Objective To explore the clinical characteristics and outcome of neonates transferred by different ways. Method A total of 1 027 neonates transferred to neonatal intensive care unit(NICU)of our hospital from July 2009 to July 2010 were analyzed prospectively. They were divided into three groups: twoway transport(TWT),hospital-aided one-way transport(HAT)and self-help one-way transport(SHT).The conditions at admission and discharge and pre-hospital care of the neonates were compared between the groups. The data were statistically analyzed with square tests, variance analysis and Mann Whitney U test. Results The median ages of TWT,HAT, and SHT groups at admission were 0.46 d,0.33 d and 5 d respectively. The TWT and HAT neonates had smaller gestational age and birth weight than SHT ones, had more severe conditions and cost more,and the differences were significant(P<0.05).Significant differences existed in all emergency treatment except in warming measures(x2=96.855～103.863,P<0.05).The cure percentage at discharge was the highest in SHT group,and differences in treatment results of three groups were significant(Z=-1.987 to-5.347,P<0.05).Conclusions The TWT and HAT neonates have smaller gestational age,ages at admission and birth weight than SHT ones,have more severe conditions,cost more and lower cure percentage at discharge than SHT ones.

Objective To explore the death risk factors of preterm infants with respiratory distress syndrome (RDS).Methods A retrospective analysis of 66 preterm infants with severe RDS,who admitted to our NICU between January 2010 and December 2011.The patients were divided into the death group and survival group according to the ending.Results There were a total of 24 cases died (36.36％).The death group's mechanical ventilation time,the median of base excess,the minimum median of pH,PaO2/FiO2,average gestational age,average birth weight,1 minute Apgar score and 5 minute Apgar score were all lower than those of survival group (P ＜ 0.05).In death group,the median duration of FiO2 ＞ 60％,intrauterine distress,polyembryony,sore for neonatal acute physiology perinatal extension version Ⅱ (SNAPPE-Ⅱ) score were all higher than those of survival group (P ＜ 0.05),but the mechanical ventilation complications had no difference between the two groups (P ＞ 0.05).Further Logistic regression analysis showed that independent risk factors were birth weight,1 minute Apgar score and SNAPPE-Ⅱ score,OR were 0.990,0.141 and 1.240 respectively.Receiver operating characteristic analysis of the ability of SNAPPE-Ⅱ score predicting death risk showed the area under curve was 0.86,the difference was statistically significant compared with 0.5 (P =0.000).Death risk prediction showed that the demarcation point SNAPPE-Ⅱ score =24.50 corresponded to the maximum (Youden index =0.70) correct prediction effect.Condusion Independent risk factors of died from severe RDS are birth weight,1 minute Apgar score and SNAPPE-Ⅱ scores; SNAPPE-Ⅱ score predicts risk of death from severe RDS accuracy is medium,equal to 24.50 is the best accuracy to the death risk prediction.

Objective To assess the incidences of intrauterine growth restriction (IUGR) and extrauterine growth restriction(EUGR) in premature infants with respiratory distress syndrome (RDS) and early nutritional efficiency on EUGR.Methods Data of 70 infants with RDS admitted in neonatal intensive care unit were reviewed.According to the weight when a premature infant was discharged,all subjects were divided into EUGR group(48 cases) and non-EUGR group(22 cases).The difference of two groups in terms of basic situation,peripartum factors,nutritional support,treatment measures and complications were compared.Results Assessing by weight,the incidence of IUGR and EUGR was 12.86％ (9/70)and 60.00％ (42/70)respectively.The differences in birth weight [(1 666.10 ±440.16) g vs (2 108.20 ±552.81) g],head circumference at birth [(28.81 ± 2.65) cm vs (30.48 ± 2.39) cm],IUGR,multiple pregnancy (16 cases vs 3 cases),cesarean delivery (29 cases vs 7 cases) were considered statistically significant (P ＜ 0.05),and there were no stastitically significant difference in gestational age,nutritional support,mechanical ventilation and complications (P ＞ 0.05).Conclusion The EUGR is related with IUGR,multiple pregnancy,cesarean delivery,low birthweight,low birth head circumference.The short time nutrition interventions can't improve EUGR in RDS.

Objective To analyze the main causes of early neonatal death in Qingdao Women &Children's Hospital in the latest 10 years.Methods The medical records of early neonatal death in the Qingdao Women&Children’s Hospital from January 2002 through December 201 1 were analyzed.Results A total of 16 314 neonates were available to study,and 525 of them died.The mortality of early neonatal death within a week after birth was 77.71% (408 cases),including 214 premature infants and 194 mature infants.A comparison of mortality between the first 5-year and the second 5-year showed that the underlying trend of mortality was downward (P <0.05 ).The mortalities of early neonatal death within 1 day,3 days, and 4-7 days after birth were 1 10 cases (27.00%),192 cases (47.06%),and 106 cases (25.98%), respectively,and most of the neonates died within 3 days after birth;and the number of severe neonates died within 24 hours was higher than that in other two groups (P <0.01).The leading causes of early neonatal death in 10 years were:preterm birth-related factors (97 cases,23.78%),severe asphyxia (91 cases, 22.3%),congenital malformations (66 cases,16.2%).From 2002 to 2006,the top three main causes of early newborn death were severe asphyxia,congenital malformations and acute respiratory distress syndrome (ARDS),whereas from 2007 to 2011,the leading causes of death were ARDS,severe asphyxia,and congenital malformations.In comparison of early neonatal death between different gestational ages,preterm infants’death occurred mainly in 32 weeks,accounting for 26.72%.Conclusions In our hospital,the early neonatal mortality was decreased in the latest 10 years,and majority of deaths occurred within 3 days after berth,and preterm infants’death occurred mainly in 32 weeks.The leading causes of overall early neonatal death in order of frequency were premature birth,severe asphyxia and congenital malformations,but in later 5 years this order of leading causes changed.

Objective To investigate pulmonary function of tidal respiration in late premature infants with non-mechanical ventilation treatment at corrected gestational age of full term. Methods A total of 26 late premature infants with non-mechanical ventilation treatment at corrected gestational age of full term were collected from Qingdao Women and Children′s Hospital between April and December 2013,and saved as the late premature infant group. Also, a total of 31 full term infants with hyperbilirubinemia or neonatal ABO hemolytic disease were recruited and treated as the full term group. Then the parameters of pulmonary func-tion of tidal respiration were compared between the two groups. The late premature infant group was equally allocated into extrauterine growth retardation and non-extrauterine growth retardation groups according to the increase in weight and the ratio of time to peak tidal expiratory flow and total expiratory time(TPEF/TE) and the ratio of expiratory volume at peak tidal expiratory flow and total expiratory volume( VPEF/VE) were respectively compared in these two groups. Another correlation analysis between body weight and TPEF/TE was carried out in the non-extrauterine growth retardation group. Results (1)Gestational age difference had no significant significance between late premature infant group and full term group ( P <0. 05 ) . The body weight[(2. 39 ± 0. 44)kg vs. (3. 21 ± 0. 43) kg] and height[(46. 51 ± 3. 22) cm vs. (50. 16 ± 2. 14) cm] in late premature infant group were still lag behind that in full term group and the difference had significant significance(P<0. 05,respectively). (2)The comparison of parameters of pulmonary function of tidal respi-ration:the TPEF/TE [ ( 41. 74 ± 10. 94 )% vs. ( 48. 17 ± 11. 79 )%] , VPEF/VE [ ( 42. 66 ± 9. 66 )% vs. (48. 31 ± 9. 94)%],VPEF[(8. 02 ± 2. 85) ml vs. (10. 23 ± 3. 56) ml] and minute ventilation[(0. 76 ± 0. 23) L/min vs. (1. 00 ± 0. 44) L/min] in late premature infant group were significantly lower than those in full term group(P<0. 05,respectively). (3)The TPEF/TE and VPEF/VE all had significant significance in both late premature infant group and full term group(late premature infant group:r=0. 958,P=0. 000; full term group:r=0. 950,P=0. 000). (4)The TPEF/TE and VPEF/VE in non-extrauterine growth retardation group were closer to those in full term group. The TPEF/TE and VPEF/VE in extrauterine growth retardation group were lower than those in non-extrauterine growth retardation group(t= -2. 775,-2. 109,P=0. 011, 0. 047). Conclusion Airway(especially small airway) resistance of late preterm infant group is higher than that of term infants. Extrauterine growth retardation influences the airway(especially small airway) resist-ance.

Objective To explore how the severity of periventricular-intraventricular hemorrhage (PIVH)impact on physique and neurodevelopment in premature infants.Methods A total of 80 preterm infants with PIVH admitted to NICU of Qingdao Women and Children's Hospital from December 2013 to June 2015 were eligible.According to the Papile classification,the premature infants were divided into 4 groups.They were grade Ⅰ PIVH group,grade Ⅱ PIVH group,grade Ⅲ PIVH group and grade Ⅳ PIVH group.The infants with grade Ⅰ PIVH and grade Ⅱ PIVH belong to the low-grade PIVH group.The infants with grade Ⅲ PIVH and grade Ⅳ belong to the severe-grade PIVH group.All of them were regularly followed up for 12 months.Neurodevelopmental outcomes of infants at 6 and 12-month correction age were assessed by using the 20 items neuromotor assessment applying for 0-1 year old and the Bayley scales of infant development-Ⅱ.The differences in physical and neurophysical development of premature infants among 4 groups were compared.Results There were no significant differences in physical growth indicators such as body weight,body length and the incidence of weight growth retardation among 4 groups (all P＞0.05).The incidence of neurobehavioral abnormalities in infants with grade Ⅲ-Ⅳ PIVH was significantly higher than that of infants with grade Ⅰ-Ⅱ PIVH at 12-month correction age (21.05％ vs 3.28％,x2 =4.284,P=0.038).Physical development index(PDI) of grade Ⅰ-Ⅱ PIVH infants was significantly higher than that of grade Ⅲ-Ⅳ PIVH infants at 6-month correction age(F=11.500,P＜0.05).At 12-month correction age,grade Ⅰ-Ⅱ PIVH infants showed a significant higher mental development index(MDI) scores and PDI scores than those of grade Ⅲ-Ⅳ PIVH infants(F=14.227,16.515,all P＜0.05).Of the 80 cases assessed,infants with grade Ⅲ-Ⅳ PIVH had significantly higher rates of cerebral palsy(21.05％ vs 1.64％,x2 =6.300,P=0.012) and developmental delay (26.32％ vs 4.92％,x2=5.185,P=0.023) compared with grade Ⅰ-Ⅱ PIVH infants.Conclusions The severe PIVH can have negative effect on the neurodevelopmental outcomes of preterm infants and might induce mental retardation,cerebral palsy and other neurodevelopmental disabilities.Therefore,the regular follow-up and early intervention in preterm infants with PIVH should be implemented to improve the quality of their lives.

Objective To analyze the incidence and the risk factors of retinopathy of prematurity (ROP) among the multiple and single gestations births.Methods A prospective control study was applied to the research.The preterm infants were selected that from September 2013 to December 2015 in neonatology department of our hospital.They were divided into multiple gestations group (52 cases) and single birth infants group (600 cases).RetCam Ⅲl retina camera and binocular indirect ophthalmoscope video were used to screening the ocular fundus.The cure rate of the two groups was compared with chi-square test.Results The incidence of ROP in multiple gestations group (32.69％) was higher than single birth infants group (20.83％) (P =0.047).There was significant difference about the multiple and single gestations births in ≤ 30 weeks (P =0.040),and there was no statistically significant difference in ＞ 30 weeks (all P ＞0.05).With the increase of birth weight,the ROP detection rate of two groupa was reduced.There was no statistically significant difference about different birth weight among the two groups (all P ＞ 0.05).The oxygen usage of ＞ 5 days ROP detection rate was higher than 5 days or less in the two groups (P =0.025,0.001).There was no significant difference in ROP detection rate between two groups with ≤5 d oxygen usage.There was significant difference about the multiple and single gestations births in oxygen usage of ＞ 5 days (P =0.020).Multivariate analysis found that multiple gestations and small gestational age were risk factors for ROP.Conclusion The smaller gestational age,the lower birth weight,and the longer oxygen therapy with the preterm infants,the higher the incidence of ROP.The number of different gestational is also the influences factors of ROP.Multiple gestations overall incidence of ROP is higher than the single birth infants.The smaller the gestational age and the longer oxygen usage,multiple gestations incidence of ROP is higher than single gestation in different births.However,there is no relationship in different birth weight among the multiple and single gestations.

Objective:To investigate the effect of exposure to histological chorioamnionitis(HCA) on premature infants with respiratory distress syndrome(RDS)complicated with bronchopulmonary dysplasia(BPD).Methods:The clinical data of premature infants with gestational age<32 weeks and survival>14 days who were born in the department of obstetrics and admitted into NICU at Qingdao Women and Children′s Hospital from January 2018 to December 2020 were collected.According to placental pathology, they were divided into positive HCA + positive RDS group(observation group)and negative HCA + positive RDS group(control group). T-test, rank sum test and χ2 test were used to analyze the occurrence and clinical characteristics of BPD between the two groups.For premature infants with positive HCA who were diagnosed as BPD, Spearman rank correlation was used to analyze the correlation between HCA stage and BPD severity. Results:There were a total of 162 premature infants with RDS.The average gestational age at birth was 29.29(28.29, 30.43) weeks, and the average birth weight was 1.32(1.13, 1.55)kg; the incidence of BPD was 69.8%(113/162), and the mortality rate of BPD was 2.7%(3/113). There were 114 cases in the observation group and 48 cases in the control group.The incidence of BPD in the observation group was 76.3%(87/114), which was higher than that in the control group(54.2%, 26/48), and the difference was statistically significant( P<0.05). Further study of 87 premature infants with positive HCA who were diagnosed as BPD showed that, the correlation between the stage of HCA and the severity of BPD had not been confirmed( rs=0.062, P=0.571). Serum C-reactive protein before the mother used antibiotics and procalcitonin on the first day after birth in the observation group were higher than those in the control group, and the differences were statistically significant( P<0.05). Among 113 premature infants with RDS who were diagnosed as BPD, the time of antibiotic use, length of stay in intensive care unit and hospitalization cost in positive HCA group were higher than those in negative HCA group, and the differences were statistically significant( P<0.05). Conclusion:HCA exposure will increase the risk of BPD in premature infants with RDS.In addition, HCA also increases the intake period of antibiotics, length of stay and cost of intensive care unit in premature infants with BPD.

Objective To investigate pulmonary function in terms of tidal respiration and the influencing factors on it in ＜ 34 weeks premature infants with RDS at corrected gestational age of 40 weeks.Methods A total of 49 of ＜ 34 weeks premature infants with RDS (RDS group) and 36 of ＜ 34 weeks premature infants without RDS (non-RDS group) followed throughout entire twelve months were collected fromn December 2013 to October 2015.Of them,35 RDS patients and 20 non-RDS patients had the pulmonary function examination.A total of 26 full term infants with hyperbilirubinemia (full term group) were recruited for comparison study.The differences in parameters of tidal respiration were compared among the three groups.The RDS patients were further divided into the mild RDS subgroup and severe RDS subgroup according to the severity of illness.Result ①The TPEF [(0.17 ± 0.04) s vs.(0.23 ± O.09) s],VPEF [(6.74±2.70) mLvs.(9.33±2.92) mL],TPEF/TE [(29.06±4.21)％ vs.(38.27± 7.16) ％],VPEF/VE [(32.54 ± 4.43) ％ vs.(39.64 ± 5.88) ％] in RDS group were significantly lower than those in full term group (P ＜0.05).The TPEF [(0.19 ±0.06) s vs.(0.23 ±0.09) s],TPEF/TE [(30.31 ±11.53)％ vs.(38.27±7.16)％],VPEF/VE [(34.39±8.44)％ vs.(39.64±5.88)％] in non-RDS group were significantly lower than those in full termn group (P ＜ 0.05).The TPEF,TPEF/TE,VPEF/VE in RDS group were lower than those in non-RDS group,but the differences were not significant (P ＞ 0.05).②The TPEF,VPEF,TPEF/TE,VPEF/VE in mild RDS group were higher than those in severe RDS group,but the differences were.not significant (P ＞ 0.05).③ Logistic regression analysis indicated that the gestational age was the protective factor of pulmonary function in premature infants with RDS.Conclusions Small airway resistance in ＜ 34 weeks premature infants with RDS is higher than that in full term infants.There was no significant difference in pulmonary function between RDS premature infants and non-RDS premature infants.The gestational age was the influencing factor of pulmonary function in premature infants with RDS.

PURPOSE: To observe changes in audiology, intellectual development, behavior development, and physical growth during systematic follow-up of infants with asymptomatic congenital human cytomegalovirus (HCMV) infection. MATERIALS AND METHODS: Fifty-two infants diagnosed with asymptomatic congenital HCMV infection from July 2003 to July 2007 served as the infection group, and 21 healthy infants served as the control group. All infants were confirmed to have HCMV infection by Fluorescent Quantative polymerase chain reaction (FQ-PCR). In both the infection and control groups, the neonates and infants at 3 months, 6 months, and 1 year of age underwent examinations. RESULTS: 1) 20 items of National Black Nurses Association (NBNA) scores of neonates 12-14 days after birth in 2 groups were 38.3 +/- 1.95 and 38.5 +/- 2.29, without significant differences. 2) Auditory test: 50 ears of 25 cases in the infection group showed abnormal auditory thresholds in V waves with an abnormal rate of 14%, while no abnormalities were found in 21 cases in the control group. 3) Mental and psychomotor development index scores in the control group (107.49 +/- 11.31 and 107.19 +/- 10.98) were compared with those in 41 asymptomatically infected infants at 1 year of age (107.21 +/- 9.96 and 108.31 +/- 11.25), and no statistically significant difference was noted. CONCLUSION: 1) An elevated threshold in the V wave was present in asymptomatically infected infants, but could not be detected through otoacoustic emission (OAE) screening. 2) Either in the neonatal or infant periods, asymptomatic congenital HCMV infection did not have a significant influence on nervous behavior or on physical and intellectual development.
Auditory Threshold ; *Child Development ; Cytomegalovirus Infections/*complications/congenital ; Female ; Humans ; Infant ; Infectious Disease Transmission, Vertical ; Male ; Neuropsychological Tests ; Psychomotor Performance