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Huang J, Shen W, Wu F, Mao J, Liu L, Chang Y, Zhang R, Ye X, Qiu Y, Ma L, Cheng R, Wu H, Chen D, Chen L, Xu P, Mei H, Wang S, Xu F, Ju R, Zheng Z, Lin X, Tong X. Risk factors for severe bronchopulmonary dysplasia in a Chinese cohort of very preterm infants. Saudi Med J 2024; 45:369-378. [PMID: 38657990 PMCID: PMC11147577 DOI: 10.15537/smj.2024.45.4.20230741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 02/16/2024] [Indexed: 04/26/2024] Open
Abstract
OBJECTIVES To examine the risk factors for severe bronchopulmonary dysplasia (BPD) in a cohort of very preterm infants (VPIs) in China, as BPD is common among VPIs and associated with a high mortality rate. METHODS In this multicenter retrospective study, medical records from infants with BPD born at gestation age (GA) of <32 weeks with birth weight (BW) of <1,500 grams (g) in 7 regions of China were included. The cohort was stratified into different BPD severity groups based on their fraction of inspired oxygen requirement at a modified GA of 36 weeks or post discharge. Risk factors were identified using logistic regression analysis. RESULTS A significant inverse correlation was revealed between BPD severity and both GA and BW (p<0.001). Independent risk factors for severe BPD (sBPD) were identified as invasive mechanical ventilation (≥7d), multiple blood transfusion (≥3), nosocomial infection (NI), hemodynamically significant patent ductus arteriosus (hsPDA), delayed initiation of enteral nutrition, and longer time to achieve total caloric intake of 110 kcal/kg. Conversely, administration of antenatal steroids was associated with reduced risk of sBPD. CONCLUSION Our study not only reaffirmed the established risk factors of low GA and BW for sBPD in VPIs, but also identified additional, potentially modifiable risk factors. Further research is warranted to explore whether intervention in these modifiable factors might reduce the risk of sBPD.Clinical Trial Reg. No.: ChiCTR1900023418.
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Affiliation(s)
- Jing Huang
- From the Department of Neonatology (Huang, Shen, Zheng, Lin), Women and Children’s Hospital, School of Medicine, Xiamen University, from the Xiamen Key Laboratory of Perinatal-Neonatal Infection (Huang, Shen, Zheng, Lin), Xiamen Clinical Research Center for Perinatal Medicine, Xiamen, from the Department of Neonatology (F. Wu), The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, from the Department of Pediatrics (Mao), Shengjing Hospital of China Medical University, Shenyang, from the Department of Neonatology (Liu), Guiyang Maternal and Child Health Hospital, Guiyang Children’s Hospital, Guiyang, from the Department of Pediatrics (Chang, Tong), Peking University Third Hospital, Beijing, from the Department of Neonatology (Zhang), Children’s Hospital of Fudan University, Shanghai, from the Department of Neonatology (Ye), Guangdong Province Maternal and Children’s Hospital, Guangzhou, from the Department of Neonatology (Qiu), General Hospital of Ningxia Medical University, Yinchuan, from the Department of Neonatology (Ma), Children’s Hospital of Hebei Province, Shijiazhuang, from the Department of Neonatology (Cheng), Children’s Hospital of Nanjing Medical University, Nanjing, from the Department of Neonatology (H. Wu), The First Hospital of Jilin University, Changchun, from the Department of Neonatology (D. Chen), Quanzhou Maternity and Children’s Hospital, Quanzhou, from the Department of Pediatrics (L. Chen), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, from the Department of Neonatology (P. Xu), Liaocheng People’s Hospital, Liaocheng, from the Department of Neonatology (Mei), the Affiliate Hospital of Inner Mongolia Medical University, Hohhot, from the Department of Neonatology (Wang), Suzhou Municipal Hospital, Suzhou, from the Department of Neonatology (F. Xu), The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, and from the Department of Neonatology (Ju), Chengdu Women’ and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
| | - Wei Shen
- From the Department of Neonatology (Huang, Shen, Zheng, Lin), Women and Children’s Hospital, School of Medicine, Xiamen University, from the Xiamen Key Laboratory of Perinatal-Neonatal Infection (Huang, Shen, Zheng, Lin), Xiamen Clinical Research Center for Perinatal Medicine, Xiamen, from the Department of Neonatology (F. Wu), The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, from the Department of Pediatrics (Mao), Shengjing Hospital of China Medical University, Shenyang, from the Department of Neonatology (Liu), Guiyang Maternal and Child Health Hospital, Guiyang Children’s Hospital, Guiyang, from the Department of Pediatrics (Chang, Tong), Peking University Third Hospital, Beijing, from the Department of Neonatology (Zhang), Children’s Hospital of Fudan University, Shanghai, from the Department of Neonatology (Ye), Guangdong Province Maternal and Children’s Hospital, Guangzhou, from the Department of Neonatology (Qiu), General Hospital of Ningxia Medical University, Yinchuan, from the Department of Neonatology (Ma), Children’s Hospital of Hebei Province, Shijiazhuang, from the Department of Neonatology (Cheng), Children’s Hospital of Nanjing Medical University, Nanjing, from the Department of Neonatology (H. Wu), The First Hospital of Jilin University, Changchun, from the Department of Neonatology (D. Chen), Quanzhou Maternity and Children’s Hospital, Quanzhou, from the Department of Pediatrics (L. Chen), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, from the Department of Neonatology (P. Xu), Liaocheng People’s Hospital, Liaocheng, from the Department of Neonatology (Mei), the Affiliate Hospital of Inner Mongolia Medical University, Hohhot, from the Department of Neonatology (Wang), Suzhou Municipal Hospital, Suzhou, from the Department of Neonatology (F. Xu), The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, and from the Department of Neonatology (Ju), Chengdu Women’ and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
| | - Fan Wu
- From the Department of Neonatology (Huang, Shen, Zheng, Lin), Women and Children’s Hospital, School of Medicine, Xiamen University, from the Xiamen Key Laboratory of Perinatal-Neonatal Infection (Huang, Shen, Zheng, Lin), Xiamen Clinical Research Center for Perinatal Medicine, Xiamen, from the Department of Neonatology (F. Wu), The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, from the Department of Pediatrics (Mao), Shengjing Hospital of China Medical University, Shenyang, from the Department of Neonatology (Liu), Guiyang Maternal and Child Health Hospital, Guiyang Children’s Hospital, Guiyang, from the Department of Pediatrics (Chang, Tong), Peking University Third Hospital, Beijing, from the Department of Neonatology (Zhang), Children’s Hospital of Fudan University, Shanghai, from the Department of Neonatology (Ye), Guangdong Province Maternal and Children’s Hospital, Guangzhou, from the Department of Neonatology (Qiu), General Hospital of Ningxia Medical University, Yinchuan, from the Department of Neonatology (Ma), Children’s Hospital of Hebei Province, Shijiazhuang, from the Department of Neonatology (Cheng), Children’s Hospital of Nanjing Medical University, Nanjing, from the Department of Neonatology (H. Wu), The First Hospital of Jilin University, Changchun, from the Department of Neonatology (D. Chen), Quanzhou Maternity and Children’s Hospital, Quanzhou, from the Department of Pediatrics (L. Chen), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, from the Department of Neonatology (P. Xu), Liaocheng People’s Hospital, Liaocheng, from the Department of Neonatology (Mei), the Affiliate Hospital of Inner Mongolia Medical University, Hohhot, from the Department of Neonatology (Wang), Suzhou Municipal Hospital, Suzhou, from the Department of Neonatology (F. Xu), The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, and from the Department of Neonatology (Ju), Chengdu Women’ and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
| | - Jian Mao
- From the Department of Neonatology (Huang, Shen, Zheng, Lin), Women and Children’s Hospital, School of Medicine, Xiamen University, from the Xiamen Key Laboratory of Perinatal-Neonatal Infection (Huang, Shen, Zheng, Lin), Xiamen Clinical Research Center for Perinatal Medicine, Xiamen, from the Department of Neonatology (F. Wu), The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, from the Department of Pediatrics (Mao), Shengjing Hospital of China Medical University, Shenyang, from the Department of Neonatology (Liu), Guiyang Maternal and Child Health Hospital, Guiyang Children’s Hospital, Guiyang, from the Department of Pediatrics (Chang, Tong), Peking University Third Hospital, Beijing, from the Department of Neonatology (Zhang), Children’s Hospital of Fudan University, Shanghai, from the Department of Neonatology (Ye), Guangdong Province Maternal and Children’s Hospital, Guangzhou, from the Department of Neonatology (Qiu), General Hospital of Ningxia Medical University, Yinchuan, from the Department of Neonatology (Ma), Children’s Hospital of Hebei Province, Shijiazhuang, from the Department of Neonatology (Cheng), Children’s Hospital of Nanjing Medical University, Nanjing, from the Department of Neonatology (H. Wu), The First Hospital of Jilin University, Changchun, from the Department of Neonatology (D. Chen), Quanzhou Maternity and Children’s Hospital, Quanzhou, from the Department of Pediatrics (L. Chen), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, from the Department of Neonatology (P. Xu), Liaocheng People’s Hospital, Liaocheng, from the Department of Neonatology (Mei), the Affiliate Hospital of Inner Mongolia Medical University, Hohhot, from the Department of Neonatology (Wang), Suzhou Municipal Hospital, Suzhou, from the Department of Neonatology (F. Xu), The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, and from the Department of Neonatology (Ju), Chengdu Women’ and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
| | - Ling Liu
- From the Department of Neonatology (Huang, Shen, Zheng, Lin), Women and Children’s Hospital, School of Medicine, Xiamen University, from the Xiamen Key Laboratory of Perinatal-Neonatal Infection (Huang, Shen, Zheng, Lin), Xiamen Clinical Research Center for Perinatal Medicine, Xiamen, from the Department of Neonatology (F. Wu), The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, from the Department of Pediatrics (Mao), Shengjing Hospital of China Medical University, Shenyang, from the Department of Neonatology (Liu), Guiyang Maternal and Child Health Hospital, Guiyang Children’s Hospital, Guiyang, from the Department of Pediatrics (Chang, Tong), Peking University Third Hospital, Beijing, from the Department of Neonatology (Zhang), Children’s Hospital of Fudan University, Shanghai, from the Department of Neonatology (Ye), Guangdong Province Maternal and Children’s Hospital, Guangzhou, from the Department of Neonatology (Qiu), General Hospital of Ningxia Medical University, Yinchuan, from the Department of Neonatology (Ma), Children’s Hospital of Hebei Province, Shijiazhuang, from the Department of Neonatology (Cheng), Children’s Hospital of Nanjing Medical University, Nanjing, from the Department of Neonatology (H. Wu), The First Hospital of Jilin University, Changchun, from the Department of Neonatology (D. Chen), Quanzhou Maternity and Children’s Hospital, Quanzhou, from the Department of Pediatrics (L. Chen), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, from the Department of Neonatology (P. Xu), Liaocheng People’s Hospital, Liaocheng, from the Department of Neonatology (Mei), the Affiliate Hospital of Inner Mongolia Medical University, Hohhot, from the Department of Neonatology (Wang), Suzhou Municipal Hospital, Suzhou, from the Department of Neonatology (F. Xu), The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, and from the Department of Neonatology (Ju), Chengdu Women’ and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
| | - Yanmei Chang
- From the Department of Neonatology (Huang, Shen, Zheng, Lin), Women and Children’s Hospital, School of Medicine, Xiamen University, from the Xiamen Key Laboratory of Perinatal-Neonatal Infection (Huang, Shen, Zheng, Lin), Xiamen Clinical Research Center for Perinatal Medicine, Xiamen, from the Department of Neonatology (F. Wu), The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, from the Department of Pediatrics (Mao), Shengjing Hospital of China Medical University, Shenyang, from the Department of Neonatology (Liu), Guiyang Maternal and Child Health Hospital, Guiyang Children’s Hospital, Guiyang, from the Department of Pediatrics (Chang, Tong), Peking University Third Hospital, Beijing, from the Department of Neonatology (Zhang), Children’s Hospital of Fudan University, Shanghai, from the Department of Neonatology (Ye), Guangdong Province Maternal and Children’s Hospital, Guangzhou, from the Department of Neonatology (Qiu), General Hospital of Ningxia Medical University, Yinchuan, from the Department of Neonatology (Ma), Children’s Hospital of Hebei Province, Shijiazhuang, from the Department of Neonatology (Cheng), Children’s Hospital of Nanjing Medical University, Nanjing, from the Department of Neonatology (H. Wu), The First Hospital of Jilin University, Changchun, from the Department of Neonatology (D. Chen), Quanzhou Maternity and Children’s Hospital, Quanzhou, from the Department of Pediatrics (L. Chen), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, from the Department of Neonatology (P. Xu), Liaocheng People’s Hospital, Liaocheng, from the Department of Neonatology (Mei), the Affiliate Hospital of Inner Mongolia Medical University, Hohhot, from the Department of Neonatology (Wang), Suzhou Municipal Hospital, Suzhou, from the Department of Neonatology (F. Xu), The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, and from the Department of Neonatology (Ju), Chengdu Women’ and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
| | - Rong Zhang
- From the Department of Neonatology (Huang, Shen, Zheng, Lin), Women and Children’s Hospital, School of Medicine, Xiamen University, from the Xiamen Key Laboratory of Perinatal-Neonatal Infection (Huang, Shen, Zheng, Lin), Xiamen Clinical Research Center for Perinatal Medicine, Xiamen, from the Department of Neonatology (F. Wu), The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, from the Department of Pediatrics (Mao), Shengjing Hospital of China Medical University, Shenyang, from the Department of Neonatology (Liu), Guiyang Maternal and Child Health Hospital, Guiyang Children’s Hospital, Guiyang, from the Department of Pediatrics (Chang, Tong), Peking University Third Hospital, Beijing, from the Department of Neonatology (Zhang), Children’s Hospital of Fudan University, Shanghai, from the Department of Neonatology (Ye), Guangdong Province Maternal and Children’s Hospital, Guangzhou, from the Department of Neonatology (Qiu), General Hospital of Ningxia Medical University, Yinchuan, from the Department of Neonatology (Ma), Children’s Hospital of Hebei Province, Shijiazhuang, from the Department of Neonatology (Cheng), Children’s Hospital of Nanjing Medical University, Nanjing, from the Department of Neonatology (H. Wu), The First Hospital of Jilin University, Changchun, from the Department of Neonatology (D. Chen), Quanzhou Maternity and Children’s Hospital, Quanzhou, from the Department of Pediatrics (L. Chen), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, from the Department of Neonatology (P. Xu), Liaocheng People’s Hospital, Liaocheng, from the Department of Neonatology (Mei), the Affiliate Hospital of Inner Mongolia Medical University, Hohhot, from the Department of Neonatology (Wang), Suzhou Municipal Hospital, Suzhou, from the Department of Neonatology (F. Xu), The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, and from the Department of Neonatology (Ju), Chengdu Women’ and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
| | - Xiuzhen Ye
- From the Department of Neonatology (Huang, Shen, Zheng, Lin), Women and Children’s Hospital, School of Medicine, Xiamen University, from the Xiamen Key Laboratory of Perinatal-Neonatal Infection (Huang, Shen, Zheng, Lin), Xiamen Clinical Research Center for Perinatal Medicine, Xiamen, from the Department of Neonatology (F. Wu), The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, from the Department of Pediatrics (Mao), Shengjing Hospital of China Medical University, Shenyang, from the Department of Neonatology (Liu), Guiyang Maternal and Child Health Hospital, Guiyang Children’s Hospital, Guiyang, from the Department of Pediatrics (Chang, Tong), Peking University Third Hospital, Beijing, from the Department of Neonatology (Zhang), Children’s Hospital of Fudan University, Shanghai, from the Department of Neonatology (Ye), Guangdong Province Maternal and Children’s Hospital, Guangzhou, from the Department of Neonatology (Qiu), General Hospital of Ningxia Medical University, Yinchuan, from the Department of Neonatology (Ma), Children’s Hospital of Hebei Province, Shijiazhuang, from the Department of Neonatology (Cheng), Children’s Hospital of Nanjing Medical University, Nanjing, from the Department of Neonatology (H. Wu), The First Hospital of Jilin University, Changchun, from the Department of Neonatology (D. Chen), Quanzhou Maternity and Children’s Hospital, Quanzhou, from the Department of Pediatrics (L. Chen), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, from the Department of Neonatology (P. Xu), Liaocheng People’s Hospital, Liaocheng, from the Department of Neonatology (Mei), the Affiliate Hospital of Inner Mongolia Medical University, Hohhot, from the Department of Neonatology (Wang), Suzhou Municipal Hospital, Suzhou, from the Department of Neonatology (F. Xu), The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, and from the Department of Neonatology (Ju), Chengdu Women’ and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
| | - Yinping Qiu
- From the Department of Neonatology (Huang, Shen, Zheng, Lin), Women and Children’s Hospital, School of Medicine, Xiamen University, from the Xiamen Key Laboratory of Perinatal-Neonatal Infection (Huang, Shen, Zheng, Lin), Xiamen Clinical Research Center for Perinatal Medicine, Xiamen, from the Department of Neonatology (F. Wu), The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, from the Department of Pediatrics (Mao), Shengjing Hospital of China Medical University, Shenyang, from the Department of Neonatology (Liu), Guiyang Maternal and Child Health Hospital, Guiyang Children’s Hospital, Guiyang, from the Department of Pediatrics (Chang, Tong), Peking University Third Hospital, Beijing, from the Department of Neonatology (Zhang), Children’s Hospital of Fudan University, Shanghai, from the Department of Neonatology (Ye), Guangdong Province Maternal and Children’s Hospital, Guangzhou, from the Department of Neonatology (Qiu), General Hospital of Ningxia Medical University, Yinchuan, from the Department of Neonatology (Ma), Children’s Hospital of Hebei Province, Shijiazhuang, from the Department of Neonatology (Cheng), Children’s Hospital of Nanjing Medical University, Nanjing, from the Department of Neonatology (H. Wu), The First Hospital of Jilin University, Changchun, from the Department of Neonatology (D. Chen), Quanzhou Maternity and Children’s Hospital, Quanzhou, from the Department of Pediatrics (L. Chen), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, from the Department of Neonatology (P. Xu), Liaocheng People’s Hospital, Liaocheng, from the Department of Neonatology (Mei), the Affiliate Hospital of Inner Mongolia Medical University, Hohhot, from the Department of Neonatology (Wang), Suzhou Municipal Hospital, Suzhou, from the Department of Neonatology (F. Xu), The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, and from the Department of Neonatology (Ju), Chengdu Women’ and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
| | - Li Ma
- From the Department of Neonatology (Huang, Shen, Zheng, Lin), Women and Children’s Hospital, School of Medicine, Xiamen University, from the Xiamen Key Laboratory of Perinatal-Neonatal Infection (Huang, Shen, Zheng, Lin), Xiamen Clinical Research Center for Perinatal Medicine, Xiamen, from the Department of Neonatology (F. Wu), The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, from the Department of Pediatrics (Mao), Shengjing Hospital of China Medical University, Shenyang, from the Department of Neonatology (Liu), Guiyang Maternal and Child Health Hospital, Guiyang Children’s Hospital, Guiyang, from the Department of Pediatrics (Chang, Tong), Peking University Third Hospital, Beijing, from the Department of Neonatology (Zhang), Children’s Hospital of Fudan University, Shanghai, from the Department of Neonatology (Ye), Guangdong Province Maternal and Children’s Hospital, Guangzhou, from the Department of Neonatology (Qiu), General Hospital of Ningxia Medical University, Yinchuan, from the Department of Neonatology (Ma), Children’s Hospital of Hebei Province, Shijiazhuang, from the Department of Neonatology (Cheng), Children’s Hospital of Nanjing Medical University, Nanjing, from the Department of Neonatology (H. Wu), The First Hospital of Jilin University, Changchun, from the Department of Neonatology (D. Chen), Quanzhou Maternity and Children’s Hospital, Quanzhou, from the Department of Pediatrics (L. Chen), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, from the Department of Neonatology (P. Xu), Liaocheng People’s Hospital, Liaocheng, from the Department of Neonatology (Mei), the Affiliate Hospital of Inner Mongolia Medical University, Hohhot, from the Department of Neonatology (Wang), Suzhou Municipal Hospital, Suzhou, from the Department of Neonatology (F. Xu), The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, and from the Department of Neonatology (Ju), Chengdu Women’ and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
| | - Rui Cheng
- From the Department of Neonatology (Huang, Shen, Zheng, Lin), Women and Children’s Hospital, School of Medicine, Xiamen University, from the Xiamen Key Laboratory of Perinatal-Neonatal Infection (Huang, Shen, Zheng, Lin), Xiamen Clinical Research Center for Perinatal Medicine, Xiamen, from the Department of Neonatology (F. Wu), The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, from the Department of Pediatrics (Mao), Shengjing Hospital of China Medical University, Shenyang, from the Department of Neonatology (Liu), Guiyang Maternal and Child Health Hospital, Guiyang Children’s Hospital, Guiyang, from the Department of Pediatrics (Chang, Tong), Peking University Third Hospital, Beijing, from the Department of Neonatology (Zhang), Children’s Hospital of Fudan University, Shanghai, from the Department of Neonatology (Ye), Guangdong Province Maternal and Children’s Hospital, Guangzhou, from the Department of Neonatology (Qiu), General Hospital of Ningxia Medical University, Yinchuan, from the Department of Neonatology (Ma), Children’s Hospital of Hebei Province, Shijiazhuang, from the Department of Neonatology (Cheng), Children’s Hospital of Nanjing Medical University, Nanjing, from the Department of Neonatology (H. Wu), The First Hospital of Jilin University, Changchun, from the Department of Neonatology (D. Chen), Quanzhou Maternity and Children’s Hospital, Quanzhou, from the Department of Pediatrics (L. Chen), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, from the Department of Neonatology (P. Xu), Liaocheng People’s Hospital, Liaocheng, from the Department of Neonatology (Mei), the Affiliate Hospital of Inner Mongolia Medical University, Hohhot, from the Department of Neonatology (Wang), Suzhou Municipal Hospital, Suzhou, from the Department of Neonatology (F. Xu), The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, and from the Department of Neonatology (Ju), Chengdu Women’ and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
| | - Hui Wu
- From the Department of Neonatology (Huang, Shen, Zheng, Lin), Women and Children’s Hospital, School of Medicine, Xiamen University, from the Xiamen Key Laboratory of Perinatal-Neonatal Infection (Huang, Shen, Zheng, Lin), Xiamen Clinical Research Center for Perinatal Medicine, Xiamen, from the Department of Neonatology (F. Wu), The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, from the Department of Pediatrics (Mao), Shengjing Hospital of China Medical University, Shenyang, from the Department of Neonatology (Liu), Guiyang Maternal and Child Health Hospital, Guiyang Children’s Hospital, Guiyang, from the Department of Pediatrics (Chang, Tong), Peking University Third Hospital, Beijing, from the Department of Neonatology (Zhang), Children’s Hospital of Fudan University, Shanghai, from the Department of Neonatology (Ye), Guangdong Province Maternal and Children’s Hospital, Guangzhou, from the Department of Neonatology (Qiu), General Hospital of Ningxia Medical University, Yinchuan, from the Department of Neonatology (Ma), Children’s Hospital of Hebei Province, Shijiazhuang, from the Department of Neonatology (Cheng), Children’s Hospital of Nanjing Medical University, Nanjing, from the Department of Neonatology (H. Wu), The First Hospital of Jilin University, Changchun, from the Department of Neonatology (D. Chen), Quanzhou Maternity and Children’s Hospital, Quanzhou, from the Department of Pediatrics (L. Chen), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, from the Department of Neonatology (P. Xu), Liaocheng People’s Hospital, Liaocheng, from the Department of Neonatology (Mei), the Affiliate Hospital of Inner Mongolia Medical University, Hohhot, from the Department of Neonatology (Wang), Suzhou Municipal Hospital, Suzhou, from the Department of Neonatology (F. Xu), The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, and from the Department of Neonatology (Ju), Chengdu Women’ and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
| | - Dongmei Chen
- From the Department of Neonatology (Huang, Shen, Zheng, Lin), Women and Children’s Hospital, School of Medicine, Xiamen University, from the Xiamen Key Laboratory of Perinatal-Neonatal Infection (Huang, Shen, Zheng, Lin), Xiamen Clinical Research Center for Perinatal Medicine, Xiamen, from the Department of Neonatology (F. Wu), The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, from the Department of Pediatrics (Mao), Shengjing Hospital of China Medical University, Shenyang, from the Department of Neonatology (Liu), Guiyang Maternal and Child Health Hospital, Guiyang Children’s Hospital, Guiyang, from the Department of Pediatrics (Chang, Tong), Peking University Third Hospital, Beijing, from the Department of Neonatology (Zhang), Children’s Hospital of Fudan University, Shanghai, from the Department of Neonatology (Ye), Guangdong Province Maternal and Children’s Hospital, Guangzhou, from the Department of Neonatology (Qiu), General Hospital of Ningxia Medical University, Yinchuan, from the Department of Neonatology (Ma), Children’s Hospital of Hebei Province, Shijiazhuang, from the Department of Neonatology (Cheng), Children’s Hospital of Nanjing Medical University, Nanjing, from the Department of Neonatology (H. Wu), The First Hospital of Jilin University, Changchun, from the Department of Neonatology (D. Chen), Quanzhou Maternity and Children’s Hospital, Quanzhou, from the Department of Pediatrics (L. Chen), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, from the Department of Neonatology (P. Xu), Liaocheng People’s Hospital, Liaocheng, from the Department of Neonatology (Mei), the Affiliate Hospital of Inner Mongolia Medical University, Hohhot, from the Department of Neonatology (Wang), Suzhou Municipal Hospital, Suzhou, from the Department of Neonatology (F. Xu), The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, and from the Department of Neonatology (Ju), Chengdu Women’ and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
| | - Ling Chen
- From the Department of Neonatology (Huang, Shen, Zheng, Lin), Women and Children’s Hospital, School of Medicine, Xiamen University, from the Xiamen Key Laboratory of Perinatal-Neonatal Infection (Huang, Shen, Zheng, Lin), Xiamen Clinical Research Center for Perinatal Medicine, Xiamen, from the Department of Neonatology (F. Wu), The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, from the Department of Pediatrics (Mao), Shengjing Hospital of China Medical University, Shenyang, from the Department of Neonatology (Liu), Guiyang Maternal and Child Health Hospital, Guiyang Children’s Hospital, Guiyang, from the Department of Pediatrics (Chang, Tong), Peking University Third Hospital, Beijing, from the Department of Neonatology (Zhang), Children’s Hospital of Fudan University, Shanghai, from the Department of Neonatology (Ye), Guangdong Province Maternal and Children’s Hospital, Guangzhou, from the Department of Neonatology (Qiu), General Hospital of Ningxia Medical University, Yinchuan, from the Department of Neonatology (Ma), Children’s Hospital of Hebei Province, Shijiazhuang, from the Department of Neonatology (Cheng), Children’s Hospital of Nanjing Medical University, Nanjing, from the Department of Neonatology (H. Wu), The First Hospital of Jilin University, Changchun, from the Department of Neonatology (D. Chen), Quanzhou Maternity and Children’s Hospital, Quanzhou, from the Department of Pediatrics (L. Chen), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, from the Department of Neonatology (P. Xu), Liaocheng People’s Hospital, Liaocheng, from the Department of Neonatology (Mei), the Affiliate Hospital of Inner Mongolia Medical University, Hohhot, from the Department of Neonatology (Wang), Suzhou Municipal Hospital, Suzhou, from the Department of Neonatology (F. Xu), The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, and from the Department of Neonatology (Ju), Chengdu Women’ and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
| | - Ping Xu
- From the Department of Neonatology (Huang, Shen, Zheng, Lin), Women and Children’s Hospital, School of Medicine, Xiamen University, from the Xiamen Key Laboratory of Perinatal-Neonatal Infection (Huang, Shen, Zheng, Lin), Xiamen Clinical Research Center for Perinatal Medicine, Xiamen, from the Department of Neonatology (F. Wu), The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, from the Department of Pediatrics (Mao), Shengjing Hospital of China Medical University, Shenyang, from the Department of Neonatology (Liu), Guiyang Maternal and Child Health Hospital, Guiyang Children’s Hospital, Guiyang, from the Department of Pediatrics (Chang, Tong), Peking University Third Hospital, Beijing, from the Department of Neonatology (Zhang), Children’s Hospital of Fudan University, Shanghai, from the Department of Neonatology (Ye), Guangdong Province Maternal and Children’s Hospital, Guangzhou, from the Department of Neonatology (Qiu), General Hospital of Ningxia Medical University, Yinchuan, from the Department of Neonatology (Ma), Children’s Hospital of Hebei Province, Shijiazhuang, from the Department of Neonatology (Cheng), Children’s Hospital of Nanjing Medical University, Nanjing, from the Department of Neonatology (H. Wu), The First Hospital of Jilin University, Changchun, from the Department of Neonatology (D. Chen), Quanzhou Maternity and Children’s Hospital, Quanzhou, from the Department of Pediatrics (L. Chen), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, from the Department of Neonatology (P. Xu), Liaocheng People’s Hospital, Liaocheng, from the Department of Neonatology (Mei), the Affiliate Hospital of Inner Mongolia Medical University, Hohhot, from the Department of Neonatology (Wang), Suzhou Municipal Hospital, Suzhou, from the Department of Neonatology (F. Xu), The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, and from the Department of Neonatology (Ju), Chengdu Women’ and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
| | - Hua Mei
- From the Department of Neonatology (Huang, Shen, Zheng, Lin), Women and Children’s Hospital, School of Medicine, Xiamen University, from the Xiamen Key Laboratory of Perinatal-Neonatal Infection (Huang, Shen, Zheng, Lin), Xiamen Clinical Research Center for Perinatal Medicine, Xiamen, from the Department of Neonatology (F. Wu), The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, from the Department of Pediatrics (Mao), Shengjing Hospital of China Medical University, Shenyang, from the Department of Neonatology (Liu), Guiyang Maternal and Child Health Hospital, Guiyang Children’s Hospital, Guiyang, from the Department of Pediatrics (Chang, Tong), Peking University Third Hospital, Beijing, from the Department of Neonatology (Zhang), Children’s Hospital of Fudan University, Shanghai, from the Department of Neonatology (Ye), Guangdong Province Maternal and Children’s Hospital, Guangzhou, from the Department of Neonatology (Qiu), General Hospital of Ningxia Medical University, Yinchuan, from the Department of Neonatology (Ma), Children’s Hospital of Hebei Province, Shijiazhuang, from the Department of Neonatology (Cheng), Children’s Hospital of Nanjing Medical University, Nanjing, from the Department of Neonatology (H. Wu), The First Hospital of Jilin University, Changchun, from the Department of Neonatology (D. Chen), Quanzhou Maternity and Children’s Hospital, Quanzhou, from the Department of Pediatrics (L. Chen), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, from the Department of Neonatology (P. Xu), Liaocheng People’s Hospital, Liaocheng, from the Department of Neonatology (Mei), the Affiliate Hospital of Inner Mongolia Medical University, Hohhot, from the Department of Neonatology (Wang), Suzhou Municipal Hospital, Suzhou, from the Department of Neonatology (F. Xu), The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, and from the Department of Neonatology (Ju), Chengdu Women’ and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
| | - Sannan Wang
- From the Department of Neonatology (Huang, Shen, Zheng, Lin), Women and Children’s Hospital, School of Medicine, Xiamen University, from the Xiamen Key Laboratory of Perinatal-Neonatal Infection (Huang, Shen, Zheng, Lin), Xiamen Clinical Research Center for Perinatal Medicine, Xiamen, from the Department of Neonatology (F. Wu), The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, from the Department of Pediatrics (Mao), Shengjing Hospital of China Medical University, Shenyang, from the Department of Neonatology (Liu), Guiyang Maternal and Child Health Hospital, Guiyang Children’s Hospital, Guiyang, from the Department of Pediatrics (Chang, Tong), Peking University Third Hospital, Beijing, from the Department of Neonatology (Zhang), Children’s Hospital of Fudan University, Shanghai, from the Department of Neonatology (Ye), Guangdong Province Maternal and Children’s Hospital, Guangzhou, from the Department of Neonatology (Qiu), General Hospital of Ningxia Medical University, Yinchuan, from the Department of Neonatology (Ma), Children’s Hospital of Hebei Province, Shijiazhuang, from the Department of Neonatology (Cheng), Children’s Hospital of Nanjing Medical University, Nanjing, from the Department of Neonatology (H. Wu), The First Hospital of Jilin University, Changchun, from the Department of Neonatology (D. Chen), Quanzhou Maternity and Children’s Hospital, Quanzhou, from the Department of Pediatrics (L. Chen), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, from the Department of Neonatology (P. Xu), Liaocheng People’s Hospital, Liaocheng, from the Department of Neonatology (Mei), the Affiliate Hospital of Inner Mongolia Medical University, Hohhot, from the Department of Neonatology (Wang), Suzhou Municipal Hospital, Suzhou, from the Department of Neonatology (F. Xu), The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, and from the Department of Neonatology (Ju), Chengdu Women’ and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
| | - Falin Xu
- From the Department of Neonatology (Huang, Shen, Zheng, Lin), Women and Children’s Hospital, School of Medicine, Xiamen University, from the Xiamen Key Laboratory of Perinatal-Neonatal Infection (Huang, Shen, Zheng, Lin), Xiamen Clinical Research Center for Perinatal Medicine, Xiamen, from the Department of Neonatology (F. Wu), The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, from the Department of Pediatrics (Mao), Shengjing Hospital of China Medical University, Shenyang, from the Department of Neonatology (Liu), Guiyang Maternal and Child Health Hospital, Guiyang Children’s Hospital, Guiyang, from the Department of Pediatrics (Chang, Tong), Peking University Third Hospital, Beijing, from the Department of Neonatology (Zhang), Children’s Hospital of Fudan University, Shanghai, from the Department of Neonatology (Ye), Guangdong Province Maternal and Children’s Hospital, Guangzhou, from the Department of Neonatology (Qiu), General Hospital of Ningxia Medical University, Yinchuan, from the Department of Neonatology (Ma), Children’s Hospital of Hebei Province, Shijiazhuang, from the Department of Neonatology (Cheng), Children’s Hospital of Nanjing Medical University, Nanjing, from the Department of Neonatology (H. Wu), The First Hospital of Jilin University, Changchun, from the Department of Neonatology (D. Chen), Quanzhou Maternity and Children’s Hospital, Quanzhou, from the Department of Pediatrics (L. Chen), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, from the Department of Neonatology (P. Xu), Liaocheng People’s Hospital, Liaocheng, from the Department of Neonatology (Mei), the Affiliate Hospital of Inner Mongolia Medical University, Hohhot, from the Department of Neonatology (Wang), Suzhou Municipal Hospital, Suzhou, from the Department of Neonatology (F. Xu), The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, and from the Department of Neonatology (Ju), Chengdu Women’ and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
| | - Rong Ju
- From the Department of Neonatology (Huang, Shen, Zheng, Lin), Women and Children’s Hospital, School of Medicine, Xiamen University, from the Xiamen Key Laboratory of Perinatal-Neonatal Infection (Huang, Shen, Zheng, Lin), Xiamen Clinical Research Center for Perinatal Medicine, Xiamen, from the Department of Neonatology (F. Wu), The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, from the Department of Pediatrics (Mao), Shengjing Hospital of China Medical University, Shenyang, from the Department of Neonatology (Liu), Guiyang Maternal and Child Health Hospital, Guiyang Children’s Hospital, Guiyang, from the Department of Pediatrics (Chang, Tong), Peking University Third Hospital, Beijing, from the Department of Neonatology (Zhang), Children’s Hospital of Fudan University, Shanghai, from the Department of Neonatology (Ye), Guangdong Province Maternal and Children’s Hospital, Guangzhou, from the Department of Neonatology (Qiu), General Hospital of Ningxia Medical University, Yinchuan, from the Department of Neonatology (Ma), Children’s Hospital of Hebei Province, Shijiazhuang, from the Department of Neonatology (Cheng), Children’s Hospital of Nanjing Medical University, Nanjing, from the Department of Neonatology (H. Wu), The First Hospital of Jilin University, Changchun, from the Department of Neonatology (D. Chen), Quanzhou Maternity and Children’s Hospital, Quanzhou, from the Department of Pediatrics (L. Chen), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, from the Department of Neonatology (P. Xu), Liaocheng People’s Hospital, Liaocheng, from the Department of Neonatology (Mei), the Affiliate Hospital of Inner Mongolia Medical University, Hohhot, from the Department of Neonatology (Wang), Suzhou Municipal Hospital, Suzhou, from the Department of Neonatology (F. Xu), The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, and from the Department of Neonatology (Ju), Chengdu Women’ and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
| | - Zhi Zheng
- From the Department of Neonatology (Huang, Shen, Zheng, Lin), Women and Children’s Hospital, School of Medicine, Xiamen University, from the Xiamen Key Laboratory of Perinatal-Neonatal Infection (Huang, Shen, Zheng, Lin), Xiamen Clinical Research Center for Perinatal Medicine, Xiamen, from the Department of Neonatology (F. Wu), The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, from the Department of Pediatrics (Mao), Shengjing Hospital of China Medical University, Shenyang, from the Department of Neonatology (Liu), Guiyang Maternal and Child Health Hospital, Guiyang Children’s Hospital, Guiyang, from the Department of Pediatrics (Chang, Tong), Peking University Third Hospital, Beijing, from the Department of Neonatology (Zhang), Children’s Hospital of Fudan University, Shanghai, from the Department of Neonatology (Ye), Guangdong Province Maternal and Children’s Hospital, Guangzhou, from the Department of Neonatology (Qiu), General Hospital of Ningxia Medical University, Yinchuan, from the Department of Neonatology (Ma), Children’s Hospital of Hebei Province, Shijiazhuang, from the Department of Neonatology (Cheng), Children’s Hospital of Nanjing Medical University, Nanjing, from the Department of Neonatology (H. Wu), The First Hospital of Jilin University, Changchun, from the Department of Neonatology (D. Chen), Quanzhou Maternity and Children’s Hospital, Quanzhou, from the Department of Pediatrics (L. Chen), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, from the Department of Neonatology (P. Xu), Liaocheng People’s Hospital, Liaocheng, from the Department of Neonatology (Mei), the Affiliate Hospital of Inner Mongolia Medical University, Hohhot, from the Department of Neonatology (Wang), Suzhou Municipal Hospital, Suzhou, from the Department of Neonatology (F. Xu), The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, and from the Department of Neonatology (Ju), Chengdu Women’ and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
| | - Xinzhu Lin
- From the Department of Neonatology (Huang, Shen, Zheng, Lin), Women and Children’s Hospital, School of Medicine, Xiamen University, from the Xiamen Key Laboratory of Perinatal-Neonatal Infection (Huang, Shen, Zheng, Lin), Xiamen Clinical Research Center for Perinatal Medicine, Xiamen, from the Department of Neonatology (F. Wu), The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, from the Department of Pediatrics (Mao), Shengjing Hospital of China Medical University, Shenyang, from the Department of Neonatology (Liu), Guiyang Maternal and Child Health Hospital, Guiyang Children’s Hospital, Guiyang, from the Department of Pediatrics (Chang, Tong), Peking University Third Hospital, Beijing, from the Department of Neonatology (Zhang), Children’s Hospital of Fudan University, Shanghai, from the Department of Neonatology (Ye), Guangdong Province Maternal and Children’s Hospital, Guangzhou, from the Department of Neonatology (Qiu), General Hospital of Ningxia Medical University, Yinchuan, from the Department of Neonatology (Ma), Children’s Hospital of Hebei Province, Shijiazhuang, from the Department of Neonatology (Cheng), Children’s Hospital of Nanjing Medical University, Nanjing, from the Department of Neonatology (H. Wu), The First Hospital of Jilin University, Changchun, from the Department of Neonatology (D. Chen), Quanzhou Maternity and Children’s Hospital, Quanzhou, from the Department of Pediatrics (L. Chen), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, from the Department of Neonatology (P. Xu), Liaocheng People’s Hospital, Liaocheng, from the Department of Neonatology (Mei), the Affiliate Hospital of Inner Mongolia Medical University, Hohhot, from the Department of Neonatology (Wang), Suzhou Municipal Hospital, Suzhou, from the Department of Neonatology (F. Xu), The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, and from the Department of Neonatology (Ju), Chengdu Women’ and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
| | - Xiaomei Tong
- From the Department of Neonatology (Huang, Shen, Zheng, Lin), Women and Children’s Hospital, School of Medicine, Xiamen University, from the Xiamen Key Laboratory of Perinatal-Neonatal Infection (Huang, Shen, Zheng, Lin), Xiamen Clinical Research Center for Perinatal Medicine, Xiamen, from the Department of Neonatology (F. Wu), The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, from the Department of Pediatrics (Mao), Shengjing Hospital of China Medical University, Shenyang, from the Department of Neonatology (Liu), Guiyang Maternal and Child Health Hospital, Guiyang Children’s Hospital, Guiyang, from the Department of Pediatrics (Chang, Tong), Peking University Third Hospital, Beijing, from the Department of Neonatology (Zhang), Children’s Hospital of Fudan University, Shanghai, from the Department of Neonatology (Ye), Guangdong Province Maternal and Children’s Hospital, Guangzhou, from the Department of Neonatology (Qiu), General Hospital of Ningxia Medical University, Yinchuan, from the Department of Neonatology (Ma), Children’s Hospital of Hebei Province, Shijiazhuang, from the Department of Neonatology (Cheng), Children’s Hospital of Nanjing Medical University, Nanjing, from the Department of Neonatology (H. Wu), The First Hospital of Jilin University, Changchun, from the Department of Neonatology (D. Chen), Quanzhou Maternity and Children’s Hospital, Quanzhou, from the Department of Pediatrics (L. Chen), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, from the Department of Neonatology (P. Xu), Liaocheng People’s Hospital, Liaocheng, from the Department of Neonatology (Mei), the Affiliate Hospital of Inner Mongolia Medical University, Hohhot, from the Department of Neonatology (Wang), Suzhou Municipal Hospital, Suzhou, from the Department of Neonatology (F. Xu), The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, and from the Department of Neonatology (Ju), Chengdu Women’ and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
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