Female ; Humans ; Infant, Newborn ; Infant, Newborn, Diseases ; etiology ; genetics ; Maternal-Fetal Relations

OBJECTIVES: To investigate the risk factors for necrotizing enterocolitis (NEC) in very preterm infants and establish a nomogram model for predicting the risk of NEC. METHODS: A total of 752 very preterm infants who were hospitalized from January 2015 to December 2021 were enrolled as subjects, among whom 654 were born in 2015-2020 (development set) and 98 were born in 2021 (validation set). According to the presence or absence of NEC, the development set was divided into two groups: NEC (n=77) and non-NEC (n=577). A multivariate logistic regression analysis was used to investigate the independent risk factors for NEC in very preterm infants. R software was used to plot the nomogram model. The nomogram model was then validated by the data of the validation set. The receiver operating characteristic (ROC) curve, the Hosmer-Lemeshow goodness-of-fit test, and the calibration curve were used to evaluate the performance of the nomogram model, and the clinical decision curve was used to assess the clinical practicability of the model. RESULTS: The multivariate logistic regression analysis showed that neonatal asphyxia, sepsis, shock, hypoalbuminemia, severe anemia, and formula feeding were independent risk factors for NEC in very preterm infants (P<0.05). The ROC curve of the development set had an area under the curve (AUC) of 0.833 (95%CI: 0.715-0.952), and the ROC curve of the validation set had an AUC of 0.826 (95%CI: 0.797-0.862), suggesting that the nomogram model had a good discriminatory ability. The calibration curve analysis and the Hosmer-Lemeshow goodness-of-fit test showed good accuracy and consistency between the predicted value of the model and the actual value. CONCLUSIONS Neonatal asphyxia, sepsis, shock, hypoalbuminemia, severe anemia, and formula feeding are independent risk factors for NEC in very preterm infant. The nomogram model based on the multivariate logistic regression analysis provides a quantitative, simple, and intuitive tool for early assessment of the development of NEC in very preterm infants in clinical practice.
Asphyxia/complications* ; Child ; Enterocolitis, Necrotizing/etiology* ; Female ; Fetal Growth Retardation ; Humans ; Hypoalbuminemia ; Infant ; Infant, Newborn ; Infant, Newborn, Diseases ; Infant, Premature ; Infant, Premature, Diseases/etiology* ; Nomograms ; Sepsis/complications*

Female ; Humans ; Infant, Newborn ; Infant, Premature ; Infant, Premature, Diseases ; etiology ; Male ; Premature Birth ; Risk Factors

OBJECTIVETo investigate the risk factors for preterm birth and complications in late preterm infants.

METHODSThe clinical data of 287 late preterm infants were retrospectively studied. Two hundred and eighty-eight term infants served as the control group. Logistic regression analysis was used to identify risk factors associated with late preterm birth. The common complications in late preterm infants were investigated.

RESULTSSeveral significant risk factors for late preterm birth were identified by logistic regression analysis: twin pregnancy, gestational diabetes mellitus, eclampsia or preeclampsia, placenta previa, placental abruption and premature rupture of membranes. The duration of hospitalization in late preterm infants was longer than that in term infants. The complications were common in late preterm infants, with a high prevalence of anemia, aspiration pneumonia, hypoglycemia and intracranial hemorrhage.

CONCLUSIONSThe late preterm infants are much more likely to suffer various complications. It is important to reduce the incidence of late preterm births by decreasing perinatal risk factors above mentioned.

Adult ; Female ; Humans ; Infant, Newborn ; Infant, Newborn, Diseases ; etiology ; Logistic Models ; Male ; Pregnancy ; Premature Birth ; etiology ; Retrospective Studies ; Risk Factors

Intussusception is an interesting condition and is one of the most common causes of intestinal obstruction in the infant. We experienced a case of neonatal intussusception in a two-day-old male. The patient developed bloody stool, without a history of vomiting-after passing meconium, on the second day of life. Diagnosis of ileo-cecal type intussusception, which was induced by congenital polyp, was confirmed by exploratory laparatomy performed on the 4th day of life. The polyp was found at the proximal portion of the ileum, 45 cm from the ileo-cecal valve. In Korea a 40 day old patient was the youngest previously reported. We have presented this case with a review of the literature.
Human ; Ileum* ; Infant, Newborn ; Infant, Newborn, Diseases/etiology* ; Intestinal Polyps/complications ; Intestinal Polyps/congenital* ; Intussusception/etiology* ; Male

OBJECTIVES: To study the effect of gut microbiota on hematopoiesis in a neonatal rat model of necrotizing enterocolitis (NEC). METHODS: Neonatal Sprague-Dawley rats were randomly divided into a control group and a model group (NEC group), with 6 rats in each group. Formula milk combined with hypoxia and cold stimulation was used to establish a neonatal rat model of NEC. Hematoxylin and eosin staining was used to observe the pathological changes of intestinal tissue and hematopoiesis-related organs. Routine blood tests were conducted for each group. Immunohistochemistry was used to observe the changes in specific cells in hematopoiesis-related organs. Flow cytometry was used to measure the changes in specific cells in bone marrow. 16S rDNA sequencing was used to observe the composition and abundance of gut microbiota. RESULTS: Compared with the control group, the NEC group had intestinal congestion and necrosis, damage, atrophy, and shedding of intestinal villi, and a significant increase in NEC histological score. Compared with the control group, the NEC group had significantly lower numbers of peripheral blood leukocytes and lymphocytes (P<0.05), nucleated cells in the spleen, thymus, and bone marrow, and small cell aggregates with basophilic nuclei in the liver (P<0.05). The NEC group had significant reductions in CD71⁺ erythroid progenitor cells in the liver, CD45⁺ lymphocytes in the spleen and bone marrow, CD3⁺ T lymphocytes in thymus, and the proportion of CD45⁺CD3^-CD43⁺SSC^hi neutrophils in bone marrow (P<0.05). There was a significant difference in the composition of gut microbiota between the NEC and control groups, and the NEC group had a significant reduction in the abundance of Ligilactobacillus and a significant increase in the abundance of Escherichia-Shigella (P<0.05), which replaced Ligilactobacillus and became the dominant flora. CONCLUSIONS Multi-lineage hematopoietic disorder may be observed in a neonatal rat model of NEC, which may be associated with gut microbiota dysbiosis and abnormal multiplication of the pathogenic bacteria Escherichia-Shigella.
Rats ; Animals ; Enterocolitis, Necrotizing/etiology* ; Gastrointestinal Microbiome ; Rats, Sprague-Dawley ; Animals, Newborn ; Infant, Newborn, Diseases

Brain Stem ; physiology ; Humans ; Infant, Newborn ; Infant, Newborn, Diseases ; etiology ; Movement Disorders ; etiology ; Myoclonus ; etiology ; Reflex, Abnormal ; Reflex, Startle ; Tremor ; etiology

OBJECTIVETo investigate the effect of advanced maternal age on birth defects and postnatal complications of neonates.

METHODSAmong the 1 109 neonates who were born at The First People's Hospital of Yunnan Province between January 2014 and December 2015, 536 neonates whose mothers were aged ≥35 years were enrolled as advanced age group and 573 neonates whose mothers were aged <35 years were enrolled as appropriate-age group. The incidences of the comorbidities in pregnancy, fetal intrauterine distress, neonatal birth defects, and postnatal complications were compared between the two groups. A univariate logistic regression analysis was performed to analyze the effect of advanced maternal age on neonatal comorbidities during perinatal period.

RESULTSCompared with the appropriate-age group, the advanced age group had significantly higher rate of caesarean section and incidence rates of multiple birth, gestational diabetes, pregnancy-induced hypertension, in vitro fertilization, and fetal intrauterine distress (P<0.01). The neonates in the advanced age group had a significantly higher incidence rate of cleft lip and palate and a significantly lower rate of skeletal dysplasia than in the appropriate-age group (P<0.05). Advanced maternal age was the risk factor for fetal intrauterine distress (OR=2.27, 95%CI: 1.33-3.88, P=0.003), neonatal resuscitation (OR=1.66, 95%CI: 1.19-2.31, P=0.003), and intracranial hemorrhage (OR=2.70, 95%CI: 1.21-6.04, P=0.02).

CONCLUSIONSThe women of maternal advanced age have higher incidence rates of pregnancy comorbidities than those of appropriate age, and the neonates born to the mothers of advanced maternal age have a higher incidence rate of cleft lip and palate. Advanced maternal age may increase the risks of fetal intrauterine distress, neonatal resuscitation, and intracranial hemorrhage.

Adult ; Cerebral Hemorrhage ; etiology ; Cesarean Section ; Congenital Abnormalities ; etiology ; Female ; Humans ; Infant, Newborn ; Infant, Newborn, Diseases ; etiology ; Logistic Models ; Maternal Age ; Middle Aged ; Pregnancy ; Pregnancy Complications ; etiology

Colonic Diseases ; diagnosis ; etiology ; surgery ; Female ; Humans ; Infant, Newborn ; Intestinal Perforation ; diagnosis ; etiology ; surgery ; Male

Female ; Fetal Diseases ; etiology ; Hemangioma ; complications ; Humans ; Infant, Newborn ; Splenic Rupture ; etiology ; Thrombocytopenia ; complications