Jipeng Shi

To study the clinical characteristics, treatment, and outcomes of neonatal dengue fever in Foshan. A retrospective study was conducted on 49 neonatal dengue fever cases collected from eight hospitals in Foshan between June and November 2024. Clinical characteristics and outcomes were evaluated. Cases were divided into an early-onset group (diagnosed ≤7 days of age; n=32) and a late-onset group (diagnosed 7 days of age; n=17) for comparison of clinical characteristics. Among the 49 neonates, fever was the predominant symptom (45 cases, 92%), followed by bleeding tendency (12 cases, 24%), tachypnea (11 cases, 22%), and jaundice (5 cases, 10%). The mothers of 30 neonates (61%) had perinatal dengue infection. Rates of maternal peripartum fever, confirmed maternal dengue fever during pregnancy, and perinatal dengue infection were significantly higher in the early-onset group than in the late-onset group (P0.05). The early-onset group had a longer hospital stay than the late-onset group (P0.05). Alanine aminotransferase levels were significantly higher in the late-onset group than in the early-onset group (P0.05). Symptomatic treatments, including short-term hemostatic therapy, nasal cannula oxygen supplementation, and noninvasive positive pressure ventilation when indicated, resulted in favorable outcomes without severe cases or deaths. Neonatal dengue fever in Foshan is associated with maternal perinatal dengue infection. Fever is the predominant clinical manifestation. Clinical characteristics differ by age at diagnosis, but overall prognosis is good. During dengue epidemic seasons, prevention and screening of perinatal dengue fever in pregnant women should be strengthened, and early laboratory tests such as pathogen detection and blood biochemistry should be performed on high-risk neonates.

Background: Pulmonary hemorrhage (PH) is influenced by various perinatal factors. This study aims to identify the risk factors associated with pulmonary hemorrhage in very low birth weight infants and provide a reference for the prevention of this condition in this vulnerable population. Methods: A comprehensive literature search was conducted across several databases, including PubMed, Web of Science, Embase, Cochrane Library, Scopus, CNKI, CBM, Wanfang Database and VIP Database, covering publications up to May 20, 2024. The meta-analysis was performed using RevMan 5.4 and Stata 16.0 software to analyze the risk factors for pulmonary hemorrhage in very low birth weight infants. Results: A total of 14 studies were analyzed, comprising 13 case-control studies and 1 cohort study. The combined sample included 17,122 neonates, with 1,363 neonates in the case group and 15,759 neonates in the control group. The meta-analysis identified several risk factors for pulmonary hemorrhage in very low birth weight infants, including patent ductus arteriosus (OR = 2.95, 95% CI: 2.06–4.24), low 5-minute Apgar score (OR = 1.36, 95% CI: 1.01–1.84), use of surfactant (OR = 2.29, 95% CI: 1.40–3.75), respiratory distress syndrome (OR = 6.71, 95% CI: 3.67–12.28), and early-onset sepsis (OR = 6.02, 95% CI: 2.82–12.82). Protective factors identified included complete course of antenatal corticosteroids (OR = 0.36, 95% CI:0.17–0.79). Conclusions: Several risk factors, including patent ductus arteriosus, low 5-minute Apgar scores, use of surfactant, respiratory distress syndrome, and early-onset sepsis, are associated with an increased risk of pulmonary hemorrhage in very low birth weight infants. In contrast, complete course of antenatal corticosteroids has a protective effect in reducing the risk of this severe complication.

Objective: To investigate the clinical characteristics and outcomes of newborns infected with coronavirus disease 2019 (COVID-19) during the Omicron wave.Methods: From December 1, 2022, to January 4, 2023, clinical data were collected from neonates with COVID-19 who were admitted to 10 hospitals in Foshan City, China. Their epidemiological histories, clinical manifestations and outcomes were analysed. The neonates were divided into symptomatic and asymptomatic groups. The t test or χ² test was used for comparisons between groups.Results: A total of 286 children were diagnosed, including 166 males, 120 females, 273 full-term infants and 13 premature infants. They were 5.5 (0–30) days old on average when they were admitted to the hospital. These children had contact with patients who tested positive for COVID-19 and were infected through horizontal transmission. This study included 33 asymptomatic and 253 symptomatic patients, among whom 143 were diagnosed with upper respiratory tract infections and 110 were diagnosed with pneumonia. There were no severe or critical patients. Fever (220 patients) was the most common clinical manifestation, with a duration of 1.1 (1–6) days. The next most common clinical manifestations were cough with nasal congestion or runny nose (4 patients), cough (34 patients), poor appetite (7 patients), shortness of breath (15 patients), and poor general status (1 patient). There were no significant abnormalities in routine blood tests among the neonates infected with COVID-19 except for mononucleosis. However, compared with the asymptomatic group, in the symptomatic group, the leukocyte and neutrophil granulocyte counts were significantly decreased, and the monocyte count was significantly increased. C-reactive protein (CRP) levels were significantly increased (≥10 mg/L) in 9 patients. Myocardial enzyme, liver function, kidney function and other tests showed no obvious abnormalities.Conclusions: In this study, neonates infected with the Omicron variant were asymptomatic or had mild disease. Symptomatic patients had lower leucocyte and neutrophil levels than asymptomatic patients.

Background: There are many difficulties and uncertainties in the early diagnosis of neonatal sepsis. The aim of this study was to determine whether albumin (ALB) is useful for the early diagnosis of neonatal sepsis using ALB, C-reactive protein (CRP) and procalcitonin (PCT) together. Methods: ALB, CRP, PCT and white blood cell (WBC) data from 732 patients with neonatal sepsis and 1317 neonatal infection patients hospitalized in Foshan Maternal and Child Health Hospital from 2011 to 2022 were collected. Receiver operating characteristic (ROC) and logistic regression analyses were performed to assess the diagnostic value of ALB, CRP, PCT and the WBC count for neonatal sepsis. The roles of ALB, CRP, PCT and the WBC count in the diagnosis of neonatal sepsis were analysed by using subject working characteristics (ROC) and areas under the curve (AUCs), and the variables were combined to determine which combination had the best diagnostic efficacy. Results: In the sepsis group, the ALB, CRP, and PCT levels and the WBC count were significantly higher than those in the infection group (P< 0.001). In all infants, the sensitivities and specificities of ALB, CRP, PCT, and WBC count were 0.411, 0.596, 0.483 and 0.411, respectively, and 0.833, 0.846, 0.901 and 0.796, respectively. With a sensitivity of 0.646, a specificity of 0.929, and an AUC of 0.834, the best combination was that of ALB, CRP, and PCT, which was better than that of CRP + PCT, CRP + ALB and PCT + ALB. Conclusion: In neonatal sepsis, in the absence of blood culture results, the combination of ALB, CRP, and PCT is more reliable than CRP, PCT, or CRP+PCT alone. These results suggest that ALB is a useful inflammatory biomarker for the early diagnosis of neonatal sepsis, and can improve the diagnostic efficiency.