Neonatology probation teaching is one of the difficulties in eight-year program pediatric teaching.There are some problems in the neonatology probation teaching,including partial comprehension of neonatal basic theoretical knowledge,few opportunities of clinical operations and observation,lack of effective physician-patient communication method,defective mastering of neonatal clinics skills.In order to refine the neonatology probation of eight-year program medical students and to improve the quality of hospitals' clinical teaching,an appropriate neonatology clerkship program of eightyear medical students should be investigated.A variety of teaching methods should be applied to enhance students' interest of learning the basic theory.Before entering the neonatal ward,it is necessary for eight-year program medical students to understand the workflow and a standard appraisal system should be established.At the same time,it is essential to strengthen the training of their interpersonal communication skills,clinical thinking and clinical skills.Finally,a standard out-department examination system should be established to evaluate the eight-year program medical students' neonatology learning effect objectively.

Objective To explore the differences in maternal and neonatal complications of twin pregnancies in different modes of conception.Methods Retrospective analysis was performed to compare the differences in mother's gestation history,childbirth and neonatal complications among 102 cases of in vitro fertilization-embryo transfer(IVFET) pregnancy twins,16 cases of simple ovulation induction(OI) pregnancy twins and 96 cases of spontaneous conception(SC) pregnancy twins.Results 1.The maternal age[(32.51 ±4.03) years vs (31.25 ±3.38) years vs (30.20 ± 4.13) years,F =8.061,P ＜ 0.05] and birthrate of full-term infants (21.5 ％ vs 0 vs 10.4％,x2 =7.566,P ＜ 0.05) of IVF-ET group were significantly higher than that of OI group and SC group.The body weight at birth of OI group was significantly lower than that of IVF-ET group and SC group [(1 918.1 ±516.4) g vs (2 228.3 ±4542) g vs (2 164.4 ±442.5) g,F =3.293,P ＜0.05].The birthrate of late preterm infant(87.5％ vs 51.0％ vs 64.6％,x2 =9.322,P ＜ 0.05) and the incidence of twin discordance (50.0％ vs 21.6％ vs 18.8％,x2 =7.781,P ＜ 0.05) of OI group were significantly higher than that of IVF-ET group and SC group,while the incidence of monozygotic twins of SC group was significantly higher than that of IVF-ET group and OI group(52.1％ vs 5.9％ vs 0,x2 =58.016,P ＜ 0.05).2.The incidence of pregnancy induced hypertension of OI group was significantly higher than those of IVF-ET group and SC group(50.0％ vs 17.6％ vs 22.9％,x2 =8.344,P ＜ 0.05).The incidence of gestational diabetes mellitus of OI group and spontaneous group was significantly higher than that of IVF-ET group(12.5％ vs 14.6％ vs 3.9％,x2 =6.838,P ＜0.05).3.The incidence of twin transfusion syndrome of SC group was significantly higher than that of the other groups(6.3％ vs 0 vs 0,x2 =7.588,P ＜0.05),but the incidence of apnea of prematurity of OI group was significantly higher than that of IVF-ET group and SC group(43.8％ vs 15.7％ vs 24.0％,x2 =7.081,P ＜0.05).The incidence of asphyxia,transient tachypnea of the newborn,hypoglycemia,intracranial hemorrhage and septicemia of OI group were higher than that of IVF-ET group and SC group,but there was no significantly difference among 3 groups.Conclusions IVF-ET conceived twin pregnancies are not at greater risk for pregnancy complications and adverse perinatal outcome than SC twin pregnancies.But the incidence of some adverse maternal and neonatal complications of simple OI twin pregnancies is higher than that of IVF-ET group and SC group.More attention should be paid to the perinatal health care of OI conception twins,which is important to avoid serious complications.

Objective: To investigate the effect of maternal malignant tumor and related therapy on the outcome of newborns. Methods: The clinical data of 78 pregnant women with malignant tumors and 15 newborns whose mothers suffered from malignant tumors between January 2011 and December 2016 in Peking University People′s Hospital were studied.At the same time, 64 cases of pregnant women with no disease were randomly selected as the control group, and the effect of maternal malignant tumors and related therapy on neonatal growth and development were analyzed. Results: Among the 78 pregnant women suffering from malignant tumors, 14 women chose abortion or induced labor, and 64 women chose to continue pregnancy until delivery.Among the 78 women, 23 cases suffered from acute leukemia, 20 cases suffered from chronic myeloid leukemia, 11 cases suffered from cervical cancer, 9 cases suffered from thyroid carcinoma, 6 cases suffered from unclassified leukemia, 3 cases suffered from oophoroma, 3 cases suffered from lymphoma, 2 cases suffered from endometrial carcinoma and 1 case suffered from invasive mole.Among the 64 mothers, 20 mothers did not receive any treatment during pregnancy and 44 cases received chemotherapy or other treatments such as intermittent transfusion therapy.Among the 64 newborns, 24 cases were vaginal deliveries, 6 cases were forceps deli-very and 34 cases were caesarean section.The mean gestational age [(37.6±2.3) weeks vs.(40.0±1.2) weeks], body weight[(2 998±637) g vs.(3 389±360) g]and body length[(48.5±2.8) cm vs.(50.2±1.5) cm]at birth of neonates, whose mothers with malignant tumors during pregnancy were smaller than those of the control group, and the differences were statistically significant (all P<0.05). The incidence of small for gestational age[7.8%(5/64 cases) vs.0(0/64 cases)], late preterm infants[25.0%(16/64 cases) vs.1.6%(1/64 cases)], low birth weight infants[20.3%(13/64 cases) vs.0(0/64 cases)], caesarean section rate[53.1%(34/64 cases) vs.31.2%(20/64 cases)] and the neonatal intensive care unit(NICU) admission[23.4%(15/64 cases) vs.1.6%(1/64 cases)] were higher than those of the control group, but the incidence of term infants was lower [70.3%(45/64 cases) vs.98.4%(63/64 cases)], and the differences were statistically significant (all P<0.05). Among the 15 neonates, there was only one neonate who was admitted to hospital 4 days after birth, while the other 14 newborns were all admitted within 2 hours after birth.Their average hospitalization time was (8.9±4.3)days.Among the 15 neonates, 1 case had congenital heart malformation and 6 cases suffered from infection.The average number of white blood cells, hemoglobin and platelet were (14.7±4.3)×10⁹/L, (170.6±21.4) g/L and (220±63.7)×10⁹/L, respectively.The first biochemical tests of the 15 newborns showed that 1 case had elevated alanine aminotransferase, 3 cases had elevated glutamic-oxalacetic transaminase, 1 case suffered from hypoglycemia and another one suffered from hyperglycemia.While albumin, cholesterol, triglyceride, urea nitrogen and creatinine were all in the normal range. Conclusions Maternal cancer and related therapy increase the incidence of premature, cesarean section and NICU admission of their offspring.Meanwhile, it can also affect the growth, hematologic system and liver function of some newborns.

Red blood cell transfusion is an important method to treat anemia of prematurity. HoWever,there are 3 areas of controversy:(1)complications associated With red blood cell transfusion in preterm infants;(2)indications of red blood cell transfusion in preterm infants;(3)Which kind of red blood cell products is more suitable for preterm infants. In recent years,With the deepening of research,these problems above have made some neW progress and they have been applied to clinic. The implementation of these ideas and measures makes the premature infants With anemia get reasonable treatment,and reduces incidence of complications associated With red blood cell transfusion in preterm infants,and improves the prognosis of those sick preterm infants. NoW,the neW progress of red blood cell transfusion in preterm infants Was revieWed.

Objective:To study the effects of maternal moderate and severe gestational thrombocytopenia (GT) and primary immune thrombocytopenia (ITP) on neonates.Method:From Jan 2018 to Dec 2019, pregnant women with platelet count <100×10 9/L during pregnancy admitted to our hospital were retrospectively reviewed. The infants were assigned into GT group and ITP group according to their mothers' diagnoses. The clinical outcomes were compared between the two groups. Result:Of 104 mothers with platelet count <100×10 9/L, 32 (30.8%) were diagnosed with ITP and 72 (69.2%) with GT. Gestational age (GA) of the ITP group was smaller than the GT group [(37.0±1.5) weeks vs. (38.0±2.0) weeks, P<0.05]. The maternal platelet count within 24 h before delivery (39×10 9/L vs. 86×10 9/L) and the lowest platelet count during pregnancy (17×10 9/L vs. 75×10 9/L) in the ITP group were both lower than the GT group, the differences were statistically significant ( P<0.001). The maternal platelet count after birth in ITP group were lower than the GT group (184×10 9/L vs. 277×10 9/L, P<0.01). Neonates in the ITP group have an increased tendency to develop neonatal thrombocytopenia (NT) than the GT group (43.8% vs. 6.9%, P<0.001). The platelet count on the first day after birth (92×10 9/L vs. 170×10 9/L) and the lowest platelet count (43×10 9/L vs. 103×10 9/L) of NT newborns in the ITP group were lower than the GT group ( P<0.05). No differences existed for the time needed reaching the lowest platelet count in NT newborns between the two groups [(3.5±1.2) d vs. (4.4±0.4) d, P>0.05]. Neither group had intracranial hemorrhage. Conclusion:Neonates born to pregnant mother with platelet count <100×10 9/L have a tendency to develop NT. The incidence of NT in neonates born to mothers with ITP is higher than GT, but the overall prognosis of the newborns is good.

Objective To investigate the effects of mothers suffering from disease on the preterm infants.Methods One hundred and eighty-seven premature neonates in accordance with inclusion criteria,who were admitted to the Department of Pediatrics,Peking University People's Hospital from January to December 2012,were chosen as study samples.The preterm infants were divided into 2 groups:mothers with pregnancy disease group (observation group) and mothers without pregnancy disease group (control group).Then the general condition,causes of preterm birth as well as complications of preterm infants in the 2 groups were compared.In addition,the main types of pregnancy diseases of mothers were also analyzed.Results The incidence of caesarean section delivery [71.8％ (84/117 cases) vs 52.9％ (37/70 cases)] and fetal distress [9.4％ (11 / 117 cases) vs 1.4％ (1/70 cases)] were higher in the observation group,the differences were statistically significant(x2 =6.878,P ＜ 0.01 ;x2 =5.246,P ＜ 0.05).However,the proportion of infants appropriate for gestational age in the observation group was less [76.0％ (89/117 cases) vs 88.6％ (62/70 cases),x2 =4.404,P ＜ 0.05].Chronic hypertension,pregnancy-induced hypertension,gestational diabetes and diabetes were the main types of pregnancy diseases of the mothers with preterm infants,accounting for 49.6％ (58/117 cases),23.0％ (27/17 cases),38.5％ (45/117 cases) and 14.5％ (17/117 cases),respectively.The ratio of premature birth due to pregnancy diseases was 51.3％ (60/117 cases) in the observation group,significantly higher than other causes.While compared with control group,the incidence of premature rupture of the fetal membrane was lower in the observation group[18.80％ (22/117 cases) vs 47.10％ (33/70 cases),x2 =16.94,P ＜ 0.01].Compared with the control group,the incidence of neonatal asphyxia [13.70％ (16/117 cases) vs 2.90％ (2/70 cases),x2 =5.892,P ＜ 0.05] and hypoglycemia [17.10％ (20/117 cases) vs 4.30％ (3/70 cases),x2 =6.661,P ＜ 0.05] were higher in the observation group,but the neonatal hyperbilirubinemia was lower[6.80％ (8/117 cases) vs 17.10％ (12/70 cases),x2 =4.87,P ＜ 0.05].Conclusions Hypertension and diabetes are the main types of pregnancy diseases of mothers with premature offsprings.Mothers suffering from pregnancy diseases can affect the fetus intrauterine growth.At the same time,it also increases the possibility of perinatal hypoxia,hypoglycemia and cesarean section.

Objective To investigate the perinatal independent risk factors and neonatal complications of discordant twins.Methods Clinical data of 152 (76 pairs) discordant twins and 552 (276 pairs) concordant twins were enrolled at the Obstetrics of Peking University People's Hospital from November 1,2011 to October 31,2016.The perinatal characteristics and the neonatal complications in 2 groups were analyzed and compared.Binary Logistic regression analysis was used to identify the independent risk factors associated with the occurrence of discordant twins.Results (1) The gestational age,the incidence of term infants and birth weight of the discordant twins were significantly lower than those of the concordant twins[(35.8 ±2.5) weeks vs.(36.7 ± 1.8) weeks,48.7％ vs.60.2％,(2 277.1 ± 575.7) g vs.(2 545.0 ± 413.4) g],and the differences were statistically significant (all P ＜ 0.05).The incidence of premature infants,the incidence of infants small for gestational age and the rate of transferring discordant twins to pediatric department were significantly higher than that of concordant twins (51.3％ vs.39.9％,40.8％ vs.13.2％,46.1％ vs.26.8％),and the differences were statistically significant (all P ＜ 0.05).(2) The incidence of neonatal asphyxia,neonatal respiratory distress syndrome,neonatal pneumonia,neonatal apnea,bronchopulmonary dysplasia,neonatal sepsis and neonatal intracranial hemorrhage were significantly higher than those of concordant twins (6.6％ vs.2.5％,7.2％ vs.3.1％,5.3％ vs.1.3％,9.2％ vs.3.3％,3.9％ vs.0.9％,3.3％ vs.0.7％,4.6％ vs.O.7％),and the differences were statistically significant(all P ＜ 0.05).(3) The birth weight in the twins with low body weight group was significantly lower than that in the twins with high body weight group [(1 926.7 ± 414.1) g vs.(2 618.7 ± 504.6) g],and the differences were statistically significant (P ＜ 0.05).The incidence of small for gestational age,the rate of conversion to pediatrics and the incidence of neonatal intracranial hemorrhage in the twins with low body weight group were significantly higher than those in the twins with high body weight group (65.8％ vs.6.6％,56.6％ vs.35.5 ％,9.2％ vs.0),and the differences were statistically significant (all P ＜ 0.05).(4) Logistic regression analysis showed that hypertensive disorder during pregnancy (OR =2.127,95％ CI:1.392-3.253) and gestational diabetes mellitus (OR =1.684,95％ CI:1.112-2.552) were independent risk factors for the occurrence of discordant twins.Conclusions Hypertensive disorder during pregnancy and gestational diabetes mellitus are independent risk factors for the occurrence of discordant twins,who are much more likely to develop various neonatal complications,particularly low-birth-weight infants.Timely surveillance and treatment of short-term complications and long-time follow-up are essential to discordant twins.

Objective:To investigate the effect of oral glucocorticoid dose on maternal and infant outcomes in female patients with systemic lupus erythematosus(SLE), thus providing reference for clinical work.Methods:Clinical data of pregnant women with SLE admitted to Department of Obstetrics, Peking University People′s Hospital from July 2015 to June 2020 were retrospectively analyzed.According to the daily oral glucocorticoid dose during pregnancy(equivalent converted to Prednisone), pregnant women were divided into 2 groups: ≤7.5 mg group(67 cases) and >7.5 mg group(74 cases). The maternal and fetal outcomes of the 2 groups were analyzed by t-test or χ2 test or Fisher′ s exact probability method. Results:The neonatal birth weight, birth length, white blood cell count and platelet count in ≤7.5 mg group were significantly higher than those in >7.5 mg group[(2 990.69±532.20) g vs.(2 734.57±608.35) g, (48.97±2.34) cm vs.(47.43±3.38) cm, (17.69±6.16)×10 9/L vs.(15.11±6.00)×10 9/L, (276.92±74.51)×10 9/L vs.(240.05±69.29)×10 9/L], while the incidence of low birth weight and neonatal transfer rate were significantly lower(13.85% vs.30.43%, 12.31% vs.33.33%) ( t/ χ2=2.587, 3.068, 2.354, 2.841, 5.301, 8.321, all P<0.05). Meanwhile, the incidence of maternal complications like hypertension disorders in pregnancy and gestational diabetes mellitus in the ≤7.5 mg group were lower than those in the >7.5 mg group, but the incidence of anemia and postpartum hemorrhage increased, although no significant differences were detected (all P>0.05). Conclusions:The overall maternal and fetal outcomes of patients with SLE with oral Prednisone ≤7.5 mg/d were better those medicated >7.5 mg/d, but the incidence of anemia during pregnancy and postpartum hemorrhage was higher.An individual monitoring and treatment should be concerned to improve the maternal and infant outcomes.

Objective:To preliminarily explore the association of pregnancy factors with cow's milk protein allergy in infants.Methods:This study was based on data from a subcohort of a study called ge-netic susceptibility to cow's milk allergy in Chinese children,including infants born in Peking University People's Hospital between March 1,2020,and December 31,2020.The infants were divided into a cow's milk protein allergy(CMPA)group and a control group according to whether they had developed cow's milk protein allergy at the age of 1 year.We retrospectively collected the clinical data of infants and their mothers before and during pregnancy,and analyzed the association of multiple factors during pregnancy with cow's milk protein allergy in infants.Results:A total of 278 infants were enrolled in this study,including 52 infants with CMPA and 226 infants without CMPA.Among them,there were 143 boys and 135 girls.The proportion of male infants in the CMPA group(69.2％)was higher than that in the control group(47.3％),and the difference was statistically significant(P=0.004).There were no significant differences in the distribution of birth weight,gestational age at birth,low-birth-weight in-fants,premature,umbilical cord entangle neck,and neonatal asphyxia between the CMPA group and the control group(P＞0.05).The proportion of mothers complicated with autoimmune diseases,anemia or antibiotics exposure during pregnancy in the CMPA group was higher than that in the control group,and there were statistical differences between the two groups(P＜0.05).There was no significant difference in the distribution of other pregnancy complications between the two groups(P＞0.05),such as eclamp-sia/preeclampsia,chronic hypertension/gestational hypertension,diabetes/gestational diabetes,thyroid diseases,and so on.There was no significant difference in the overall distribution of some blood routine indexes during pregnancy between the CMPA group and the control group(P＞0.05).Multivariate Lo-gistic regression analysis showed that male infant,mothers complicated with autoimmune diseases or ane-mia,antibiotic exposure during pregnancy were independent risk factors for cow's milk protein allergy.Conclusion:Male infant,mothers complicated with autoimmune diseases or anemia,antibiotic exposure during pregnancy were independent risk factors for cow's milk protein allergy.

Intracytoplasmic sperm injection (ICSI) is an important treatment option for male infertility at pre-sent.However, a few patients still suffer from repeated ICSI fertilization failure because their sperm is unable to activate oocytes.Artificial oocyte activation (AOA) technology can improve the fertilization rate, pregnancy rate, live birth rate, etc., but it remains unknown whether AOA has short- and long-term effect on offspring.In this article, recent literature about the effect of AOA technology on perinatal outcomes, genetics, physical development and neurological development of offspring was summarized.This paper aims to provide reference for reproductive medicine workers and pediatricians in clinical practice.