prolong the length of hospital stay.

Analysis of the status quo and influencing factors of low birth weight in Lishui City from 2016 to 2019

LEI Jun, LUO Xia, ZHENG Xiao-hong, LAN Xian-mei, YANG Li-hua, ZHOU Xiao-yan

2022, 30(2):  221-224.  DOI: 10.11852/zgetbjzz2021-0424

Asbtract ( )   PDF (435KB) ( )  

References | Related Articles | Metrics

Objective To investigate the occurrence of low birth weight in Lishui City from 2016 to 2019 and to analyze the influencing factors for low birth weight, in order to provide basis for reducing the occurrence of low birth weight. Methods Clinical data of 934 low birth weight infants born in Lishui Maternity and Child Health Hospital from 2016 to 2019 were retrospectively collected and analyzed.Multivariate Logistic regression was used to analyze the risk factors of low birth weight. Results From 2016 to 2019, Lishui Maternity and Child Health Hospital delivered 19 535 live births of fetuses, of whom 934(4.78%) were low birth weight infants.There was no significant difference in the incidence of low birth weight infants from 2016 to 2019 (χ²=0.019, P=0.891).Multivariate Logistic regression showed that preterm birth (OR=46.283, 95%CI:38.408-56.773), twins (OR=7.023,95%CI:5.347-9.223), female infants (OR=1.549, 95%CI: 1.304-1.841), pregnancy-induced hypertension (OR=4.945, 95%CI:3.262-7.498), premature rupture of membranes (OR=1.305, 95%CI:1.053-1.618), fetal distress (OR=2.103, 95%CI:1.515-2.919), placental abruption (OR=1.651,95%CI: 1.152-2.366),rural household registration (OR=1.274,95%CI:1.014-1.601) were risk factors for low birth weight(P＜0.05). Conclusions The incidence of low birth weight in Lishui City is lower than the national average, and attention should be paid to strengthening the perinatal management of pregnant women in rural areas, pregnancy with hypertension and twins to avoid preterm delivery, premature rupture of membranes and premature abruption of the placenta, thereby reducing the incidence of low birth weight.

Appropriate Technology

Study on the influence of family intervention based on Alberta Infant Motor Scale on the motor skill development of premature infants

GAO Shu-zhi, LI Yang, JIA Yu-feng, DONG Yan, ZHANG Shuang, GAO Jing-yun

2022, 30(2):  225-228.  DOI: 10.11852/zgetbjzz2021-0127

Asbtract ( )   PDF (881KB) ( )  

References | Related Articles | Metrics

Objective To explore the effect of the Alberta Infant Motor Scale (AlMS) guiding of ultra-early family intervention on the motor skill development of premature infants. Methods A total of 70 preterm infants with corrected age of less than 1 month were enrolled in this study, and were randomly divided into the intervention group (n=34) and the control group (n=36) from January 2018 to August 2020.The baseline was determined by General Motor Scale (GMS) and AIMS assessment.The control group received routine home nursing instruction.While, parents of preterm infants in the intervention group were instructed by professional rehabilitation therapists to give individualized family intervention training guided by AIMS assessment additionally.Both groups were intervened for 3 months.GMs assessment and AIMS assessment were performed at the corrected age of 4 months in order to compare the motor skill development between the intervention group and control group. Results After intervention, each position score and total score in AIMS assessment was significantly improved in both intervention group and control group (P<0.05).But the scores of prone and supine position and total scores in the intervention group were significantly higher than those in the control group (t=8.174, 3.936, 5.619, P<0.001). Conclusion The individualized family intervention guided by AIMS can promote motor skill development of premature infants.