Along with the development of pediatric emergency technology, more preterm infants with extremely small gestational age and birth weight can survive, yet the long-term follow-up of their neuropsychological development needs to be focused. Language development of preterm infants is an important component of their intellectual development, which reflects the development of their nervous system. Studies about how language develops in preterm infants and what factors are relevant yield inconsistent results. This paper describes the factors influencing the language development of preterm infants, such as gestational age, birth weight and gender. It provides suggestions as to future research and clinical intervention for the language development of preterm infants.
Humans ; Infant, Newborn ; Infant, Premature ; growth & development ; Language Development ; Learning

OBJECTIVES: To establish a nomogram model for predicting the risk of death of very preterm infants during hospitalization. METHODS: A retrospective analysis was performed on the medical data of 1 714 very preterm infants who were admitted to the Department of Neonatology, the Third Affiliated Hospital of Zhengzhou University, from January 2015 to December 2019. These infants were randomly divided into a training cohort (1 179 infants) and a validation cohort (535 infants) at a ratio of 7∶3. The logistic regression analysis was used to screen out independent predictive factors and establish a nomogram model, and the feasibility of the nomogram model was assessed by the validation set. The area under the receiver operating characteristic curve (AUC), calibration curve, and decision curve analysis (DCA) were used to assess the discriminatory ability, accuracy, and clinical applicability of the model. RESULTS: Among the 1 714 very preterm infants, 260 died and 1 454 survived during hospitalization. By the multivariate logistic regression analysis of the training set, 8 variables including gestational age <28 weeks, birth weight <1 000 g, severe asphyxia, severe intraventricular hemorrhage (IVH), grade III-IV respiratory distress syndrome (RDS), and sepsis, cesarean section, and use of prenatal glucocorticoids were selected and a nomogram model for predicting the risk of death during hospitalization was established. In the training cohort, the nomogram model had an AUC of 0.790 (95%CI: 0.751-0.828) in predicting the death of very preterm infants during hospitalization, while in the validation cohort, it had an AUC of 0.808 (95%CI: 0.754-0.861). The Hosmer-Lemeshow goodness-of-fit test showed a good fit (P>0.05). DCA results showed a high net benefit of clinical intervention in very preterm infants when the threshold probability was 10%-60% for the training cohort and 10%-70% for the validation cohort. CONCLUSIONS A nomogram model for predicting the risk of death during hospitalization has been established and validated in very preterm infants, which can help clinicians predict the probability of death during hospitalization in these infants.
Cesarean Section ; Female ; Fetal Growth Retardation ; Hospitalization ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Infant, Premature, Diseases ; Nomograms ; Pregnancy ; Retrospective Studies

PURPOSE: This study was conducted to assess the effects of lights-out at nighttime on body weight, physiological variables, and behavioral status in premature infants and to provide basic data for applying lights-out at night time in premature infants. METHODS: Premature infants of over 32 weeks' corrected age were included in this study (January 2015-June 2015), and were allocated to two groups according to the lights-out at night for 5 hours: study group and control group. Lights-out was applied to the study group from midnight for five hours in a quiet environment. RESULTS: Fifty-two infants were included in the study: 26 in the study group and 26 in the control group. Growth rates of body weight, height, and head circumference were higher in the study group compared to the control group, but there were no statistical differences. In the physiological variables, heart rate decreased by 6.9 beats per minute in the study group, but it increased by 2.7 beats per minute in the control group (P<0.0001) during applied 5 hours at night. Anderson Behavioral State Score decreased in the study group compared to the control group (P=0.042). CONCLUSION: Lights-out at night decreased the heart rate and made the behavioral status more stable. To understand the effects of lights-out on long-term growth and development of premature infants at the highest risk of delayed growth and development, further studies with a larger number of premature infants are needed.
Body Weight* ; Circadian Rhythm ; Growth and Development ; Head ; Heart Rate ; Humans ; Infant ; Infant, Newborn ; Infant, Premature*

OBJECTIVETo study the effects of extensively hydrolyzed protein formula (eHF) on the feeding and growth in preterm infants through a multicenter controlled clinical study.

METHODSPreterm infants admitted to eight upper first-class hospitals in China between February 2012 and December 2013 were randomly selected. They were divided into two observation groups and two control groups. The first observation group consisted of preterm infants with a gestational age of <32 weeks, who were fed with eHF for 10-14 days after birth and then with standard preterm formula (SPF) until discharge. The second observation group consisted of preterm infants with a gestational age of 32-34 weeks, who were fed with SPF after birth, but were switched to eHF (7-14 days) if suffering feeding intolerance at 6-8 days after birth. The two control groups with corresponding gestational ages kept to be fed with SPF after birth. Clinical data were recorded to compare feeding condition, physical growth, blood biochemical indices, and major complications between different groups.

RESULTSA total of 328 preterm infants were enrolled. Preterm infants with a gestational age of <32 weeks in the observation group had a significantly shorter meconium evacuation time than in the corresponding control group (P<0.05). They also had significantly lower levels of serum total bilirubin at weeks 1 and 2 after birth compared with the control group (P<0.05). The observation group needed more time in reaching enteral nutrition (EN) basic energy uptake of 50 kcal/(kg·d), partial parenteral nutrition (PPN), hospitalization, and corrected gestational age at discharge compared with the controlled infants (P<0.05). There was no difference in the incidence of extrauterine growth retardation (EUGR) at discharge between the two groups (P>0.05). Preterm infants with a gestational age of 32-34 weeks in the observation group had significantly lower serum total bilirubin levels at 2 weeks after birth compared with the corresponding control group (P<0.05). They required more time in achieving EN basic energy and PPN than in the control group (P<0.05). There was no difference in the incidence of EUGR at discharge between the two groups (P>0.05).

CONCLUSIONSFor preterm infants, eHF can improve gastrointestinal motility, accelerate bilirubin metabolism and excretion and does not increase the incidence of EUGR.

OBJECTIVETo investigate the early intellectual developmental outcome of late preterm infants.

METHODSA total of 106 late preterm infants with a gestational age of 34-36weeks who were admitted to the neonatal ward between January 2012 and January 2015, cured, discharged, and regularly followed up at the outpatient service for high-risk children were enrolled as the preterm group. A total of 120 healthy full-term infants during the same period were randomly selected as the term group. Neonatal behavioral neurological assessment (NBNA) was performed for late preterm infants at a corrected gestational age of 40 weeks and full-term infants at a gestational age of 40 weeks. The Gesell Developmental Scale was used for late preterm infants at a corrected age of 3, 6, and 12 months and full-term infants at an age of 3, 6, and 12 months.

RESULTSThe preterm group had an NBNA score of <37 and a significantly lower NBNA score than the term group (P<0.05). At the corrected age of 3 months, the preterm group had significantly lower scores of gross motor, fine motor, and social competence than the term group (P<0.05). At the corrected age of 6 months, the preterm group had significantly lower scores of adaptability, gross motor, and fine motor than the term group (P<0.05). At the corrected age of 12 months, the preterm group had significantly lower scores of adaptability, gross motor, and social competence than the term group (P<0.05).

CONCLUSIONSLate preterm infants have early intellectual developmental delay. It is necessary to perform neurodevelopmental monitoring for late preterm infants.

There are various types of bioactive substances in human breast milk, such as active proteins, growth factors, cytokines, oligosaccharides, probiotics and cells. Many studies have shown that these bioactive substances in breast milk have important protective effects on infant growth and development, including anti-bacterial and anti-viral effects and the promotion of infant growth and development and immunologic maturation. They can also reduce the incidence rate of infectious diseases in infants, improve neural development in preterm infants, and reduce the risk of obesity and diabetes in future. However, there is still no clinical evidence for the effects of several active substances in breast milk, and their immunoregulatory mechanism remains unclear. Therefore, further studies are needed for clarification.
Bacteria ; Female ; Growth and Development ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Milk, Human ; Probiotics

PURPOSE: This prospective study aimed to examine the development of premature infants at 12 and 24 months and to explore the factors related to their development. METHODS: Of the 80 premature infants who were recruited, 52 participants at 12 months and 31 participants at 24months were included in this study. The development of the infants was examined using the Korean Bayley scale of infant development-II. Postnatal depression, husband's support, social support, mother-infant attachment, and the home environment were assessed using self-report questionnaires completed by the mothers and through the researcher's observations. RESULTS: There was significant difference between normal and delay group at psychomotor development at 12 months depending on social support at 6 months (t=2.03, p=.049). Mother-infant attachment at 6 months (r=.71,p < .001), 12 months (r=.37, p=.043), and 24 months (r=.40, p=.026), as well as social support (r=.38,p=.034) and the home environment (r=.41, p=.022) at 24 months, were correlated to mental development at 24 months. There was a significant positive correlation between mother-infant attachment at 6 months and psychomotor development at 24months (r=.40, p=.046). CONCLUSION: To reduce the risk of developmental delay and to promote healthy development in premature infants, early nursing interventions targeting mother-infant attachment, the home environment, and the mother’s social support structure are needed.
Depression, Postpartum ; Female ; Growth and Development ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Mothers ; Nursing ; Prospective Studies

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*

OBJECTIVETo explore the effect of aggressive nutritional support in early life on growth of preterm infants during hospitalization.

METHODTwo retrospective cohorts of preterm infants were compared; 81 infants of group A (born between January 1, 2005 and June 30, 2006) and 79 infants of group B (June 1, 2009 and November 30, 2010) with gestational age above 28 weeks and birth weight between 1000 g and 2000 g, transfered to NICU of PUMCH within 12 hours after birth, hospitalized for > or = 2 weeks, who were free of major congenital anomalies and survived to discharge were recruited. The comparison of enteral and parenteral nutrition, growth rate, biochemical indices during hospitalization between these both groups were made.

RESULTCompared to group A, group B was given greater volume of amino acid infusion on the 3(rd) and 7(th) day of life [2.00 (2.00, 2.50) g/kg vs 1.50 (1.50, 2.00) g/kg, 3.00 (2.00, 3.00) g/kg vs 2.00 (1.80, 2.60) g/kg, all P < 0.001], and Consumed more milk and total energy intake on the 3rd day of life [9.41(2.66, 18.74) ml/kg vs 14.47 (4.23, 30.77) ml/kg, P < 0.05, (64.87 ± 16.04) kcal/kg vs (55.62 ± 17.68) kcal/kg, P = 0.001]. Total energy intakes after a week of life were similar between the two groups. More infants received human milk fortifier in group B (62.8% vs 14.3%, P = 0.001). After stratification according to weight, both very low birth weight infants and infants with birth weight between 1500 g and 2000 g in group B grew more rapidly (P < 0.001). The percentage of growth retardation was increased after hospitalization in group A (65.4% vs 40.7%, P < 0.05), there were no statistically significant differences in group B. The mean Z scores at birth were comparable. The mean Z scores by discharge were higher in group B (-1.24 vs -1.54, P < 0.05). Serum albumin, prealbumin and urea values were similar in both groups at birth, but higher in group B after two weeks of life (P < 0.001). Before discharge, Serum albumin, prealbumin, and urea values in group B was higher (P < 0.001).

CONCLUSIONImprovements in nutritional practices in early life of preterm infants effectively enhanced the growth and improved the nutritional status of preterm infants during hospitalization.

Cerebral palsy (CP) is a permanent disorder in the development of movement and posture in the developing infant brain and is one of the major disabilities that result from extremely preterm birth. Early identification of possible neurodevelopmental injury offers the opportunity to deliver intervention at a very early age and thus prevent severe disability. The assessment of general movements (GMs), has emerged as a reliable and valid predictor of severe neurologic deficits in infants. This method is based on a visual Gestalt perception of the quality of GMs in the preterm and term periods, and postterm up to 5 months. The quality of "fidgety movements" is the most valuable marker for predicting neurologic outcomes.
Brain ; physiology ; Child Development ; Humans ; Infant, Newborn ; Infant, Premature ; growth & development ; Movement