Table of Content

    10 February 2024, Volume 32 Issue 2
    Professional Forum
    Establishment of early learning opportunities in nurturing care
    TONG Meiling
    2024, 32(2):  117-121.  DOI: 10.11852/zgetbjzz2024-0044
    Asbtract ( )   PDF (753KB) ( )  
    References | Related Articles | Metrics
    Both UNICEF and WHO mention that nurturing care is the most direct and effective approach to promoting early childhood development. Nurturing care emphasizes the importance of caregivers creating a suitable nurturing environment for the early development of children to promote their health and potential. The provision of early learning opportunities is an important aspect of creating a high-quality nurturing environment. This review focuses on the importance of establishing early learning opportunities, the methods of establishing early learning environments, implementing supportive strategies, and employing relevant evaluation methods, in order to provide reference and support for the establishment of early learning opportunities in nurturing care.
    Original Articles
    Factors associated with nursery care institution attendance for children aged 0 - 3 years old and the basic characteristics of nursery care institutions that children were enrolled in
    DONG Wenhong, YAO Xinmeng, XU Xin, LYU Lina, WANG Shasha, ZHENG Shuangshuang, WANG Lei, ZHU Bingquan, SHAO Jie
    2024, 32(2):  122-126.  DOI: 10.11852/zgetbjzz2023-0670
    Asbtract ( )   PDF (661KB) ( )  
    References | Related Articles | Metrics
    Objective To understand factors associated with children's attendance at nursery care institutions (NCIs) and the basic characteristics of the NCIs children were enrolled in, so as to provide scientific evidence for policymakers. Methods During November 2020 and January 2021, parents who visited the Department of Child Health Care in six selected maternal and children's hospitals, as well as nearby NCIs in Zhejiang were invited to finish an online questionnaire. Information such as children's sociodemographic characteristics, parents' knowledge, attitude and practice regarding nursery and feeding, etc. were collected. A total of 1 756 questionnaires were collected. Results Compared to children who were not in NCIs, children enrolled in NCIs were older (94.4% of children ≥24 months vs. 30.1%, χ2=835.27), more likely to be from the local area (87.2% vs. 81.4%, χ2=12.25), more likely to have parents with a college degree (mother:83.6% vs. 74.2%, χ2=35.29; father:79.9% vs. 70.0%, χ2=27.01), had a higher prevalence of family annual income >200 000 CNY (49.5% vs. 28.2%, χ2=110.49), and were less likely to have their grandparents available to take care of them (16.7% vs. 26.8%, χ2=31.4)The difference all have great significant.(P<0.05). In a multivariate Logistic regression model, the older the child, the more likely they were to attend an NCI (for children aged 6 - 23 months, OR=6.70; for children aged 24 - 35 months, OR=134.03; and for children aged 36 - 42 months, OR=699.33; P<0.05). Family annual income was positively associated with children's attendance at NCIs (for those earning 100 000 - 200 000 CNY/year, OR=1.63; for those earning 200 000 - 500 000 CNY/year, OR=2.96; and for those earning >500 000 CNY/year, OR=4.62, P<0.05). Conversely, the higher the level of grandparent involvement in daily care, the lower the attendance at NCIs (for children cared for by both parents and grandparents, OR=0.57; for those primarily cared for by grandparents, OR=0.26, P<0.05). For children who used to stay at NCIs, 82.8% stayed at institutions that only recruited children aged 0 - 3 years, 97.4% spent their whole day in NCIs, and 71.4% spent less than 3 000 CNY per month for NCI services. Additionally, over 95% of parents were satisfied with the food and care services in NCIs, as well as their children's physical development in NCIs. However, 32.1% of NCIs were reported by parents as having no room for breastfeeding. Conclusions Children's age, grandparent involvement in routine care, and family annual income are the main factors associated with children's attendance at NCIs. There is a greater need for more affordable and community-based NCIs, particularly for children under 2 years old. Additionally, more attention should be paid to the quality surveillance, assessment and management of NCIs.
    Correlation of parental meta-emotion philosophy and family rearing environment in infants and toddlers
    XU Yuying, ZHANG Xi, AN Zifen, YU Liping
    2024, 32(2):  127-132.  DOI: 10.11852/zgetbjzz2023-0411
    Asbtract ( )   PDF (622KB) ( )  
    References | Related Articles | Metrics
    Objective To explore the relationship between parental meta-emotion philosophy and family rearing environment in infants and toddlers, in order to provide guidance for building a positive family rearing environment. Methods The Parental Meta-Emotion Philosophy Scale was used to measure parents' social emotions. Family rearing environment of infants was investigated by combining demographic data and Family Rearing Environment Scale. Independent sample t-tests, one-way analysis of variance, Spearman correlation analysis, and multiple linear regression were utilized to analyze the relationship between parental meta-emotion philosophy and the family rearing environment. Results A total of 370 infant caregivers were included in the study. The average age of infants was (27.81±7.76) months, with 192 boys (51.9%) and 178 girls (48.1%). Parents' education level (F=4.71), whether they were the only child or not (t=8.85), whether the infant attended nursery or not (t=-2.49), and the per capita monthly income of the family (F=4.77) showed statistical significance in relation to the differences observed among the family rearing environments of infants and toddlers (P<0.05). Multivariate analysis indicated that the emotional teaching dimension of parental meta-emotion philosophy had a positive predictive effect on the overall level of the infant's family rearing environment (β=0.50, 95%CI:1.11 - 1.59), while the emotional loss dimension had a negative predictive effect (β=-0.15, 95%CI:-0.85 - -0.07). Conclusion The parental meta-emotion philosophy is closely related to the family rearing environment and serves as an important factor influencing it. It is supposed to improve parents' emotional literacy and enrich their knowledge of parental meta-emotion philosophy, so as to help build a positive family rearing environment.
    Relationship between responsive caregiving for infants and young children and parenting confidence among caregivers
    LIU Panting, ZHANG Lei, HONG Qin, CHI Xia, TONG Meiling, QIAN Jun
    2024, 32(2):  133-137.  DOI: 10.11852/zgetbjzz2023-0689
    Asbtract ( )   PDF (501KB) ( )  
    References | Related Articles | Metrics
    Objective To investigate the current state of infant responsive caregiving and to analyze its correlation with caregiver parenting confidence, in order to provide theoretical basis for improving the level of responsive care for infants and young children. Methods A cross-sectional survey was conducted from October 2022 to February 2023 to select 1 028 infants and young children under 3 years old who underwent health examinations in the Department of Child Healthcare. Participants completed a general data questionnaire, the Karitane Parenting Confidence Scale, and the Infant Responsive Caregiving Scale. Hierarchical multiple linear regression analysis was used to investigate the related influencing factors of infant responsive care and to analyze the relationship between caregiver parenting confidence and responsive caregiving. Results The level of responsive caregiving was found to be associated with various factors such as infant age(χ2=21.196), mode of pregnancy(Z=-2.072), history of pregnancy protection during pregnancy(Z=-4.713), history of pregnancy complications (Z=-4.504), gestational week at birth(χ2=41.358), small for term infants(Z=-3.497), neonatal intracranial hemorrhage(Z=-5.425), neonatal hyperbilirubinemia(Z=-2.184), maternal education level(χ2=9.419), family income(χ2=11.211) as well as type of family (χ2=15.360)(P < 0.05). Additionally, a significant correlation was observed between parenting confidence and responsive caregiving(r=0.421, P<0.001). Hierarchical multiple linear regression analysis revealed that caregiver parenting confidence had a significant positive effect on the level of responsive caregiving (B=0.623, P<0.05), even after controlling for the effect of demographic factors. Conclusion The level of infant responsive caregiving is influenced by caregiver parenting confidence, and increasing caregiver parenting confidence can effectively improve the quality of responsive caregiving for infants and young children.
    Development and test of reliability and validity of the Visual Cognitive Ability Assessment Scale for Preschool Children
    WANG Na, ZHOU Shuqing, GUO Xiaojie, ZHANG Xin, CHI Xia, LI Xiling, TONG Meiling
    2024, 32(2):  138-141.  DOI: 10.11852/zgetbjzz2023-0790
    Asbtract ( )   PDF (519KB) ( )  
    References | Related Articles | Metrics
    Objective To develop the Visual Cognitive Ability Assessment Scale for Preschool Children and to evaluate its reliability and validity, in order to provide reference for clinical evaluation of visual cognitive ability of preschool children. Methods 1) From November 2021 to February 2022, construct the dimension framework was constructed and the pool of scale items was compiled according to the theory. 2) In March to June 2022, items were screened preliminarily through group discussion and Delphi method. In August 2022, the entries was revised by a pre-survey in a small sample (n=50). 3) Parents of children aged 4 - 7 from 8 kindergartens in 4 main urban areas of Nanjing were investigated by stratified cluster random sampling method in September to December 2022. The valid sample of the first survey (n=344) was analyzed to conduct item analysis and re-test reliability analysis, the valid sample of the second survey (n=695) was tested for reliability and confirmatory factor analysis, then the scale was finally compiled and evaluated. Results 1) The scale contained 19 items in 4 dimensions:visual memory, discerning vision, spatial vision and visual integration. All items passed the project analysis test. 2) The Cronbach's α coefficient of each dimension ranged from 0.604 to 0.886, and the Cronbach's α coefficient of the whole scale was 0.917. During the two surveys, the scores of each item were correlated, and the average retest reliability coefficient was 0.601 (P< 0.05). 3) Content validity index (S-CVI) at scale level was 0.91, and item level content validity index (I-CVI) ranged from 0.8 to 1.0. After several rounds of model modification, the confirmatory factor model fit well. Conclusion The reliability and validity of the Visual Cognitive Ability Assessment Scale for Preschool Children are acceptable and meet the requirements of the scale, which provides a practical tool for clinical screening of visual and cognitive disorders.
    Effects and changes of intrapartum antimicrobial prophylaxis on antibiotic resistance genes in gut microbiota of infants within 6 months of age
    QI Qi, ZHU Zhonghai, WANG Liang, ZHU Yingze, ZENG Lingxia
    2024, 32(2):  142-148.  DOI: 10.11852/zgetbjzz2023-0526
    Asbtract ( )   PDF (665KB) ( )  
    References | Related Articles | Metrics
    Objective To explore the impact of intrapartum antibiotic prophylaxis (IAP) on antibiotic resistance genes (ARGs) in the gut microbiota of infants up to 6 months of age and their longitudinal changes, in order to provide theoretical basis for the rational use of antibiotics and antibiotic resistance control. Methods Fecal samples were collected within 3 days, 2 months, and 6 months from a maternal and birth cohort conducted between January 2018 and June 2019. A panel of 6 common ARGs (aac(6')-Ib, qnrS, blaTEM, ermB, mecA, tetM) were tested, the absolute abundance and positive detection rate by qPCR were calculated. Nonparametric and linear mixed model (LMM) analysis were used to assess the influence of IAP on the absolute abundance of antibiotic resistance genes and the longitudinal changes in their abundance at the three time points. Results A total of 157 samples from 65 singleton infants were analyzed, including 15 mothers (23.1%) who received IAP. The detection rate of ARGs was high in infants up to six months of age, and the abundance of ARGs tended to increase over time. IAP significantly increased the abundance of the mecA gene in the gut microbiota of vaginally delivered infants at 6 months of age (6.1±1.1 in the VDIAP group vs. 3.8±4.6 in the VDno-IAP group, P=0.046). Additionally, in cesarean section infants, there was a significant increase in the abundance of aac(6')-Ib genes at 2 months(β=3.81, Sx-=1.45, P<0.05), P<0.05] and 6 months of age (β=4.89, Sx-=1.11, P<0.001), P<0.001) compared to 3 days of age. Conclusions The findings suggest that IAP can increase the abundance of ARGs in 6-month-old infants, and this effect is still significant after stratifying by delivery mode. Therefore, the rational and standardized use of intrapartum antibiotics may help reduce the development of antibiotic resistance.
    Application value of different language assessment tools in language development assessment of 12-month-old high-risk infants
    JIAN Lanying, LUO Yan, ZHU Yan, SHEN Chengwei, TU Kexin, QIN Huiling, JIN Lifang
    2024, 32(2):  149-153.  DOI: 10.11852/zgetbjzz2023-0724
    Asbtract ( )   PDF (661KB) ( )  
    References | Related Articles | Metrics
    Objective To explore the application value of different language assessment tools in the assessment of language development of 12-month-old high-risk infants, and to screen out simple and valid language assessment tools. Methods A total of 217 11- to 13-month-old high-risk infants who were followed up at the outpatient service for high-risk infants at the child health clinic of Guiyang Maternal and Child Health Hospital from March 2022 to May 2023 were selected as the study subjects. Their language was evaluated by Early Language Milestone Scale (ELMS), Putonghua Communicative Development Inventory (PCDI) and Ages and Stages Questionnaire-Third Edition (ASQ-3). With Gesell as the gold standard for the assessment of language, the area under receiver operating characteristic curve (AUC), sensitivity, specificity, accuracy, positive predictive value, negative predictive value, Youden index and Kappa value of the three tools were calculated. Spearman correlation analysis was used to analyze the correlation between the different language assessment scales. The Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) was used to evaluate the three tools. Results 1)Among 217 high-risk infants, 78 preterm infants was the most (35.94%). The rate of delayed language development detected by Gesell, ELMS, PCDI-comprehension, PCDI-expression, ASQ-3 were 5.5%, 7.8%, 36.4%, 30.0% and 11.5%, respectively. 2)ASQ-3 had the strongest correlation with Gesell language region (rs=0.607, P<0.01) and it had the most AUC (AUC=0.812, P<0.05). The consistency between ASQ-3 and Gesell was moderate (Kappa=0.56, P<0.01). ASQ-3 had the highest sensitivity(91.7%), accuracy(93.1%), negative predictive value(99.5%) and Youden index(0.85), and ELMS had the highest specificity(94.6%). 3) Comprehensive evaluation of three tools by the TOPSIS indicated that ASQ-3 was the best, followed by ELMS and PCDI-comprehension was the worse. Conclusion Among the three assessment tools, ASQ-3 has the highest value in assessing the language development of 11- to 13-month-old high risk infants, and it may be necessary to expand the age range and establish a national norm of ELMS and PCDI in the future.
    Basic Experimental Articles
    Effects of gestational diabetes mellitus on brain development and miRNAs expression profile in neonatal mice
    HUANG Wanyi, ZHANG Youxiang, OU Qiaoqun, LIU Yuanchun, GUO Jiayu
    2024, 32(2):  154-158.  DOI: 10.11852/zgetbjzz2023-0077
    Asbtract ( )   PDF (1224KB) ( )  
    References | Related Articles | Metrics
    Objective To study the effects of gestational diabetes (GDM) on morphological structure of brain tissue and microribonucleotide (miRNA) expression profile in neonatal mice, and to provide a new research target for the prevention and treatment of abnormal neurodevelopment in GDM progeny. Methods The pregnant mice were divided into model group and control group, each group consisted of 10 mice. The model group mice established a GDM model by injecting streptozotocin to measure fasting blood glucose (FPG) and random blood glucose (GLU) at different times. Successful molded mice were randomly divided into model group A and model group C, and control mice were divided into control group B and control group D, with 5 mice in each group.The newborn mice in groups A and B were used for hippocampal tissue GeneChip detection and brain morphology structure observation, and group C and D newborn mice were used for qRT-PCR detection of hippocampus tissue expression differences to verify the differentially expressed genes of miRANs obtained by GeneChip screening.After giving birth, the neonatal mice were sacrificed by decapitation, and the brain tissue was dissected to observe the overall morphological structure. The structural changes of hippocampus were observed under HE chromogenic microscope. The Agilent mouse miRNA oligonucleotide gene chip was used to detect the miRNA expression profile of mouse hippocampus, screen differential miRNAs and predict their target genes, and conduct GO analysis and signal transduction pathway analysis of target genes. The relative expression levels of the screened miRNAs were verified by qRT-PCR. Results Compared with the control group, the GLU increased significantly from the 3rd day after drug administration in the model group (P<0.01). Macroscopic observation of control group B mice had normal brain morphology and structure, smooth appearance, clear gyrus, close arrangement of hippocampus cell structure, uniform staining and complete structure; in model group A, the number of hippocampus cells decreased, loose arrangement and deep staining. In the initial screen of miRNA microarray, there were 11 differentially expressed miRNAs between control and model groups, all of which were downregulated miRNAs, including let-7b-5p、miR-130b-3p、miR-181c-5p、miR-181d-5p、miR-3099-3p、miR-3470a、miR-3473a、miR-3473b、miR-500-3p、miR-532-5p、miR-7047-5p(P<0.05)。Two miRNAs (miR-3473b, miR-7047-75p) and 5 target genes (MAPK3, MAPK11, MAPK14, CALM3, AKT3). The relative expression of miR-3473b and miR-7047-5p in model group C were lower than that in control group D (t=19.13 and 6.24, P<0.05), and the validation results were consistent with the microarray test results. Conclusion Compared with the offspring of normal pregnant mice, GDM offspring mice have abnormal development of brain structure and damage of hippocampal nerve cells, and there are a large number of abnormal expression of miRNAs in hippocampal tissue. Differentially expressed miRNAs can be used as research targets for prevention and treatment of GDM offspring neurodevelopmental abnormalities.
    Dyadic parent-child interaction coding system and its application
    CHENG Fengjie, LI Jing
    2024, 32(2):  159-163.  DOI: 10.11852/zgetbjzz2023-0483
    Asbtract ( )   PDF (636KB) ( )  
    References | Related Articles | Metrics
    In recent years, externalizing behavior problems in children have become increasingly prevalent. Research has shown that early parenting interventions can effectively improve children's externalizing behaviors. The dyadic parent-child interaction coding system (DPICS) is a validated, evidence-based tool for assessing and guiding parent-child interactions in families with children aged 3 - 8 years. This article reviews the current status and influence mechanisms of parent-child interactive interventions using DPICS, aiming to provide richer evidence for interventions targeting children's behavior problems.
    Role of enriched environment in the model of maternal separation
    LI Jicheng, JIANG Min, HEI Mingyan
    2024, 32(2):  164-168.  DOI: 10.11852/zgetbjzz2023-0604
    Asbtract ( )   PDF (563KB) ( )  
    References | Related Articles | Metrics
    Early life stress in humans can affect the normal development of individual neural networks, ultimately leading to diseases such as anxiety, depression, and autism in such children. The maternal separation model is commonly used to study the effects of early adverse experiences in human infants. Studies have shown that maternal separation in mice can lead to anxiety, depression, and impairments in spatial learning and memory in young mice during adulthood. However, enriched environmental interventions have been found to ameliorate the negative outcomes of early life stress by exerting a range of beneficial effects. This article provides an overview of the positive effects of enriched environmental interventions on mice in the maternal separation model.
    Research progress on cognitive dysfunction in offspring due to sleep deprivation during pregnancy
    ZHOU Ziyu, LYU Jing, FENG Guangwu, WANG Xinyue, DU Shuyao, LI Qing
    2024, 32(2):  169-173.  DOI: 10.11852/zgetbjzz2023-0695
    Asbtract ( )   PDF (541KB) ( )  
    References | Related Articles | Metrics
    Sleep deprivation refers to the loss of sleep caused by self-inflicted or external factors. There is increasing evidence that pregnancy is prone to sleep deprivation, which not only disrupts maternal functions but also affects offspring's cognitive function. This article reviews the effects of sleep deprivation during pregnancy on offspring cognition and its underlying mechanisms, in order to establish a foundation for developing scientifically sound sleep strategies during pregnancy and to provide clinical insights for improving the neurodevelopment and cognitive function of offspring.
    Genetic factors, risk factors and pathogenesis of cerebral palsy comorbid epilepsy
    GONG Chao, LIAN Beibei, LI Xuemei, ZHANG Peng, SONG Fanxu, GUO Jin
    2024, 32(2):  174-180.  DOI: 10.11852/zgetbjzz2023-0344
    Asbtract ( )   PDF (743KB) ( )  
    References | Related Articles | Metrics
    Compared to the general population, there is a higher prevalence of epilepsy in individuals with cerebral palsy (CP). Epilepsy serves as an indicator of CP severity and has a significant impact on the early survival and future quality of life of children with CP. Therefore, it is crucial to investigate the shared mechanisms underlying CP and epilepsy. This study aims to summarize the comorbidity of CP and epilepsy from genetic factors, risk factors, and pathophysiological mechanisms, in order to provide a reference for further research.
    Meta Analysis
    Summary of best evidence/teenagers hypoglycemia prevention strategies in children with type 1 diabetes
    JIANG Yanxin, HAN Jinyan, ZHAO Juan
    2024, 32(2):  181-186.  DOI: 10.11852/zgetbjzz2023-0741
    Asbtract ( )   PDF (740KB) ( )  
    References | Related Articles | Metrics
    Objective To establish strategies for preventing and managing hypoglycemia in children and adolescents with type 1 diabetes, in order to provide a clinical practice basis for reducing the incidence of hypoglycemia and optimizing comprehensive blood sugar management. Methods All domestic and foreign evidence on the prevention and management of hypoglycemia in children was retrieved until August 2023, including clinical practice guidelines, evidence summaries, best practice information books, expert consensus, systematic reviews, and original studies. Results This study included 9 articles, comprising 3 practical guidelines, 4 expert consensus articles, 1 clinical decision, and 1 evidence summary, covering 9 aspects ranging from hypoglycemia identification, risk factors, blood sugar monitoring, insulin treatment plans, health education, diet, exercise, and psychological support. It presents a total of 34 pieces of evidence, synthesizing the best evidence from both domestic and international sources on hypoglycemia prevention strategies for children and adolescents with type 1 diabetes. Conclusion Based on the latest evidence from domestic and global sources, this study systematically illustrates prevention strategies for hypoglycemia in children and adolescents with type 1 diabetes, providing comprehensive evidence and a reliable theoretical basis for raising clinical caregivers' awareness of hypoglycemia prevention, reducing the risk of hypoglycemia occurrence, and constructing a systematic hypoglycemia prevention and control strategy.
    Clinical Research
    Prevalence and associated risk factors of retinopathy of prematurity in preterm infants with gestational age ≤34 weeks
    WANG Xiaokang, LIANG Yifei, ZHU Yanping
    2024, 32(2):  187-190.  DOI: 10.11852/zgetbjzz2023-0582
    Asbtract ( )   PDF (589KB) ( )  
    References | Related Articles | Metrics
    Objective To understand the prevalence of retinopathy (ROP) in preterm infants with gestational age ≤34 weeks in the First Affiliated Hospital of Xinjiang Medical University, and to analyze the associated risk factors, so as to provide a basis for early screening of high-risk premature infants. Methods A retrospective analysis was conducted on the relevant case data of hospitalized premature infants with gestational age ≤34 weeks in neonatal intensive care unit (NICU) of the First Affiliated Hospital of Xinjiang Medical University from June 2015 to June 2020. Infants were divided into ROP group and non-ROP group based on the results of fundus screening. Relevant data were collected to analyze the relevant risk factors for ROP in premature infants. Result A total of 1 738 premature infants with gestational age ≤34 weeks were included, with 292 cases (16.8%) in ROP group and 1 446 cases in non-ROP group. Logistic regression analysis revealed that bronchopulmonary dysplasia(BPD) (OR=3.379, 95%CI:1.835 - 6.221), anemia (OR=7.388, 95%CI: 4.262 - 12.806), receiving blood transfusion treatment (OR=2.129, 95%CI: 1.278 - 3.547), oxygen requirement time >7 days (OR=3.429, 95%CI: 2.309 - 5.094), and the fraction of inspired oxygen greater than 40% (OR=2.541, 95%CI: 1.540 - 4.193) were independent risk factors for the occurrence of ROP. Among these patients, 167 eyes (103 patients) received treatment of ROP, including 108 eyes treated with intraocular injection of Rizumab, 35 eyes treated with fundus laser, and 24 eyes treated with combination of both. All patients had acceptable outcomes during the follow-up. Conclusions Premature infants with anemia, BPD, receiving blood transfusion treatment, oxygen requirement time >7 days, and the fraction of inspired oxygen >40% are at high risk of developing ROP. Standardized fundus screening and timely treatment measures are essential to reduce the risk of visual impairment in premature infants.
    Influencing factors of follow-up compliance of special diet therapy in patients with phenylketonuria in four prefectures of Xinjiang Uygur Autonomous Region
    ZHOU Shangqin, CHEN Xi, XUE Shuyuan, ZHANG Luhan, DING Guifeng
    2024, 32(2):  191-195.  DOI: 10.11852/zgetbjzz2023-0336
    Asbtract ( )   PDF (747KB) ( )  
    References | Related Articles | Metrics
    Objective To investigate the influencing factors behind the follow-up compliance of patients with low/no phenylketonuria (PKU) for special medical use, in order to provide a basis for regulating the follow-up of PKU patients and ensuring the effectiveness of special diet treatment. Methods A survey was conducted on PKU patients treated in Urumqi Maternal and Child Health Hospital for over 1 year, from January 2010 to December 2020. Interviews and questionnaires were conducted with their caregivers to collect and analyze the current status of PKU patients undergoing special diet treatment, and to identify the influencing factors behind their compliance with follow-up treatment. Results Patients who had received neonatal disease screening, neonatal gene diagnosis, and maternal Down's screening during pregnancy had better compliance, with statistically significant differences (χ2=5.753, 10.993, 9.189, P<0.05). PKU children with parents who had a college education or above showed significantly higher adherence to special diet treatment (χ2=8.321, 7.415, P<0.05). PKU children with parents having a fixed occupation also showed higher compliance, with a statistically significant difference (χ2=20.626, 7.895, P<0.05). Patient age, interval of buying special diet, number of blood samples sent and enrollment of normal age, all had a significant impact on the follow-up compliance of PKU patients with special diet (χ2=19.443, 8.090, 69.482, 12.001, P<0.05). Conclusions PKU is a treatable genetic metabolic disease. Strengthening health education, formulating standardized follow-up plans and procedures, and improving follow-up treatment compliance are crucial in enhancing the treatment and follow-up effectiveness of PKU patients.
    Correlation of umbilical cord blood IL-25 and IL-33 with early infantile eczema
    YANG Yunyue, WANG Wen'ge, TAN Hanxu, YANG Yunyan, LU Xujun
    2024, 32(2):  196-201.  DOI: 10.11852/zgetbjzz2023-0115
    Asbtract ( )   PDF (784KB) ( )  
    References | Related Articles | Metrics
    Objective To investigate the correlation of the levels of interleukin-25 (IL-25) and interleukin-33 (IL-33) in cord blood with the development of infantile eczema within 42 days after birth, so as to provide theoretical support for the prevention of early infant eczema. Methods A total of 145 newborns who met the inclusion criteria and were born in the Obstetrics and Gynecology Department of the Air Force Special Medical Center from September 2020 to September 2021 were selected. Cord venous blood was collected at birth and the levels of IL-25 and IL-33 in cord blood were measured. The occurrence and severity of infantile eczema were recorded in 42 days. Results Among 145 infants, 79(54.5%) suffered from eczema. The level of IL-25 in cord blood in eczema group was significantly lower than that in non-eczema group (Z=4.957, P<0.001), and the level of IL-33 in cord blood in eczema group was significantly higher than that in non-eczema group (Z=4.594, P<0.001). The proportion of family history of allergy in the eczema group was significantly higher than that in non-eczema group (χ2=4.693, P<0.05). Logistic regression analysis showed that family history of allergy (OR=4.296), lower level of IL-25(<14.5pg/mL) (OR=4.034) and higher level of IL-33(>21.1pg/mL) (OR=2.759) in cord blood were risk factors for eczema (P<0.05), while birth weight was not associated with the onset of eczema in infants at 42 days (P>0.05). Meanwhile, the level of IL-33 in cord blood was related to the mode of delivery (P<0.05). ROC analysis showed that the optimized positive cutoff value was <14.0pg/mL for cord blood IL-25(sensitivity 62.0%, specificity 75.8%) and >22.1pg/mL for IL-33 (sensitivity 64.6%, specificity 69.7%). Spearman correlation test found that there was a linear correlation of the level of cord blood IL-33 with eczema area and severity index (EASI) score (r=0.398, P<0.01). Conclusion Family allergy history, lower level of cord blood IL-25 and higher level of cord blood IL-33 are important influencing factors of infant eczema in 42 days after birth, and higher level of cord blood IL-33 will aggravate the severity of early infantile eczema.
    Epidemiological characteristics of neonatal congenital heart disease and related factors in Zhejiang Province
    LU Lingya, CHENG Wei, LYU Lanqiu
    2024, 32(2):  202-207.  DOI: 10.11852/zgetbjzz2023-0358
    Asbtract ( )   PDF (675KB) ( )  
    References | Related Articles | Metrics
    Objective The purpose of this study was to investigate the prevalence status of neonatal congenital heart disease (CHD) in Ningbo City, Zhejiang Province from 2017 to 2021, and to analyze the influencing factors, so as to provide reference for preventing the risk of CHD and reduce the prevalence of CHD. Methods Using cross-sectional survey method, the neonatal data from March 2017 to December 2021 were captured from Zhenjiang Neonatal Disease Screening Center, and were analyzed by linear trend chi-square test; binary Logistic regression was used to analyze the influencing factors of CHD. Results A total of 13 156 newborns screened positive for CHD in Ningbo, Zhejiang Province, with CHD confirmed in 6 300 cases. Among these, 3 066 cases were boys (48.7%) and 3 234 cases were girls (51.3%). The prevalence rates of neonatal CHD in Ningbo city for the years 2017, 2018, 2019, 2020, and 2021 were 2.07%, 1.10%, 2.00%, 2.04% and 1.08%, respectively, with an overall prevalence from 2017 to 2021 of 1.69%. The chi-square test for the linear trend indicated a decreasing prevalence of neonatal CHD over time(χ2=178.518, P<0.001). Multivariate analysis showed that maternal age [36 to 45 years(OR=1.24), >45 years(OR=1.66)], male infants (OR=1.26), premature birth [<32 weeks (OR=1.13), 32 - 36 weeks(OR=1.54)], and being a second birth (OR=2.56) were independent risk factors for the development of CHD (P<0.05). Conclusions The prevalence of CHD in Ningbo, Zhejiang Province is higher than that of CHD in China and other cities of Zhejiang Province. Although the prevalence showed a decreasing trend over time, targeted prevention and control measures need to be implemented to reduce the prevalence of CHD.
    Experience Exchange
    Physical and neuropsychological development of the offspring born to mother with gestational diabetes mellitus at 2 years old
    LU Anfeng, HUANG Peilu, BI Lei, HUANG Guosheng, HUANG Haiyan
    2024, 32(2):  208-211.  DOI: 10.11852/zgetbjzz2023-0726
    Asbtract ( )   PDF (573KB) ( )  
    References | Related Articles | Metrics
    Objective To investigate the physical and neuropsychological development of the offspring born to mothers with gestational diabetes mellitus (GDM) at 2 years of age, and to provide evidence to enhance the physical and neuropsychological development of GDM offspring. Methods A retrospective analysis was conducted on neonates born in the Department of Obstetrics at Qinzhou Maternal and Child Health Hospital from January 2018 to December 2018 and regularly followed at the outpatient service. The neonates were categorized into two groups based on whether their mothers were diagnosed with GDM during pregnancy:the GDM group (n=243) and the control group (n=362). The general clinical data, follow-up information on physical development and neuropsychological development at 1 year and 2 years of age for all children were collected. Their height, head circumference, body weight, BMI, and Gesell developmental quotients (DQs) at 1 year and 2 years of age for both groups were analyzed. Results 1) There were no significant differences in height, head circumference, body weight, and body mass index (BMI) between the two groups at 1 year and 2 years of age during the follow-up period (P>0.05). 2) At 1 year of age, the GDM group exhibited higher rates of abnormal language development (8.6% vs. 3.3%, χ2=7.854), adaptive behavior(11.4% vs. 5.0%, χ2=8.605), and personal social behavior(8.2% vs. 3.0%, χ2=8.062) compared to the control group (P<0.05), and lower DQs for these Gesell subscales (language development 87.6±7.7 vs. 89.4±9.2, t=2.591; adaptive behavior:88.4±7.8 vs. 90.5±8.9, t=2.957; personal social behavior:89.1±7.0 vs. 91.2±7.5, t=3.495, P<0.05). 3) At 2 year of age, the GDM group also showed higher rates of adaptive behavior (8.2% vs. 4.1%, χ2=3.927) and personal social behavior (7.3% vs. 3.0%, χ2=4.093) compared to the control group (P<0.05), and lower DQs for these Gesell subscales (adaptive behavior:89.5±6.5 vs. 91.9±6.9, t=3.878; personal social behavior:89.9±7.1 vs. 92.1±6.9, t=3.311, P<0.05). Conclusions The development of adaptive behavior and personal social behavior in offspring born to mothers with GDM remains delayed. Follow-up for GDM offspring should prioritize achieving a balanced development of adaptive behavior and personal social behavior.
    Family analysis of primary microcephaly caused by complex heterozygous variants of the RTTN gene and literature review
    ZHAO Chenyue, JIANG Jinsong, ZHANG Lixue, GUO Min, GAO Jingbo, SUN Xiayu, GUO Rong, LU Hongyong, WU Jianrui, XUE Huiqin
    2024, 32(2):  212-217.  DOI: 10.11852/zgetbjzz2023-0521
    Asbtract ( )   PDF (2619KB) ( )  
    References | Related Articles | Metrics
    Objective To analyze the genetic variation characteristics and clinical phenotypes of a family with primary microcephaly (MCPH) caused by RTTN gene variation, and to provide reference for genetic counseling and prenatal diagnosis. Methods Clinical data of the three patients (including2 fetuses and 2-year-old proband, and one fetus with clinical diagnosis) and their parents were collected and analyzed. Two of the children and their parents were tested by trio whole exome sequencing (trio-WES), sanger sequencing validation sites, and the hazard of their compound heterozygous variants was predicted. Literature review was conducted through domestic and international databases to collect reported RTTN gene mutation cases. Results Three patients in this family had anomalies of the septum pellucidum, hypoplasia of the corpus callosum and other brain malformations during fetal period. The proband (G2) and fetus (G3) showed intrauterine growth retardation and MCPH in late pregnancy; besides, G2 was born with global developmental delay. Trio-WES detected a c.2101(exon16)C>T(p.Arg701Ter, 1526) nonsense and a c.2863(exon22)G>A(p.Glu955Lys)missense in the RTTN gene of G2 and G3, which were inherited from their father and mother, forming a compound heterozygous variant. According to the American College of Medical Genetics and Genomics (ACMG) variant classification guidelines, two variants were likely to be pathogenic (LP) and uncertain significance (VUS). Among them, c.2863(exon22)G>A was a newly discovered missense, which was predicted by the software to be harmful to the gene product. Conclusions Complex heterozygous variations of RTTN gene (c.2101C>T and c.2863G>A) are the genetic cause of MCPH in this family. This report has enriched the variation spectrum of RTTN gene, provided guidance for prenatal diagnosis and reproduction of this family, as well as material and reference for further understanding of the diseases caused by this gene mutation.
    Epidemiological analysis of accidental death among children under 5 years old in Guangdong Province from 2018 to 2022
    HA Linna, XU Haoli
    2024, 32(2):  218-222.  DOI: 10.11852/zgetbjzz2023-0703
    Asbtract ( )   PDF (507KB) ( )  
    References | Related Articles | Metrics
    Objective To investigate the main causes of accidental death of children under 5 years old and their epidemiological distribution in Guangdong Province from 2018 to 2022, it provides theoretical basis for formulating further preventive measures and intervention methods. Methods Children under 5 years of age who died in Guangdong Province from 2018 to 2022 were selected as the study subjects. The International Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) codes S00-T98 and V01-Y98 were used to classify cases of accidental death, and the related rate and composition ratio were calculated to analyze the causes of accidental death in children and their distribution. Results From 2018 to 2022, the total mortality rate in Guangdong Province was 2.94‰, with a total of 21 329 deaths. Among these deaths, 3 819 were accidental deaths (0.53‰), the sex ratio of males to females was 1.29∶1, and the sex distribution of accidental death among all age groups showed significant difference (χ2=16.38, P<0.01). The top 3 causes for accidental deaths were accidental suffocation (1 590/3 819), drowning (926/3 819) and traffic accident (527/3 819). The accidental death rate of boys at all ages was higher than that of girls, although the difference was not statistically significant (χ2=13.68, P=0.19). The cause of death varied significantly among different age groups (χ2=1 723.28, P<0.01), and the treatment before death was statistically significant (χ2=174.31, P<0.01). Conclusion Accidental suffocation and drowning are the main causes of death in children under 5 years old in Guangdong Province. Age-specific preventive measures should be implemented to enhance the identification and prevention of accidental injuries among children and their parents, thus reducing the accidental death rate in this age group.
    Appropriate Technology
    Efficacy of tele-rehabilitation program for preschool children with functional articulation disorders
    JIA Yufeng, LI Yang, ZHANG Shuang, GAO Shuzhi, GAO Jingyun, LI Shuang
    2024, 32(2):  223-227.  DOI: 10.11852/zgetbjzz2023-0587
    Asbtract ( )   PDF (635KB) ( )  
    References | Related Articles | Metrics
    Objective To observe the effect of tele-rehabilitation program on the articulation resolution of preschool children with functional articulation disorders (FAD), so as to provide reference for the clinical application of tele-rehabilitation in this context. Methods A total of 66 preschool children diagnosed with FAD in the outpatient department of Child Rehabilitation, Tangshan Maternal and Child Health Hospital from March 2022 to March 2023 were selected into this study, and were divided into tele-rehabilitation group (n=32) and control group (n=34) by random number table method. The control group received daily family rehabilitation guidance, while the tele-rehabilitation group underwent a tele-rehabilitation program lasting for 3 months. All children were assessed using the Chinese phonological ability evaluation lexicon before and 3 months after the treatment. Results After 3 months of treatment, both the tele-rehabilitation group and the control group showed significant improvements in articulation resolution compared to before treatment (t=12.165、12.986, P<0.05). Notably, the tele-rehabilitation group exhibited significantly greater improvement than the control group (t=2.138, P<0.05). Within the tele-rehabilitation group, children were further divided into three subgroups based on the severity of their dysphonia:mild, moderate, and severe. After 3 months of treatment, the articulation resolution of the mild and moderate groups improved significantly compared to before treatment (Z=2.226, 31.900, P<0.05), whereas no statistically significant improvement was observed in the severe group compared to before treatment (Z=1.857, P>0.05). Conclusion Tele-rehabilitation program effectively improves articulation resolution in preschool children with FAD, especially for mild to moderate preschool children with FAD.
    Case Report
    Clinical and genetic analysis of short stature families caused by ACAN gene mutation
    Hong Zhuoqing, Li Mali, Wang Zhihua
    2024, 32(2):  228-232.  DOI: 10.11852/zgetbjzz2023-0079
    Asbtract ( )   PDF (1629KB) ( )  
    References | Related Articles | Metrics