Background: Birth asphyxia causes hypoxia or inadequate perfusion to the organs of newborns, leading to metabolism dysfunctions including blood glucose disorders.Methods: Neonates with and without birth asphyxia were retrospectively recruited from 53 hospitals in Hubei Province from January 1 to December 31, 2018. In summary, 875, 1139, and 180 cases in the control group, the mild asphyxia group, and the severe asphyxia group were recruited, respectively. Neonatal blood glucose values at postnatal 1, 2, 6, and 12 h (time error within 0.5 h was allowed) were gathered from the medical records.Results: The incidence rates of hyperglycemia in the control group, the mild asphyxia group and the severe asphyxia group were 2.97%, 7.90%, and 23.33%, respectively (p < 0.001). Additionally, the incidence rates of hypoglycemia in the three groups above were 3.66%, 4.13%, and 7.78%, respectively (p = 0.042). The blood glucose values of neonates with hypoglycemia in the asphyxia group were lower than in the control group (p = 0.003). Furthermore, the blood glucose values of neonates with hyperglycemia were highest in the severe asphyxia group (p < 0.001). There were 778 and 117 cases with blood glucose records at four predefined time points in the mild and severe asphyxia group, respectively. The incidence of blood glucose dis-orders in the mild asphyxia group significantly decreased from postnatal 6 h (p<0.05). Howev-er, we found no obvious changes of the incidence of glucose disorders within postnatal 12 h in the severe asphyxia group (p = 0.589).Conclusion: Birth asphyxia is likely to cause neonatal blood glucose disorders, both hypoglyce-mia and hyperglycemia, during the early postnatal life. The neonates with severe asphyxia have higher incidence, worse severity and longer duration of blood glucose disorders than ne-onates with mild asphyxia.Copyright (c) 2023, Taiwan Pediatric Association. Published by Elsevier Taiwan LLC. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/ by-nc-nd/4.0/).

Objective: China was the first country suffering from the SARS-CoV-2 pandemic and one of the countries with stringent mother-neonate isolation measure implemented. Now increasing evidence suggests that coronavirus disease 2019 (COVID-19) should not be taken as an indication for formula feeding or isolation of the infant from the mother.Methods: We conducted a retrospective cohort study in 44 hospitals from 14 provinces in China to investigate the management of neonates whose mothers have confirmed or suspected COVID-19. In addition, 65 members of Chinese Neonatologist Association (CNA) were invited to give their comments and suggestions on the clinical management guidelines for high-risk neonates. Results: There were 121 neonates born to 118 mothers suspected with COVID-19 including 42 mothers with SARS-CoV-2 positive results and 76 mothers with SARS-CoV-2 negative results. All neonates were born by caesarean section, isolated from their mothers immediately after birth and were formula-fed. Five neonates were positive for SARSCoV-2 at initial testing between 36 and 46 h after birth. Regarding the confusion on the clinical management guidelines, 58.78％ of the newborns were put into isolation, 32.22％ were subject to PCR tests, and 5.16％ and 2.75％ received breastfeeding and vaccination, respectively. Conclusion: The clinical symptoms of neonates born to mothers with confirmed SARS-CoV-2 were mild, though five neonates might have been infected in utero or during delivery. Given the favorable outcomes of neonates born to COVID-confirmed mothers, full isolation may not be warranted. Rather, separation of the mother and her newborn should be assessed on a case-by-case basis, considering local facilities and risk factors for adverse outcomes, such as prematurity and fetal distress.

Background The pandemic of Coronavirus Disease 2019 (COVID-19) brings new challenges for pediatricians, especially in the differentiation with non-COVID-19 pneumonia in the peak season of pneumonia. We aimed to compare the clinical characteristics of pediatric patients with COVID-19 and other respiratory pathogens infected pneumonias. Methods We conducted a multi-center, cross-sectional study of pediatric inpatients in China. Based on pathogenic test results, pediatric patients were divided into three groups, including COVID-19 pneumonia group, Non-COVID-19 viral (NCV) pneumonia group and Non-viral (NV) pneumonia group. Their clinical characteristics were compared by Kruskal-Wallis H test or chi-square test. Results A total of 636 pediatric pneumonia inpatients, among which 87 in COVID-19 group, 194 in NCV group, and 355 in NV group, were included in analysis. Compared with NCV and NV patients, COVID-19 patients were older (median age 6.33, IQR 2.00-12.00 years), and relatively fewer COVID-19 patients presented fever (63.2%), cough (60.9%), shortness of breath (1.1%), and abnormal pulmonary auscultation (18.4%). The results were verified by the comparison of COVID-19, respiratory syncytial virus (RSV) and influenza A (IFA) pneumonia patients. Approximately 42.5%, 44.8%, and 12.6% of the COVID-19 patients presented simply ground-glass opacity (GGO), simply consolidation, and the both changes on computed tomography (CT) scans, respectively; the proportions were similar as those in NCV and NV group (p>0.05). Only 47.1% of COVID-19 patients had both lungs pneumonia, which was significantly lower than that proportion of nearly 80% in the other two groups. COVID-19 patients presented lower proportions of increased white blood cell count (16.5%) and abnormal procalcitonin (PCT) (10.7%), and a higher proportion of decreased lymphocyte count (44.0%) compared with the other two groups. Conclusion Majority clinical characteristics of pediatric COVID-19 pneumonia patients were milder than non-COVID-19 patients. However, lymphocytopenia remained a prominent feature of COVID-19 pediatric pneumonia.

Background: There is an emerging literature on the mental health of both pre-and post-partum mothers during the coronavirus disease 2019 (COVID-19) pandemic. Methods: As of April 1, 2020, 23 mothers confirmed with COVID-19, 15 mothers suspected with COVID-19 but with negative polymerase chain reaction tests, and 33 mothers without COVID-19 (Control Group) were recruited for a study from Hubei Province in China. The Maternal Postnatal Attachment Scale (MPAS), the Zung Self-rating Anxiety Scale, and the Zung Self-rating Depression Scale were applied to investigate the attachment of mothers to their neonates and the postpartum mental health of mothers within the first 3 months after delivery (between 20 to 89 days). Results: The period of mother-child separation among the confirmed group (33.9?20.9 days) was significantly longer than that of suspected group (16.7?12.2 days) and control group (10.7?8.4 days). The total score of the MPAS in mothers confirmed with COVID-19 (45.5?4.2) was significantly lower (indicating less mother-child attachment) than that in the suspected (50.5?4.7) and control (48.8?4.6) groups. A negative correlation was noted between the mother-child separation time and the MPAS scores, including the subscale scores of attachment (MPAS acore: Spearman?s ? =?0.33, 95% CI: ?0.095 to ?0.538, P=0.005; Subscale score of attachment: Spearman?s ? =?0.40, 95% CI: ?0.163 to ?0.592, P=0.001). The incidence of postpartum anxiety in the confirmed, suspected and control groups was 4.3%, 6.7% and 12.1%, respectively; and the incidence of postpartum depression was 39.1%, 33.3% and 30.3%, respectively. No significant difference was found with regards to maternal postpartum anxiety and depression among the three groups. Conclusions: Decreased mother-child attachment found among mothers confirmed with COVID-19, indicates that further intervention is needed to ensure mother-child interaction to appropriately develop attachment. Mother-child attachment experienced disruption due to prolonged mother-child separation necessitated by the COVID-19 management protocol, which needs to be revised to reduce prolonged mother-child separation. Additionally, mothers with and without COVID-19 suffered a high incidence of depression, which warrants further mental health investment for pregnant mothers during the COVID-19 pandemic.

Abstract Introduction Since December 2019, severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) has spread rapidly around the world and caused more than 487 000 infections and 22 000 deaths worldwide. Methods We report two infant cases with coronavirus disease 2019 (COVID‐19) in Yichang, Hubei, China. The younger of the two is only 5‐months old. We recorded their clinical manifestations, epidemiological history, laboratory examination, and treatment in detail. In addition, we provide computed tomographic images of their chest, which are the most serious imaging manifestation among the infants recorded so far. Results Although both of them eventually recovered and were discharged from the hospital, they were complicated with varying degrees of liver and myocardial injury. In addition, one of them was complicated with mycoplasma pneumoniae infection. Conclusions Pediatricians should consider the potential risks of developing severe illness of infants infected by SARS‐CoV‐2 and take them seriously.

Objective Surfactant and noninvasive ventilation are two major strategies for the treatment of neonates with respiratory distress syndrome (RDS). However, the optimal time for surfactant administering is yet controversial. This study compared the early and rescue Calsurf administration in preterm infants with RDS. Study Design Preterm infants born between 260/7 and 326/7 weeks of gestation and needed nasal continuous positive airway pressure (nCPAP) immediately after birth were randomly assigned to the early or rescue Calsurf treatment group. In the early treatment group, neonates were intubated, administered surfactant with bag–mask ventilation, and extubated to nCPAP (INSURE [intubation–surfactant–extubation]). In the rescue treatment group, InSurE was given until the clinical manifestation and chest X-ray displayed RDS. The primary outcome was to compare the reintubation rate within 72 hour age between the two groups. Results Among 305 neonates randomized to the early (n = 154) and rescue (n = 151) groups, the reintubation rate within 72 hours of age in these two groups did not differ significantly (p > 0.05). The incidence of oxygen dependence until 36 weeks' corrected age was similar in both groups. Conclusion No differences were observed between early and rescue Calsurf treatment groups with respect to the reintubation rate within 72 hours of age and the incidence of bronchopulmonary dysplasia.

Objective: The goal of this study was to explore the efficacy of low molecular weight heparin (LMWH) combined with prednisone and its influence on coagulation and kidney function of pediatric with nephrotic syndrome. Methods: A total of 94 pediatric cases of nephrotic syndrome were divided into an experimental group (n=47) and a control group (n=47) according to different treatments. Pediatricin the control group merely received prednisone (2 mg/(kgd) 3 times/day, with an adjustment of the dose after 2 weeks) treatment, while LMWH (150 IU/(kgd) once/day) was added on the treatment plan of the experimental group. The two groups' clinical efficacies were compared, including coagulation function (prothrombin time (PT), activated partial thromboplastin time (APTT)), kidney function (blood urinary nitrogen (BUN), creatinine clearance rate (Ccr), serum creatinine (SCr)), bone metabolism (blood GLA protein (BGP), bone alkaline phosphatase (BALP)), and other blood biochemistry criterion (serum albumen (Alb), including total cholesterol (TC)). Adverse events were monitored in both groups and compared. Results: The clinical effective rate of the experimental group was significantly higher than that of the control group (P=0.036). After treatment, both groups showed significantly-elevated Ccr levels (both P<0.001) with a more distinct elevation in the experimental group (P<0.01). The BUN and SCr levels were all significantly decreased (both P<0.001), especially in the experimental group (both P<0.01) compared with the control group. Comparison of coagulation function among paired before-treatment,/after-treatment and control/experimental groups resulted in no significant difference (all P>0.05). For bone metabolism indexes, both groups showed significantly elevated BGP levels (both P<0.001) and decreased BALP levels (both P<0.001) and the experimental group had higher BGP level (P<0.01) and lower BALP level (P<0.01) compared with those of control group respectively. Alb level was elevated significantly in both groups (both P<0.001) and was higher in experimental group (P<0.01) while TC level was decreased significantly (both P<0.001) and lower in experimental group (P<0.01). Comparison between incidences of adverse events between groups showed no difference (P=0.168). Conclusion: For pediatric patients with nephrotic syndrome, LMWH combined with prednisone could significantly improve their clinical symptoms with improved kidney function, coagulation function and bone metabolism.