Health Status Of Infants Research Articles

Impact of Maternal Daily Oral Low-Dose Vitamin A Supplementation on the Mother-Infant Pair: A Randomised Placebo-Controlled Trial in China.

Background: The nutritional status of vitamin A in lactating mothers and infants is still not optimistic. Due to the dietary habits and dietary restrictions of postpartum customs in China, vitamin A supplementation has been advocated as a potential strategy to improve vitamin A status of lactating mothers with inadequate dietary vitamin A intake. Existing clinical trials are limited to single or double high-dose maternal administrations. However, in China, vitamin A supplements are readily available in the form of daily oral low-dose supplements, and the effect of these is unknown. This study aimed to evaluate the effects of daily oral low-dose vitamin A supplementation on the retinol levels in the serum and breast milk of lactating mothers and the health status of infants in China. Methods: Lactating mothers who met the inclusion criteria and planned to continue exclusive breastfeeding were randomly assigned to receive either daily oral vitamin A and D drops (one soft capsule of 1800 IU vitamin A and 600 IU vitamin D2), or a matching placebo for 2 months. Before and after the intervention, dietary intake was investigated by instant photography, and the retinol concentration in maternal serum and breast milk was determined by ultra-high performance liquid chromatography-tandem mass spectrometry. During the trial, the health status of infants was diagnosed by a paediatrician or reported by lactating mothers. A total of 245 participants completed the study, with 117 in the supplementation group and 128 in the control group. Results: After the 2-month intervention, maternal serum retinol concentrations increased in the supplementation group with no change in the control group. Although breast milk retinol concentrations decreased significantly in both groups, the decrease in the supplementation group was significantly lower than that in the control group. However, maternal vitamin A supplementation was not associated with a lower risk of infant febrile illness, respiratory tract infection, diarrhoea, and eczema. Conclusions: Daily oral low-dose vitamin A supplementation is helpful in improving maternal vitamin A status, despite having no effect on infant health status through breast milk.

Nursing of prematurely born children: indicators of the effectiveness

The study and monitoring of international indicators of the health status of premature infants is the current vector of scientific research in neonatology.Objective. To assess the effectiveness of the nursing technologies of premature babies in the Republic of Belarus based on the analysis of long-term indicators of morbidity, mortality and survival of the infants with extremely low body weight.Material and methods. Statistical reports data were used for a retrospective analysis of epidemiological indicators for the period of 2002–2018.Results. The proportion of premature infants in the Republic of Belarus was stabilized at 4,2–4,5% increase in the absolute numbers, including those born weighing less than 1500 g. The ratio of the absolute number of alive and stillborn infants with extremely low body weight is many times higher than the initial values (p<0,05). The survival rate of infants with a body weight of 500–999g up to 1 year increased 2 times to the maximum level in 2018 (81,5%). There was an increase in the overall incidence of premature children in 2002–2010 (p<0,05) and a decrease by 2016 (p=0,001), including those born with a body weight of 500–999 g. Respiratory distress syndrome, intrauterine hypoxia and asphyxia during childbirth, an increase in the frequency of infections specific to the perinatal period (p <0,05) were registered more often. Among the children born with a body weight of 500–999 g, the incidence of congenital pneumonia for the period 2002–2009 increased to a maximum level of 263,4 ‰ (p <0,05) with a twofold decrease by 2018. The republican mortality rate of premature babies was stabilized at the level of 0,95 ‰ in the last 9 years, while the indicator was decreased 5 times among children weighing 500–999 g.Conclusion. The assessment of the long-term dynamics of the main indicators of the health status of premature infants in the Republic of Belarus testified to the effectiveness of a complex of organizational and medical measures for their nursing.

Assessment of the health status of infants born from women of the late reproductive period

Objective.To assess the condition of newborns from women of the late reproductive period (LRP), depending on the parity of births.Material and methods.The authors examined 130 pregnant women and their 130 newborns. Group I consisted of 60 primiparouswomen of late reproductive period and their 60 newborns, Group II included 40 multiparous women of the late reproductive periodand their 40 newborns, Group III (control group) consisted of 30 healthy pregnant women aged from 18 to 25 years and their 30newborns. The authors performed a retrospective analysis of the gestation course and perinatal outcomes. Ultrasound and neurosonography were used among the instrumental research methods.Results.Women of the late reproductive period gave birth to children in a state of asphyxia twice more often, who develop neurologicaldisorders 1,5 times more often and complex postnatal adaptation and disorders of the perinatal period are twice more likely. Amongwomen of the late reproductive period, primiparous women gave birth to children with the most severe disorders.Conclusion.The high incidence of neurological diseases in children born from women of the late reproductive period is associatedwith age-related changes in their germ cells, the implementation of assisted reproductive technologies, and the intake of hormonaldrugs in early pregnancy. The data obtained should be taken into account by obstetricians in the course of pregnancy in women of latereproductive age; they should be included in the group of high risk of developing neurological disorders in children.

Determinant of Mother's Health Promotional Measures Practice of Infant with Age 6-12 Months in a Tertiary Hospital of Nepal.

Background Promotion of health is vital for the optimal growth and development of every infant. Globally, many infants died due to common problems such as diarrhoea and respiratory infection; most of these problems are related to inadequate breast feeding, improper complimentary feeding, lack of immunization, and home accident. Infant and child health status depends upon mothers' knowledge and practice regarding health promotional measures. This study aimed to determine practice and its determinants regarding health promotional measures of infant with 6–12 months age amongst the mothers attending Pediatrics Outpatient Department of Universal College of Medical Science and Teaching Hospital, Bhairahawa, Rupandehi, Nepal. Methods Hospital-based cross-sectional study was conducted in Universal College of Medical Science, Bhairahawa, Rupandehi, Nepal, among 414 mothers attending pediatrics outpatient department from September 2019–March 2020. Purposive sampling technique was used to select mothers of infants aged 6–12 months. Bivariate analysis was used primarily to assess the association between dependent and independent variables. Variables which were associated in bivariate analysis with p < 0.05 were entered into a multivariable logistic regression model to identify associated factors of health promotional measures. The goodness of fit of multivariate logistic regression was checked by Nagelkerke R square and variation inflation factor. Results The mean age and family size was 25.89 ± 4.81 years and 5.94 ± 2.48, respectively. A total of 71.5% mothers have good practice of health promotional measures. Mothers from Dalit caste (adjusted odds ratio = 0.04, confidence interval: 0.005–0.30), mothers with below school leaving certificate education (AOR = 0.08, CI: 0.02–0.27), fathers engaged in nonagricultural work (AOR = 7.21, CI: 2.59–20.11), birth space of index child greater than 2 years (AOR = 12.88, CI: 3.49–47.58), and family monthly income greater than 20000 Nepalese rupees (AOR = 3.29, CI: 1.16–13.32 were significantly associated with good practice of health promotional measures. Conclusions More than one-fourth of the mothers have poor practice of health promotional measures. Ethnicity, mothers' education, fathers' occupation, birth space of index child, and family monthly income were found to be independent determinants of practice of health promotion measures. Thus, policy makers should provide specific education regarding health promotional measures to both parents.

Exploring Infant Feeding Beliefs and Practices among Mothers in Major Urban Informal Settlements in Kenya

Appropriate infant feeding is a proxy indicator for the good health and nutritional status of infants. The objective of this qualitative study was to explore mother’s beliefs and practices of infant feeding practices up to two years of age or beyond in major urban informal settlements in Kenya. A total of nine focus groups were conducted in three randomly selected sites, namely: Kaptembwo in Nakuru, Manyatta ‘A’ in Kisumu, and Kibera in Nairobi. Sixty-four mothers of children aged 6-24 months were chosen purposively, and the results were thematically analyzed. Results showed that most mothers still breast-fed their children, but they intended to stop breastfeeding when the child is 18 months old. Generally, the mothers reported the benefits of breastfeeding for two years of age or beyond, such as protection against diseases, improving health, and making the child strong. They perceived barriers to breastfeeding up to two years or beyond such as child illness, child’s decision, return to work, baby addiction to breast milk, and inconvenience brought about by breastfeeding. The foods perceived by mothers as good for the baby included yogurt, groundnuts, pumpkins, bananas, pawpaw, watermelon, oranges, spinach, and traditional vegetables. While the foods perceived as not good for the baby were processed milk, eggs, and sweet foods such as sodas, biscuits, cakes. Participants had a positive attitude towards water treatment and handwashing practices. The most commonly reported method of treating water was boiling. The perceived barriers to water treatment and handwashing practices included lack of fuel and water, forgetfulness, inadequate money, not able to control children. The findings indicate that increasing awareness on the duration of breastfeeding may motivate more mothers to breastfeed for two years and beyond.

Human milk composition promotes optimal infant growth, development and health

Human milk is a living dynamic fluid that promotes optimal nutrition and development of the infant and impacts health across the lifespan. This review reports on the diverse range of nutrients, immune protection factors, hormones, microbes and metabolites in human milk and their impacts on infant nutrition and health. While many of these components are stable across lactation and similar between women, some vary over time, and in response to maternal and infant health status, maternal diet and geographic location. Human milk may be considered as personalized nutrition, with many components working synergistically to stimulate and support the infant's immature immune system, while enhancing appropriate development, growth and body composition.

Knowledge Regarding Health Promotional Measures of Infant among Mothers Attending Pediatric OPD of Universal College of Medical Sciences

INTRODUCTION&#x0D; Infant and child health status depends upon knowledge of mothers regarding health promotional measures. This study aimed to determine knowledge and its associated factors regarding health promotional measures of infants amongst the mothers attending pediatrics outpatient department of Universal College of Medical Sciences Teaching Hospital, Bhairahawa, Rupandehi, Nepal.&#x0D; MATERIAL AND METHODS&#x0D; Hospital based cross-sectional study was conducted in Universal College of Medical Sciences Teaching Hospital, Bhairahawa, Rupandehi, Nepal among 414 mothers attending pediatrics outpatient department from June 2019 to March 2020. Bivariate and multivariate logistic regressions were used to explore associations between different factors with health promotional measures.&#x0D; RESULTS&#x0D; The mean age and family size was 25.89 ±4.81 and 5.94 ±2.48 respectively. A total of 73.2% mothers have good knowledge of health promotional measures. Mothers greater than 20 years (AOR =8.13, CI: 2.16-30.67), Dalit (AOR=0.02, CI: 0.003-0.16), living in rural area (AOR=0.27, CI: 0.08-0.61), family size greater than 5 (AOR =3.99, CI: 1.37-11.59), below SLC education (AOR=0.29, CI: (0.09-0.88) and fathers with SLC and above education (AOR=25.40, CI: 4.54-142.0), fathers engaged in non-agricultural work (AOR =4.78, CI: 1.80-12.68) and birth space of index child greater than two years (AOR =5.88, CI: 1.48-23.55) were significantly associated with knowledge of health promotional measures.&#x0D; CONCLUSIONS&#x0D; Mothers’ age, caste, residence, family size, education of parents, occupation of father and birth space of index child were found to be independent associated factors of knowledge. Thus policy makers should provide specific education regarding health promotional measures to both parents focusing rural area. Similarly, local Government needs to subsidize in reducing teenage marriage.&#x0D;

Competing Risk Analysis of the Health Status of Neonates with Respiratory Distress Syndrome

Introduction: Respiratory distress syndrome (RDS) is not only the most common respiratory disorder in premature infants but also the main cause of neonatal mortality. Methods: Competing risk framework was used to examine and identify potential prognostic factors of the health status of preterm infants with respiratory distress syndrome. Preterm infants with RDS admitted to the neonatal intensive care units (NICUs) of selected hospitals in Ethiopia were followed for 28 days and only neonates with complete cases were included in the analysis. The Fine-Gray or sub-distribution hazard model was used to identify significant prognostic factors. Three outcome variables (death due to RDS, death due to other causes and discharged alive) were considered. Results: The Fine-Gray model fit results revealed that anemia, multiple pregnancies, birth-weight and gestational age were the prognostic factors significantly associated with the death of neonates due to Respiratory distress syndrome problem while Pneumonia, meningitis, anemia and gestational age of neonates were the significant prognostic factors for death of neonates due to other causes. Moreover, pneumonia, birth weight and gestational age were identified as the prognostic factors associated with neonates being discharged alive. Conclusion: Offering intensive and adequate treatments for neonates with lowest birth-weights and gestational age may be useful to reduce neonatal mortality and increase the incidence of being discharged alive.

Maternal and Neonatal Characteristics in Obstetric Intensive Care Unit Admissions

(Int J Obstet Anesth. 2020;41:65–70) The World Health Organization defines severe acute maternal morbidity as “a woman who nearly died, but survived a complication that occurred during pregnancy, childbirth or within 42 days of termination of pregnancy.” Intensive care unit (ICU) admission resulting from maternal morbidity is most commonly associated with hemorrhage-related cardiovascular instability and severe preeclampsia. This retrospective register-based study from January 2007 to December 2011 held 3 objectives: (1) to evaluate the course of pregnancy and delivery for obstetric patients admitted to ICU, (2) discern the health status of infants born to those women, and (3) comparison of the results with reference data on Finnish parturients and infants.

Infant and child health status ahead of implementation of an integrated intervention to improve nutrition and survival: a cross-sectional baseline assessment

BackgroundBurundi has one of the poorest child health outcomes in the world. With an acute malnutrition rate of 5% and a chronic malnutrition rate of 56%, under five death is 78 per 1000 live births and 47 children for every 1000 children will live until their first birthday. In response to this grim statistics, Village Health Works, a Burundian-American organisation has invested in an integrated clinical and community intervention model to improve child health outcomes. The aim of this study is to measure and report on child health indicator ahead of implementing this model.MethodsA cross sectional design was employed, adopting the Demographic Health Survey methodology. We reached out to a sample of 952 households comprising of 2675 birth, in our study area. Mortality data was analysed with R package for mortality computation and other outcomes using SPSS. Principal component analysis was used to classify households into wealth quintiles. Logistic regression was used to assess strength of associations and significance of association was considered at 95% confidence level.ResultsThe incidence of low birth weight (LBW) was 6.4% at the study area compared to 10% at the national level with the strongest predictor being malnourished women (OR 1.4 95%CI 1.2–7.2 p = 0.043). Fever incidence was higher in the study area (50.5%) in comparison to 39.5% nationally. Consumption of minimum acceptable diet was showed a significant protection against fever (OR 0.64 95%CI 0.41–0.94 p = 0.042). Global Acute Malnutrition rate was 7.6% and this significantly reduced with increasing age of child. Under-five mortality rate was 32.1 per 1000 live births and infant mortality was 25.7 per 1000 in the catchment with most deaths happening within the first 28 days of life (57.3%).ConclusionImproving child health status is complex, therefore, investing into an integrated intervention for both mother and child could yield best results. Given that most under-five deaths occurred in the neonatal period, implementing integrated clinical and community newborn care interventions are critical.

Assessment of physiological disturbances during pre‐ and early postnatal development based on microscopic analysis of human deciduous teeth from the Late Epipaleolithic site of Shubayqa 1 (Jordan)

To study pre- and early postnatal tooth formation and to analyze the effects of physiological disturbances on enamel and dentin formation in deciduous teeth of infants from the Late Epipaleolithic (Natufian) site Shubayqa 1. Ten deciduous teeth from six infants (ages at death between 21 and 239 days) were analyzed by light and scanning electron microscopy. Marked prism cross-striations and an abnormal wavy course of the prisms were recorded in pre- and postnatal enamel of all analyzed teeth. Single or multiple accentuated incremental lines were observed in prenatal enamel of nine teeth and in postnatal enamel of eight teeth. Accentuated Andresen lines and broader zones exhibiting an enhanced calcospheritic pattern were recorded in the pre- and postnatally formed dentin of nine teeth. The structural abnormalities in the pre- and postnatally formed enamel of the infants are considered indicative of chronic stress that negatively affected the activity of secretory ameloblasts. The structural aberrations in pre- and postnatal dentin denote that odontoblasts were also affected by this stress. The presence of single or multiple accentuated incremental lines in pre- and postnatal enamel is interpreted as reflecting (short-term) impacts of higher intensity superimposed on the chronic stress. Our findings suggest compromised maternal health affecting the late fetus and compromised health in newborns. Although limited by the small number of analyzed individuals, the present study contributes to the knowledge of maternal and early infant health conditions in Late Epipaleolithic populations.

HUBUNGAN AKSES DAN MOTIVASI IBU DENGAN PEMBERIAN IMUNISASI DASAR PADA BAYI 0-11 BULAN DI DESA LUMBAN TORUAN WILAYAH KERJA PUSKESMAS KENTARA KECAMATAN LAEPARIRA KABUPATEN DAIRI TAHUN 2019

Basic immunization is given to prevent various diseases, including hepatitis B, tuberculosis, diphtheria, pertussis, tetanus, polio and measles. Based on the data found, basic immunization coverage is still below the target. The condition was caused by the family not allowing and immunization service places far from their homes. This study aims to determine the relationship between access and motivation of mothers with basic immunization for infants aged 0-11 months in Lumban Toruan Village, Kentara Health Center, Dairi District, 2019. This type of research is analytic with cross sectional design. The population in this study were all mothers with babies aged 0-11 months who visited the Posyandu in Lumban Toruan village as many as 34 people. The sample used is total population. The data used are primary and secondary data, instruments used in questionnaires, data analysis using statistical tests, namely Chi-Square test with ? &lt;0.05. The results showed that there was a relationship between access and basic immunization for infants aged 0-11 months in Lumban Toruan Village, Kentara Health Center Work Area, Dairi Regency in 2019, with a value of ? = 0.001 (&lt;0.05). There is a relationship between maternal motivation and basic immunization for infants aged 0-11 months in Lumban Toruan Village, Kentara Health Center Work Area, Dairi Regency in 2019, with a value of ? = 0.001 (&lt;0.05). It is hoped that health workers in Lumban Toruan Village will improve information or counseling about the importance of basic immunization and make home visits for mothers with 011 months infants who have difficult access to improve the health status of infants.

Dietary Practices and Nutrition Status of Infants Born to Adolescent Mothers in Transmara West, Narok County, Kenya

Background: Infant and young child feeding practices contribute to the growth and development of infants as well as preventing the occurrence of common illnesses. Infants of young mothers are at risk of malnutrition because they are unprepared for child care. Objectives: The purpose of this study was to determine dietary practices, health and nutrition status of infants born to adolescent mothers in Transmara West, Narok County. Method: A descriptive cross-sectional study design was adopted and five health facilities were purposively selected in Transmara West sub county, Narok County. A sample size of 246 infants and 246 adolescent mothers were recruited from the selected health facilities. A semi-structured questionnaire was used to collect quantitative data which was analyzed using analyzed using SPPS for windows version 24.0 and ENA for SMART survey 2011. Chi-square and Pearson Product Correlation relationship was used to establish associations between variables at a significance level of &lt;0.05 . Result: The findings of the study revealed that m ost of the mothers were between 16 to 17 years with the youngest mother being 14 years old. The prevalence of wasting, stunting and underweight was 17.1%, 22.0% and 22.0% respectively. The proportion of infants who were breastfed in the 24 hours preceding the study was as follows: 48.8% of 0-6months, 24% 6-8 months and 27.2% of 9-12months.The children that attained the minimum dietary diversity in the age groups included; 37.4% and 53.9% for the age groups 6-8 months and 9-11 months respectively. Slightly less than half (46.3%) of the infants received their recommended minimum meal frequency. Meal frequency and exclusive breastfeeding two weeks before the study were significant (p&lt;0.05) factors associated with malnutrition. Conclusion: Based on the above outcome, it is recommended that more attention should be given to infants of young mothers. The government and other stakeholders should formulate policies that govern the health care and feeding practices of infants of adolescent mothers. Similar research should be replicated specially to compare the nutrition status of infants of adult mothers with that of young mothers.

Infant Feeding Frequency Impacts Human Milk Composition: A Metabolomic Analysis

Abstract Objectives The nutritional composition of human milk is affected by many factors, including stage of lactation and time of day. Metabolomic profiling of milk provides a biochemical fingerprint of hundreds of metabolites being consumed by the infant, which may help to understand potential factors affecting infant health, growth and nutritional status. We hypothesized that frequency of daily lactations would alter the profile of metabolites and lipids in the milk. Methods Human milk samples from 630 individuals [378 mothers exclusively breast feeding and 252 mothers partially breast feeding (i.e., infant supplemented with formula feeding)] from a single sample (infant aged 3 months) were subjected to biphasic extraction and metabolite profiling performed using two separate untargeted liquid chromatography high resolution mass spectrometry analysis methods (polar metabolites and the lipidome). Results Univariate statistical analysis of the lipidome data matrix revealed considerable differences in lipid concentrations between partial or exclusive feeding. Of the 241 lipids measured in the non-polar extracts, 203 were significantly different between the two groups after multiple testing correction (FDR corrected p-value &amp;lt;0.05). These included 96 triglycerides, 78 phospholipids, 27 sphingomyelins and 2 ceramides, all significantly elevated with exclusive feeding. Of the 320 metabolite features measured in the polar extracts, 69 were significantly different between the two groups, including carnitine and metabolites from the lysine degradation pathway, all reduced with exclusive feeding. Random forest analysis highlighted that overall profiles in both polar metabolite and lipid extracts were more consistent across the exclusive feeding group. Conclusions This study provides insight into effects of feeding frequency on metabolite/lipid profiles, showing impact of possible altered milk synthesis and storage on relative abundances of discrete polar metabolites, with a broad impact on many lipid species. Funding Sources Funded by AgResearch Strategic Science Investment Fund via the New Zealand Ministry of Business, Innovation and Employment.

Differences in Underlying Causes of Infant Malnutrition Between a Pastoral and an Agro Pastoral Community in Ethiopia

Abstract Objectives To determine the difference in underlying factors related to child nutritional status between pastoral and agro pastoral based communities in Ethiopia. Methods This cross-sectional study was conducted in two rural pastoral communities located in the Somali region and agro pastoral community located in Southern Nations. Pairs of mothers and their infants aged 6 to 52 months were randomly selected to participate in the survey. Data was collected using the Household Food Insecurity Access Scale, Dietary Diversity, and Sanitation for Household Survey. Anthropometric measurements taken included height, length, and weight using WHO Anthro version 3.2.2. Chi-square tests were used to assess differences between communities. Logistic regression were used to analyze factors that contributed to infant health status. Results A total of 232 participants from both communities completed the survey. The agro pastoral community reported a higher food insecurity rate at 87% than the pastoral community at 70%. The prevalence of women not achieving the minimum dietary diversity was significantly higher in the pastoral community than the agro pastoral community (94% vs 68%, P &amp;lt; .001). Similarly, more households in the pastoral community reported accessing drinking water from unimproved sources (64% vs 0.9%, P &amp;lt; .001) and using unimproved toilet facilities (97% vs. 77%, P &amp;lt; .001) than the agropastoral community. Although almost all participants from both the agropastoral and pastoral communities reported washing their hands during critical times (100% and 96%) respectively. In addition, the pastoral community had significantly higher prevalence rates of infants’ wasting (44.5% vs 0%, P &amp;lt; .001) and underweight (47.8% vs 7.7%, P &amp;lt; .001) than the agro pastoral community. Conclusions Even though the prevalence of food insecurity was higher in the agro pastoral community than the pastoral community, they had lower rates of infant malnutrition. In contrast, although the pastoral community reported a lower rate of food insecurity, they had higher rates of child wasting and underweight, reported low dietary diversity, and poor hygiene practices. Based on these findings, dietary diversity and environmental sanitation may be protective of child wasting and underweight over and above food insecurity. Funding Sources Feed the Future Livestock Systems Innovation Lab (LSIL).

Parental satisfaction with quality of neonatal care in different level hospitals: evidence from Vietnam

BackgroundMost health systems provide the most specialized, and presumably also the highest quality of care at a central level. This study assessed parental satisfaction and its determinants in the context of neonatal care in a provincial as well as a national hospital of Vietnam.MethodsIn this cross-sectional quantitative study, parents of 340 preterm infants admitted to neonatal care units of a national and a provincial hospital in 2018 were interviewed using structured questionnaires. Unadjusted and adjusted linear regression models were used to assess the relationship between parental satisfaction and hospital rank.ResultsThe mean parental satisfaction score was 3.74 at the provincial, and 3.56 at the national hospital. These satisfaction differences persisted when parent and child characteristics were adjusted for in multivariate analysis. Longer length of stay and worsening infant health status were associated with parents reporting lower levels of satisfaction with the quality of care being provided at the healthcare facility.ConclusionsThis study suggests that parents of preterm infants admitted in a provincial hospital were more satisfied with the quality of care received than those in a specialized national hospital. Length of stay and infant health status were the two most important determinants of level of parental satisfaction.

The value of intelligent ultrasound sensor used in the measurement of fetal hemodynamics and evaluation of health factors

ObjectiveThe purpose is to discuss the application of intelligent ultrasound sensor in the measurement of fetal hemodynamics and the evaluation of health factors. Methods: 237 pregnant women who were hospitalized in the fourth people's hospital of Jinan from June 2016 to May 2018 were selected as the study objects. According to the situation of pregnant women, they were divided into pre-pregnancy diabetes group (Group IB, 19 cases), gestational diabetes group (Group IA, 93 cases), and normal control group (Group II, 125 cases). In order to evaluate the health status of pregnant women and infants, intelligent ultrasound sensor was used for pregnant women measurement in each group, including ultrasonic parameters, hemodynamic parameters, and body weight. ResultsThere was no significant difference in age, height, weight, and gestational weeks between Group IA, Group IB, and Group II (P > 0.05). Pregnant women in each group showed that the blood glucose content of Group IB and Group IA increased significantly after fasting and glucose tolerance test, compared with the control group (P < 0.05), and the blood glucose content of Group IB was always higher than that of Group IA (P < 0.05). Compared with the control group, fetal ultrasound parameters and body weight were significantly increased in Group IB and Group IA (P < 0.05). The hemodynamic parameters of MCA (Middle Cerebral Artery), UA (Umbilical Artery), and Ut-A (Uterine Artery) in Group IB and Group IA were significantly different from that of the control group (P < 0.05). Furthermore, the area under ROC (Receiver Operating Characteristic) curve of MCA-PI was the largest, and the effect of predicting pregnancy outcome was the most obvious. ConclusionThrough the study, it was found that the measurement of hemodynamic parameters in the later period of pregnancy with intelligent ultrasound sensor could predict the outcome of pregnancy, especially the adverse pregnancy outcome of patients with abnormal glucose metabolism. It could provide experimental basis for the prediction of the outcome of pregnancy and the evaluation of health status of patients with abnormal glucose metabolism in the later period of pregnancy.

Assessment of Fetal and Infant health status based on Non-Stress Test

Introduction: Non stress test (NST) is commonly considered as a screening test to assess the health of the fetus especially in high risk pregnancies in most studies. The purpose of this study was to Assessment of fetal and Infant health status based on Non-Stress Test. Methods: This study was a case-control design carried out on 984 pregnant in Urmia selected by census sampling during 2014-2015; 500 pregnant had experienced NST and considered as case group and 484 pregnant had not experienced NST and considered as control group. Data were collected using records of NST among mothers and checklist including variables related to maternal characteristics such as fetal characteristics. The data were analyzed through SPSS version 22 software. Results: In pregnant women who experienced NST, the mean age, Apgar min 1 and 5 was significantly different and NST group had better situation than other group (p=0.001). Fetal distress was more in the presence of meconium (p=0.0001). In binary logistic regression analysis, meconium and NST were presented as a risk factor in the model, that is, by shifting one level of the meconium or NST status (yes/no) (OR Meconium = 14.262, p = 0.0001; OR NST = 2.874, p = 0.001). Conclusion: Using non stress test to observe the abnormal results of the fetus especially meconium-stained amniotic fluid is crucial and vital because can prevent the fetal distress, infection of pregnant women and fetus and even the mortality of the fetus.&#x0D;

Optimizing High-risk Infant Follow-up in Nonresearch-based Paradigms: The New England Follow-up Network.

To establish the first regional quality improvement collaborative solely dedicated to follow-through care of high-risk infants after Neonatal intensive care unit (NICU) discharge and to characterize extremely low birth weight (ELBW) follow-up in New England. Eleven of 14 follow-up programs in New England partnered with the Vermont Oxford Network (VON) ELBW project for an initial data collection project. We collected information about the health status and developmental outcomes of infants born ≤1,000 g or younger than 28 weeks 2014-2016 at the 18-24 months corrected for gestational age (CGA) follow-up visit. VON collected and compiled the data. Of 993 eligible infants, 516 (52.0%) had follow-up visits. The rehospitalization rate was 33.9%, mostly respiratory illness. Ninety-six children (19.3%) had weight less than 10th percentile and 44 (8.9%) had weight less than third percentile at 18-24 months. Only 170 (61.4%) children had recommended hearing screening after NICU discharge. Forty-six (9.1%) had cerebral palsy; 81 of the 441 infants that completed all 3 sections of the Bayley Scales of Infant Development, third edition (18.4%) had any composite score less than 70. Over half of the social and demographic data were missing. Most quality initiatives in neonatology stop at NICU discharge. This first project by the New England Follow-up Network showed a low rate for clinical follow-up. It demonstrated many opportunities to improve postdischarge follow-through specific to NICU-based care. Future projects will aim to improve the quality of follow-through services through collaborative learning, data sharing, and comparative outcomes.

Development of parenting self-efficacy in mothers of high-risk infants

PurposeThe aim of this prospective, longitudinal study was to (1) examine the development of parenting self-efficacy (PSE), (2) explore the influence of contextual factors (e.g., family functioning, family centered care, and infant medical caregiving complexity) on PSE development, and (3) whether PSE and contextual factors predict parent and infant health outcomes in a high-risk infant population. MethodMothers (n = 67) of infants diagnosed with a complex medical condition following birth were enrolled within 3 weeks of their infant's diagnosis and admission to intensive care. Participants completed an online study survey at study enrollment (T1), infant discharge (T2), and 3 months after discharge (T3). Change in PSE was examined using mixed modeling and predictors of parent and infant health outcomes were explored using multiple regression. ResultsPSE significantly increased over time (b = 2.08, p < .0001). Family functioning was the only significant contextual factor, where worse family functioning at enrollment was associated with lower confidence over time. Mothers who were older and had more than one child were significant predicators of higher PSE. Interestingly, being married, compared to being single, was associated with decreased PSE. Higher PSE was also predictive of positive maternal psychological wellbeing at 3 months after discharge and a decrease in infant's medical complexity was associated with higher maternal psychological well-being. ConclusionThese are important findings given that PSE is known to contribute to infant development and health status.