中华围产医学杂志最新文献

{"title":"Early essential newborn care: a healthy start for every newborn baby in the Western Pacific Region","authors":"P. Mannava","doi":"10.3760/CMA.J.ISSN.1007-9408.2019.08.002","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-9408.2019.08.002","url":null,"abstract":"To improve newborn survival and ensure a healthy start for every baby, Member States of World Health Organization endorsed the Action Plan for Healthy Newborn Infants (2014-2020) in the Western Pacific Region in 2013. The focus of which is on implementation of early essential newborn care (EENC). Such items, regional approach to introducing, sustaining and scaling up EENC; progress in EENC implementation; mobilizing social support for newborn care; best practice, lessons learned and future directions, were summarized in this editorial. Efforts are being undertaken in China, which would help to achieve the Sustainable Development Goal targets on maternal and child health and universal health coverage. \u0000 \u0000 \u0000Key words: \u0000Neonatal nursing; Health promotion; Maternal-child health services","PeriodicalId":52320,"journal":{"name":"Chinese Journal of Perinatal Medicine","volume":"22 1","pages":"540-549"},"PeriodicalIF":0.0,"publicationDate":"2019-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42641246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology and perinatal risk factors of neonatal asphyxia in Hubei Enshi Tujia and Miao Autonomous Prefecture","authors":"Su-Ying Wu, F. Peng, Ting Ding, Hong-Yan Tan, Qian-qian Wu, Hongyan Liu, Xin-qiao Yu, Cong-Rong Tan, Zhi-Ping Pan, Zuo-Fen Yuan, Zhen-Ju Huang, Shi-wen Xia","doi":"10.3760/CMA.J.ISSN.1007-9408.2019.08.008","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-9408.2019.08.008","url":null,"abstract":"Objective \u0000To investigate the incidence and risk factors of neonatal asphyxia in Hubei Enshi Tujia and Miao Autonomous Prefecture. \u0000 \u0000 \u0000Methods \u0000Live born infants, including those diagnosed with neonatal asphyxia, were recruited from 16 different hospitals in Hubei Enshi Tujia and Miao Autonomous Prefecture from January to December of 2016. The 16 hospitals included four grade A tertiary hospitals (three general hospitals and one traditional Chinese medicine hospital) and 12 grade A secondary hospitals (eight general hospitals, one maternal and child health hospital and three traditional Chinese medicine hospitals). A retrospective investigation was conducted using questionnaire to analyze the basic information, perinatal risk factors and prognosis of those infants. Chi-square test was used for statistical analysis. \u0000 \u0000 \u0000Results \u0000Among 22 294 recruited live born infants, 733 (3.29%) were diagnosed with neonatal asphyxia on discharge, including 627 (85.54%) mild cases and 106 (14.46%) severe cases. And neonatal asphyxia resulted in deaths of 27 cases (3.68%). The risk factors for neonatal asphyxia included multiple pregnancy, pregnancy conceived with assisted reproductive technology, premature infant, low birth weight infant, fetal malposition, congenital malformation, male infant, born during transfer, mother of Tujia nationality, low educational level (primary school or lower), living in rural area, the number of antenatal visits ≤3, history of early threatened abortion, anemia in pregnancy, hypertensive disorders of pregnancy, chorioamnionitis, abnormal pregnancy history and abnormality of umbilical cord, amniotic fluid or placenta. \u0000 \u0000 \u0000Conclusions \u0000The incidence of neonatal asphyxia in Enshi area is obviously higher than the national average. The main risk factors for neonatal asphyxia in this area are related to maternal background and the living condition of the mother during pregnancy, delivery as well as the newborn at birth. \u0000 \u0000 \u0000Key words: \u0000Asphyxia neonatorum; Incidence; Risk factors; Minority Groups","PeriodicalId":52320,"journal":{"name":"Chinese Journal of Perinatal Medicine","volume":"22 1","pages":"575-580"},"PeriodicalIF":0.0,"publicationDate":"2019-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48049549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of kangaroo mother care during cesarean section on neonatal health parameters of late preterm newborns within \"golden hour\"","authors":"Jianping Xu, Xiao-ming Wang, Shuiqin Gu, Min Zhang, X. Cui, Qun'e Zhu, Xun Li","doi":"10.3760/CMA.J.ISSN.1007-9408.2019.08.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-9408.2019.08.005","url":null,"abstract":"Objective \u0000To evaluate the effects of kangaroo mother care (KMC) during cesarean section on neonatal health parameters in the \"golden hour\" of late preterm infants. \u0000 \u0000 \u0000Methods \u0000A total of 120 singleton pregnant women undergoing preterm cesarean section (34-36+6 gestational weeks) from January 1 to December 31, 2018 in Jiaxing Women and Children's Hospital Affiliated to Wenzhou Medical University were prospectively enrolled and divided into two groups (observation and control groups) with 60 cases in each by random number table method. During cesarean section, the both groups received the thorough drying immediately and delayed cord clamping, in addition, the observation group adopted KMC, while the control group received routine maternal and infant care. Several parameters including changes in body temperature, crying, respiration, oxygen saturation and other vital signs, as well as the incidence of hypothermia, transfer to the Department of Neonatology and the success rate of early breastfeeding initiation during the \"golden hour\" were compared between the two groups. Satisfaction of obstetricians, pediatricians, the pregnant women and their families to KMC and routine maternal and infant care were compared. Two-independent sample t test and Chi-square test were used as statistical methods. \u0000 \u0000 \u0000Results \u0000In total, 113 cases (58 in the observation group and 55 in the control group) were finally analyzed. The body temperature of the late preterm infants at 5 and 10 min after birth in the observation group was higher than that in the control group (36.5 vs 36.0 ℃, 36.4 vs 35.8 ℃, t=11.756 and 7.512, both P 0.05). The observation group had a lower incidence of hypothermia [0% (0/58) vs 15% (8/55), χ2=9.079, P<0.001] and a higher success rate of early breastfeeding initiation [86% (50/58) vs 58% (32/55), χ2=11.137, P<0.001] than the control group. The satisfaction scores of obstetricians (19.3±1.1 vs 13.4±1.9, t=20.517), pediatricians (18.2±1.8 vs 12.6±2.1, t=15.382), gravidas (19.6±0.4 vs 13.6±1.6, t=27.723) and their family members (18.2±0.9 vs 15.3±1.1, t=11.535) were all higher in the observation group than those in the control group (all P<0.001). \u0000 \u0000 \u0000Conclusions \u0000KMC during cesarean section can improve the body temperature of late premature infants in the \"golden hour\", reduce the occurrence of hypothermia, facilitate early initiation of breastfeeding and improve the satisfaction of doctors and patients on health care. \u0000 \u0000 \u0000Key words: \u0000Cesarean section; Maternal-child nursing; Neonatal nursing; Feasibility studies; Infant, premature","PeriodicalId":52320,"journal":{"name":"Chinese Journal of Perinatal Medicine","volume":"22 1","pages":"560-564"},"PeriodicalIF":0.0,"publicationDate":"2019-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41363606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multidisciplinary team building for neonatal resuscitation","authors":"Mei-hua Piao","doi":"10.3760/CMA.J.ISSN.1007-9408.2019.08.003","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-9408.2019.08.003","url":null,"abstract":"Multidisciplinary team cooperation was highlighted in Neonatal Resuscitation Program (7th edition), which combining with effective team communication were considered as the essential skills during neonatal resuscitation. The key points of the multidisciplinary team cooperation were the identification of the team leader, mutual support, communication, correct records, and reports after resuscitation. It is of great importance to master the crucial skills, emphasize simulation training of the team cooperation, and strengthen the multidisciplinary team cooperation in decreasing the incidence of neonatal asphyxia. \u0000 \u0000 \u0000Key words: \u0000Asphyxia neonatorum; Infant, newborn; Multidisciplinary team","PeriodicalId":52320,"journal":{"name":"Chinese Journal of Perinatal Medicine","volume":"22 1","pages":"550-552"},"PeriodicalIF":0.0,"publicationDate":"2019-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41831934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Meningeal cysts complicated with tethered cord syndrome diagnosed by prenatal ultrasonography: a case report","authors":"Shen-Hua Wu, Xinxiu Liu, Ling Chen, Z. Qu","doi":"10.3760/CMA.J.ISSN.1007-9408.2019.08.015","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-9408.2019.08.015","url":null,"abstract":"We reported a case diagnosed with meningeal cysts complicated with tethered cord syndrome based on prenatal ultrasound images at 37+5 gestational weeks, which also showed horseshoe kidney and intrahepatic vascular abnormalities (arteriovenous fistula) in the fetus. The gravida had a precipitate delivery at 39+4 gestational weeks. The anus of this newborn was about 1 cm in front of the normal position. Intrahepatic arteriovenous fistula and horseshoe kidney were detected by neonatal ultrasound and CT scan, and spinal cystic occupying lesion was found by lumbar-sacrum MRI. Intraspinal tumors were removed through spinal canal exploration and spinal cord tumor resection and were confirmed as ependymal cysts by pathological analysis, which was consistent with the prenatal diagnosis. Postoperative changes of lumbar spine was reported by CT scan after the operation. The baby received successful anoplasty when five months old and no abnormal growth or development were found when followed up to one year and eight months old. Raising awareness of tethered cord syndrome can help reduce missed diagnosis and misdiagnosis. \u0000 \u0000 \u0000Key words: \u0000Neural tube defects; Ependyma; Cysts; Ultrasonography, prenatal","PeriodicalId":52320,"journal":{"name":"Chinese Journal of Perinatal Medicine","volume":"22 1","pages":"614-616"},"PeriodicalIF":0.0,"publicationDate":"2019-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42956636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness and feasibility of early essential newborn care during term cesarean section","authors":"Jianping Xu, Shuiqin Gu, Qun'e Zhu, X. Cui, Min Zhang, Lianbu Wan, Kaini Lu","doi":"10.3760/CMA.J.ISSN.1007-9408.2019.08.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-9408.2019.08.007","url":null,"abstract":"Objective \u0000To explore the effects of early essential newborn care (EENC) on short-term maternal and neonatal health and to evaluate the satisfaction and acceptability of both patients and medical staff in the operating room regarding the implementation of EENC during term cesarean section(CS). \u0000 \u0000 \u0000Methods \u0000Two hundred gravidas who underwent CS in Wenzhou Medical University Affiliated Women and Children Hospital from January 2018 to April 2018 were recruited in this prospective study. According to the odd or even number of their medical records, these women were randomly divided into EENC or control group, 100 in each. EENC was offered to those in the EENC group immediately after birth, including drying the newborn immediately and thoroughly, mother–infant skin-to-skin contact at least 90 min and initiating the first breastfeeding, and delayed cord clamping until l-3 min after birth. Routine neonatal care was provided to the control group, including regular drying, insufficient skin-to-skin contact and cord clamping within 1 min after birth. Differences were compared between the two groups in the incidence of abnormal pulse, low oxygen saturation, hypothermia and mild asphyxia from the neonatal aspect and the incidence of postpartum hemorrhage and early initiation of breastfeeding from the maternal aspect. The acceptability and satisfaction of all the participants and the medical staff were also analyzed. t-test and Chi-square test were used as statistical methods. \u0000 \u0000 \u0000Results \u0000All of the 200 participants were finally analyzed. In the EENC group, the incidence of neonatal hypothermia [2% (2/100) vs 13% (13/100), χ2=8.721, P=0.003] and maternal postpartum hemorrhage [1% (1/100) vs 6% (6/100), χ2=5.701, P=0.035] were lower comparing to the control group, while the initiation rate of early breastfeeding was higher [56% (56/100) vs 5% (5/100), χ2=61.352, P 0.05). The scores of maternal satisfaction (24.6±0.4 vs 23.4±1.9, t=6.443, P=0.001) and acceptability (24.3±0.5 vs 23.5±1.4, t=5.436, P=0.001) in the EENC group were also significantly higher than those in the control. For the obstetric operation team, the acceptability scores among obstetricians (22.6±0.8 vs 21.6±1.3, t=2.379, P=0.019), instrument nurses (23.2±0.9 vs 21.3±1.1, t=13.592, P<0.001) and anesthetists (22.6±0.9 vs 21.5±1.7, t=5.625, P=0.001) in the EENC group were higher than those in the control group. However, no significant difference was observed in the acceptability among rounding nurses between the two groups (P=0.086). \u0000 \u0000 \u0000Conclusions \u0000EENC during CS could stabilize the neonatal temperature, reduce postpartum hemorrhage, promote early breastfeeding and improve the maternal satisfaction as well as the acceptability of both obstetric operation team and puerperae. There is a clinical significance to promote EENC during CS. \u0000 \u0000 \u0000Key words: \u0000Cesarean section; Maternal-child nursing; Neonatal nursing; Feasibility studies","PeriodicalId":52320,"journal":{"name":"Chinese Journal of Perinatal Medicine","volume":"22 1","pages":"570-574"},"PeriodicalIF":0.0,"publicationDate":"2019-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43026852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breastfeeding for a good start of life","authors":"Dan-hua Wang","doi":"10.3760/CMA.J.ISSN.1007-9408.2019.07.001","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-9408.2019.07.001","url":null,"abstract":"Breastfeeding has great benefits for public health and social economy, while the exclusive breastfeeding rate within six months after birth and early initiation rate of breastfeeding in China are lower than the average level of the world. \"Early skin to skin contact (SSC), early sucking and early initiation of breastfeeding\" is an important start to ensure the success of breastfeeding. SSC between mother and baby is the first key step. Continuous SSC can stabilize the vital signs of newborns, provide the infants with healthy flora from mothers to establish a good micro-ecology and stimulate the rooting reflex of the baby to get colostrum as early as possible to protect them from infections and save their lives. Kangaroo mother care(KMC) for preterm/low birth weight infants can promote breastfeeding, and effectively reduce severe infections and mortality. Early SSC and KMC at the beginning of life are crucial to ensure successful breastfeeding. \u0000 \u0000 \u0000Key words: \u0000Breast feeding; Skin to skin contact; Kangaroo mother care","PeriodicalId":52320,"journal":{"name":"Chinese Journal of Perinatal Medicine","volume":"22 1","pages":"433-435"},"PeriodicalIF":0.0,"publicationDate":"2019-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46558959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chromosomal anomalies in fetuses with structural malformation detected by ultrasonography at 11-13+6 gestational weeks","authors":"Ju Zheng, Jie‐Ling Feng, Meifang Lin, T. Lei, L. Du, R. Peng","doi":"10.3760/CMA.J.ISSN.1007-9408.2019.07.012","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-9408.2019.07.012","url":null,"abstract":"Objective \u0000To investigate the clinical performance of ultrasound screening for fetal structural anomalies at 11-13+6 weeks of gestation and to evaluate the relation of structural anomalies with karyotypes and copy number variations. \u0000 \u0000 \u0000Methods \u0000A retrospective analysis was conducted on fetuses with structural anomalies detected by ultrasound examination at 11-13+6 gestational weeks in First Affiliated Hospital of Sun Yat-Sen University from January 2013 to December 2017. Karyotype and chromosomal microarray analysis(CMA) were offered to these fetuses and ultrasound scans were repeated at 16-18 gestational weeks. All fetuses were followed up to termination or birth. Fisher's exact test was used for statistical analysis. \u0000 \u0000 \u0000Results \u0000A total of 362 fetuses with structural anomalies were studied including 101 (27.9%) fatal malformations, 253 (69.9%) major malformations and eight (0.2%) minor malformations. Cardiac malformation (32.6%, 118/362), central nervous system anomalies (24.9%, 90/362) and anterior abdominal wall defects (20.9%, 76/362) were the three most common abnormalities. Invasive prenatal test was performed in 107 cases including 25 fatal, 79 major and three minor malformations. Thirty (28%) out of the 107 cases had abnormal karyotypes, which were chromosomal aneuploidies (n=28) and chromosomal fragment abnormalities (n=2). Among the 99 cases received CMA, 25 had abnormal karyotypes, and copy number variations were identified in eight [three (4.05%) were pathogenic variations] out of the rest 74 with normal karyotypes. The incidence of chromosomal abnormalities in fetuses with major malformations was higher than that of fetuses with fatal malformation [32.9% (26/79) vs 12.0% (3/25), P=0.045]. Altogether, 117 cases repeated second-trimester ultrasound among which 16 (13.7%) were normal; 19 (16.2%) had cardiac defect which was discordant with the first-trimester evaluation and five (4.2%) were found to have additional malformations. Diagnosis of the other 77 cases were consistent with the first-trimester ultrasound findings. After the second-trimester ultrasound scanning, 49 pregnancies were terminated; 39 twin pregnancies and four triplet pregnancies underwent selective fetal reduction; 25 continued to delivery with good neonatal outcomes. Out of the 23 699 cases without abnormal ultrasound findings at 11-13+6 gestational weeks, 20 182 (85.2%) were successfully followed up, among which structural abnormalities were found in 178 during the second trimester and in 31 after birth. \u0000 \u0000 \u0000Conclusions \u0000A detailed ultrasound examination at 11-13+6 weeks of gestation is important to identify fetal structural defects. However, it could not replace the second-trimester ultrasound. There is a high risk of chromosomal abnormalities in fetuses with early-detected structural defects. CMA is able to identify pathogenic copy number variations with a relatively low detection rate. \u0000 \u0000 \u0000Key words: \u0000Congenital abnormalities; Chromosome aberrations; DNA ","PeriodicalId":52320,"journal":{"name":"Chinese Journal of Perinatal Medicine","volume":"22 1","pages":"488-494"},"PeriodicalIF":0.0,"publicationDate":"2019-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47699692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application and evaluation of mobile device-based continuous breastfeeding intervention program","authors":"Hui Yu, Nafei Guo","doi":"10.3760/CMA.J.ISSN.1007-9408.2019.07.008","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-9408.2019.07.008","url":null,"abstract":"Objective \u0000To investigate the effects of a mobile application-based continuous breastfeeding intervention program for gravidas. \u0000 \u0000 \u0000Methods \u0000Pregnant women who received prenatal care and delivered at First Maternity and Infant Hospital Affiliated to Tongji University were enrolled in this quasi-experiment from April 1 to May 31, 2017. Those women who met the inclusion criteria in the Eastern and Southern campuses of the hospital were recruited as intervention group (n=100) and control (n=100) group, respectively. In addition to the routine breastfeeding support which the control group was offered only, the intervention group also received mobile application-based continuous breastfeeding intervention, namely a questionnaire was sent through WeChat official account where the pregnant women had free access to continuous breastfeeding support based on their survey results, such as understanding the benefits of breastfeeding at the first trimester, relationships between breastfeeding and immunity at the second trimester, breast care at the third trimester, treatment of milk spillage/spit during labor, and iron and vitamin supplementation at puerperium. Basic information about the participants, results of Breastfeeding Knowledge Questionnaires administered at the first, second and third trimesters and during labor and the puerperium, responses to Self-efficacy of Breastfeeding Questionnaires during labor and the puerperium, and exclusive breastfeeding rates at discharge and 42 d postpartum were compared between the two groups using two independent sample t-test and Chi-square test. \u0000 \u0000 \u0000Results \u0000There were 83 and 80 pregnant women in the intervention group and control group finally analyzed, respectively. No statistical difference in the scores of the Breastfeeding Knowledge Questionnaire at the first trimester was observed between the intervention group and control group (13.4±1.9 vs 13.3±1.9, t=0.133, P=0.895). However, the scores at the second and third trimesters and during labor and the puerperium in the intervention group were higher than those in the control group (14.1±1.3 vs 13.5±2.0, 14.7±1.1 vs 14.2±1.3, 15.3±1.7 vs 14.4±1.2 and 15.7±1.5 vs 14.9±1.0; t=2.160, 2.435, 4.104 and 3.946; all P<0.05), respectively. The scores of Self-efficacy of Breastfeeding Questionnaires during labor and the puerperium were also higher in the intervention group (123.5±4.7 vs 118.5±5.7 and 128.4±4.2 vs 119.0±6.5, t=6.170 and 10.959, both P<0.01). Compared to the control group, the intervention group had higher exclusive breastfeeding rate at discharge and on 42 d after delivery [78.3% (65/83) vs 61.2% (49/80), χ2=5.641; 57.8% (48/83) vs 38.8% (31/80), χ2=5.938; both P<0.05]. \u0000 \u0000 \u0000Conclusions \u0000The mobile application-based continuous breastfeeding intervention program may effectively improve breastfeeding outcomes. \u0000 \u0000 \u0000Key words: \u0000Breast feeding; Telemedicine; Clinical protocols; Validation studies","PeriodicalId":52320,"journal":{"name":"Chinese Journal of Perinatal Medicine","volume":"22 1","pages":"467-471"},"PeriodicalIF":0.0,"publicationDate":"2019-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44170429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of continuous quality improvement on breastfeeding in very/extremely low birth weight infants","authors":"Feng Liu, Shuping Han, Zhang-bin Yu","doi":"10.3760/CMA.J.ISSN.1007-9408.2019.07.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-9408.2019.07.005","url":null,"abstract":"Objective \u0000To implement a continuous quality improvement (QI) initiative to increase the breastfeeding rate of mother's own milk(MOM) in very low birth weight infant (VLBWI) and extremely low birth weight infant (ELBWI) in neonatal intensive care unit (NICU) and to evaluate its impact on the morbidity of these infants. \u0000 \u0000 \u0000Methods \u0000A retrospective analysis was performed to analyze the clinical data of VLBWIs and ELBWIs who were admitted to the Nanjing Maternity Hospital Affiliated to Nanjing Medical University from July 1, 2014 to December 31, 2017 (n=587). The QI initiative was implemented in the hospital on August 1, 2015, the effect was assessed at the end of 2016 and the QI process was adjusted from 2017 to ensure continuous quality improvement of breastfeeding, based on which the 587 infants were divided into three groups: those in pre-QI group admitted from July 1, 2014 to July 31, 2015 (n=141), post-QI group admitted from August 1, 2015 to December 31, 2016 (n=243) and continuous QI group admitted from January 1, 2017 to December 31, 2017 (n=203). Differences in breastfeeding rates of MOM, the time of first breastfeeding of MOM, duration of parenteral nutrition, time to achieve full enteral feeding, average length and costs in NICU stay and the incidence of feeding intolerance, bronchopulmonary dysplasia (BPD), necrotizing enterocolitis (NEC) and late-onset sepsis (LOS) were compared between the three groups. Statistical analysis was performed using analysis of variance, rank-sum test, Chi-square test and Bonferroni test. \u0000 \u0000 \u0000Results \u0000Compared with the pre-QI group, both the post-QI and continuous QI groups had significantly increased breastfeeding rates of MOM [0-7 d: 38.2%(0.0%-69.0%) vs 72.8%(42.6%-84.2%) and 75.5%(49.8%-87.2%); 0-14 d: 37.8%(29.9%-80.5%) vs 91.9%(79.1%-96.0%) and 92.0%(71.0%-96.8%); 0-28 d: 58.2%(30.0%-90.1%) vs 96.6%(90.3%-98.9%) and 96.4%(83.1%-98.9%); during hospitalization: 50.0%(30.0%-85.5%) vs 96.6%(89.5%-99.1%) and 96.8% (83.0%-99.3%); all P<0.05] and volume of MOM intake [0-7 d: 31 (0-397) vs 82 (0-506) and 95 (0-510) ml; 0-14 d: 198 (0-1 596) vs 622 (0-1 828) and 717 (0-1 868) ml; 0-28 d: 1 458 (0-4 960) vs 2 707 (0-7 074) and 2 893 (0-10 238) ml; during hospitalization: 2 000 (0-18 767) vs 4 071 (0-22 961) and 3 979 (0-17 260) ml] within 7, 14 and 28 d after birth and during hospitalization. Moreover, the volume of MOM intake in the continuous QI group was higher than that in the post-QI group during the first 7 d after birth (all P<0.05). The time on first MOM breastfeeding in the post-QI and continuous QI groups were earlier than that in the pre-QI group [69 (16-633) and 68 (3-456) vs 73 (8-348) h, P<0.05]. Full enteral feeding was achieved earlier in the continuous QI group than the post- and pre-QI group [14 (5-40) vs 17 (6-53) and 19 (11-56) d, P<0.05]. The length of parenteral nutrition, incidence of feeding intolerance, BPD and LOS and hospital stay in the continuous QI group, post- and pre-QI group ","PeriodicalId":52320,"journal":{"name":"Chinese Journal of Perinatal Medicine","volume":"22 1","pages":"451-456"},"PeriodicalIF":0.0,"publicationDate":"2019-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48917596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}