BACKGROUND & AIMS: :The authors wish to make a correction to Section 2 [...].

背景与目标： ：作者希望对第2节[...]进行更正。

BACKGROUND & AIMS: AIM:Levels of infant and child mortality in many developing countries remain unacceptably high, and they are disproportionably higher among high-risk groups such as newborn and infant of multiple births, particularly in countries where advanced medical cares are available only at regional referral levels with limited access by the poor rural women and children. This study examined the relationship between high-risk infant of multiple birth and infant mortality in Bangladesh. METHODS:The analysis uses information on 7001 childbirths in 5 years preceding the 2004 Bangladesh Demographic and Health Survey to examine the relationship between multiple birth and infant mortality using multivariate analysis, controlling for child's sex, birth order, prenatal care, delivery assistance; mother's age at child birth, nutritional status, education level; household living conditions and several other risk factors. RESULTS:Results indicate that children born multiple birth were more than six-times as likely to die during infancy as those born singletons (hazard ratio = 6.51; 95% confidence interval: 4.10, 10.36). Controlling for all other risk factors does not change the strength and direction of the relationship (hazard ratio = 6.18; 95% confidence interval: 3.65, 10.46). Receiving prenatal care and access to safe drinking water are associated with lower risk. CONCLUSION:Multiple births are strongly negatively associated with infant survival in Bangladesh independent of other risk factors. This evidence suggests that improving maternal and child health at the community level, screening for high-risk pregnancies and making referral services for these conditions more accessible to the rural women and children will be key to improving child survival in Bangladesh.

背景与目标： 目的：在许多发展中国家，婴儿和儿童的死亡率仍然很高，令人难以接受，在新生儿和多胎婴儿等高危人群中，婴儿和儿童的死亡率却高得不成比例，特别是在只有在地区转诊时才可获得高级医疗的国家贫穷的农村妇女和儿童获得的机会有限。这项研究检查了孟加拉国多胎高危婴儿与婴儿死亡率之间的关系。
方法：该分析使用2004年孟加拉国人口与健康调查之前5年中7001名分娩的信息，通过多变量分析检查多胎与婴儿死亡率之间的关系，控制孩子的性别，出生顺序，产前保健，分娩辅助;母亲的出生年龄，营养状况，教育程度；家庭生活条件和其他几个危险因素。
结果：结果表明，多胎出生的婴儿死于婴儿的可能性是单胎死亡的六倍以上（危险比= 6.51； 95％置信区间：4.10，10.36）。控制所有其他风险因素并不会改变关系的强度和方向（危险比= 6.18； 95％置信区间：3.65、10.46）。接受产前检查和获得安全饮用水与较低的风险相关。
结论：孟加拉国多胎出生与婴儿存活率呈强烈负相关，而与其他危险因素无关。这些证据表明，改善社区一级的妇幼健康，筛查高危妊娠以及使农村妇女儿童更容易获得针对这些疾病的转诊服务，将是改善孟加拉国儿童生存的关键。

BACKGROUND & AIMS: INTRODUCTION:Early life is a critical developmental window coinciding with the establishment of a community of neonatal gut microbes which are vitally important for immune development. The composition of this microbial community is affected by multiple factors. AREAS COVERED:The effect of pre-pregnancy and pregnancy maternal health, maternal nutrition, pregnancy disorders such as gestational diabetes, maternal antibiotic usage, delivery mode, infant feeding, and infant antibiotic usage on gut microbial composition are outlined along with the potential impact of associated microbiota differences on infant health. EXPERT OPINION:Recent developments in understanding what shapes our microbiota indicates that the greatest impact on infant gut microbiota composition during the first year of life is seen with the mode of delivery, infant diet, and infant antibiotic usage. Current data is insufficient to fully establish the role of apparently less important factors such as maternal health on microbiota development although their impact is likely smaller. Technological advances will allow for improved understanding of underlying mechanisms by which specific microbes impact on infant health, which in time will enable full appreciation of the role of the gut microbiota in early life development.

背景与目标： 简介：早期生命是一个至关重要的发展窗口，这与建立新生儿肠道微生物群落相一致，而新生儿肠道微生物对于免疫发育至关重要。该微生物群落的组成受多种因素影响。
覆盖的区域：概述了孕前和孕期孕产妇健康，孕产妇营养，妊娠疾病（如妊娠糖尿病），孕产妇抗生素使用，分娩方式，婴儿喂养和婴儿抗生素使用对肠道微生物组成的影响，以及孕激素的潜在影响。相关的微生物群差异对婴儿健康的影响。
专家意见：最近了解微生物菌群形状的进展表明，分娩方式，婴儿饮食和婴儿抗生素的使用对生命的第一年对婴儿肠道菌群组成的影响最大。尽管母体健康对微生物群发育的影响可能较小，但目前的数据不足以完全确立诸如母亲健康等看似不太重要的因素的作用。技术的进步将使人们更好地了解特定微生物对婴儿健康的影响的潜在机制，这将使人们充分认识到肠道菌群在早期生命发展中的作用。

BACKGROUND & AIMS: OBJECTIVE:To determine whether maternal or paternal use of cocaine, opiates, or marijuana during conception and pregnancy and postnatally increases the risk of sudden infant death syndrome (SIDS) during the first year of the infant's life. This is an important issue and may prove useful in further decreasing the rate of SIDS. METHODS:A case-control study was conducted consisting of 239 infants who died of SIDS in southern California between 1989 and 1992, and 239 healthy infants who were matched on the basis of birth hospital, date of birth, age, and sex. Specific drug use at the period of conception, during pregnancy and breastfeeding, and in the presence or vicinity of the infant was ascertained by telephone for the white, African American, Hispanic, Asian American, and Pacific Islander case and control fathers and mothers. RESULTS:Maternal recreational drug use during pregnancy was not associated with the risk of SIDS after adjusting for maternal smoking during pregnancy (adjusted odds ratio [OR] = 2.0; 95% confidence interval [CI], 0.6-6.5). There were statistically significant differences between case and control fathers' use of marijuana during conception (OR = 2.2; 95% CI, 1.2-4.2; P =.01), during pregnancy (OR = 2.0; 95% CI, 1.0-4.1; P =.05), and postnatally (OR = 2.8; 95% CI, 1.1-7.3; P =.04) and the risk of SIDS, while adjusting for paternal smoking and alcohol use. CONCLUSIONS:There was no association between maternal recreational drug use and SIDS. Paternal marijuana use during the periods of conception and pregnancy and postnatally were significantly associated with SIDS. The role of paternal psychoactive drug use, especially the relationship between marijuana and SIDS, is an understudied area; however, before any definitive role for the father can be confirmed, these findings should be investigated and replicated in future studies.

背景与目标： 目的：确定在怀孕和怀孕期间以及产后出生时母亲或父亲使用可卡因，鸦片或大麻，以及产后增加婴儿出生后第一年发生婴儿猝死综合症（SIDS）的风险。这是一个重要的问题，可能有助于进一步降低小岛屿发展中国家的比率。
方法：进行了一项病例对照研究，该研究由1989年至1992年在南加州的239名死于小岛屿发展中国家的婴儿以及根据出生医院，出生日期，年龄和性别相匹配的239名健康婴儿组成。通过电话确定白人，非裔美国人，西班牙裔，亚裔美国人和太平洋岛民病例以及对照父母的电话，确定在受孕期间，怀孕期间和母乳喂养期间以及在婴儿存在或附近时的特定药物使用情况。
结果：在调整孕妇吸烟后，孕妇在怀孕期间使用娱乐性药物与SIDS的风险无关（校正比值比[OR] = 2.0； 95％置信区间[CI]，0.6-6.5）。在怀孕期间，病例父亲和对照组父亲使用大麻的统计学差异显着（OR = 2.2； 95％CI，1.2-4.2； P = .01），怀孕期间（OR = 2.0； 95％CI，1.0-4.1； 95％CI，1.0-4.1；或7％）。 P = .05）和产后（OR = 2.8； 95％CI，1.1-7.3； P = .04）和SIDS风险，同时针对父亲吸烟和饮酒进行了调整。
结论：孕产妇休闲药物使用与小岛屿发展中国家之间没有关联。在怀孕，怀孕和产后期间使用父本大麻与SIDS显着相关。父亲使用精神活性药物的作用，特别是大麻与小岛屿发展中国家之间的关系，是一个尚未充分研究的领域；但是，在确定父亲的任何确定角色之前，应对这些发现进行调查，并在以后的研究中加以复制。

BACKGROUND & AIMS: BACKGROUND:To reach the Millennium Development Goals for health, influential international bodies advocate for more resources to be directed to the health sector, in particular medical treatment. Yet, health has many determinants beyond the health sector that are less evident than proximate predictors. AIM:To assess the relative importance of major socioeconomic determinants of population health, measured as infant mortality rate (IMR), at country level. METHODS:National-level data from 152 countries based on World Development Indicators 2003 were used for multivariate linear regression analyses of five socioeconomic predictors of IMR: public spending on health, GNI/capita, poverty rate, income equality (Gini index), and young female illiteracy rate. Analyses were performed on a global level and stratified for low-, middle-, and high-income countries. RESULTS:In order of importance, GNI/capita, young female illiteracy, and income equality predicted 92% of the variation in national IMR whereas public spending on health and poverty rate were non-significant determinants when adjusted for confounding. In low-income countries, female illiteracy was more important than GNI/capita. Income equality (Gini index) was an independent predictor of IMR in middle-income countries only. In high-income countries none of these predictors was significant. CONCLUSIONS:The relative importance of major health determinants varies between income levels, thus extrapolating health policies from high- to low-income countries is problematic. Since the size, per se, of public health spending does not independently predict health outcomes, functioning health systems are necessary to make health investments efficient. Potential health gains from improved female education and economic growth should be considered in low- and middle-income countries.

背景与目标： 背景：为实现卫生领域的千年发展目标，有影响力的国际机构主张将更多资源用于卫生部门，特别是医疗领域。但是，卫生领域除了卫生部门以外还有许多决定因素，远没有最近的预测因素那么明显。
目的：在国家一级评估人口健康的主要社会经济决定因素的相对重要性，以婴儿死亡率（IMR）衡量。
方法：根据2003年世界发展指标，从152个国家/地区获得的国家级数据用于对IMR的五种社会经济指标进行多元线性回归分析：公共卫生支出，国民总收入/人均，贫困率，收入平等（基尼系数）和年轻人女性文盲率。在全球范围内进行了分析，并针对低，中，高收入国家进行了分层。
结果：按重要性排序，国民总收入/人均，年轻女性文盲和收入平等预测了全国IMR的92％差异，而在进行混杂因素调整后，公共卫生和贫困率支出是不重要的决定因素。在低收入国家，女性文盲比人均国民总收入更重要。收入平等（基尼指数）仅是中等收入国家对IMR的独立预测指标。在高收入国家，这些预测指标都不重要。
结论：主要健康决定因素的相对重要性因收入水平而异，因此从高收入国家向低收入国家推断健康政策是有问题的。由于公共卫生支出的规模本身并不能独立地预测卫生结果，因此运作有效的卫生系统对于提高卫生投资的效率是必不可少的。在低收入和中等收入国家，应考虑通过改善女性教育和经济增长带来的潜在健康收益。

BACKGROUND & AIMS: INTRODUCTION:High-grade vesicoureteral reflux (VUR) in infants is associated with congenital renal abnormalities, recurrent UTI, and bladder dysfunction. Endoscopic treatment (ET) is a well-established method in children with low to moderate reflux grades, but there is a lack of randomised controlled trials regarding the use of ET versus continuous antibiotic prophylaxis in infants with high-grade VUR. OBJECTIVE:This study aimed to determine whether high-grade VUR in infants can be treated with endoscopic injection and whether ET is superior to antibiotic prophylaxis in the treatment of VUR. MATERIALS AND METHODS:This prospective, randomised, controlled, multicentre, 1-year follow-up trial comprised 77 infants (55 boys, 22 girls) <8 months of age with VUR grade 4-5 (n = 30/n = 47). Of the infants, 52 (68%) had bilateral VUR. Thirty-nine were randomised to antibiotic prophylaxis and 38 to ET (with prophylaxis until resolution). Voiding cystourethrogram, ultrasound, renal scintigraphy, and free voiding observation were performed at study entry and after 1 year to evaluate VUR grade, and renal and bladder function. RESULTS:VUR grade ≤2 was seen in 22 (59%) infants in the endoscopy group and eight (21%) in the prophylaxis group at follow-up (p = 0.0014). The success rate in the endoscopy group was 100% in unilateral grade 4, falling to 31% in bilateral grade 5 (p = 0.0094). Correspondingly, the results in the prophylaxis group were 40% in grade 4 down to 0% in bilateral grade 5 (p = 0.037) (Table). Logistic regression analyses identified ET, VUR grade 4, unilaterality, and low residual urine at baseline as positive predictors of VUR down-grading to ≤2 (area under ROC curve 0.88). In four patients with reflux resolution after one injection, dilating reflux recurred at the 1-year follow-up. One patient had a UTI possibly related to ET. In our material four patients required re-implantation, of whom one was obstructive after injection. DISCUSSION:The opportunity to offer even small infants with high-grade VUR an alternative, minimally invasive treatment option is a great advance in paediatric urology. In this high-risk group, bilateral VUR grade 5 stands out with its poor bladder function and low chance of resolution. The recurrence rate of dilating VUR after successful ET is consistent with previous studies. The limitations are the relatively small number of patients and the short follow-up. CONCLUSION:High-grade VUR in infants can be treated with injection therapy and the resolution rate is higher than that of prophylaxis treatment. The complication rate is low and VUR grade 4, unilaterality, and low residual urine are favourable for the resolution and down-grading of VUR.

背景与目标： 简介：婴儿高级别膀胱输尿管反流（VUR）与先天性肾脏异常，复发性尿路感染和膀胱功能障碍有关。对于低至中度反流级别的儿童，内镜治疗（ET）是一种行之有效的方法，但是对于高级别VUR的婴儿使用ET与持续预防抗生素的关系，尚缺乏随机对照试验。
目的：本研究旨在确定内镜下注射是否可以治疗婴儿中高级别的VUR，以及在VUR的治疗中，ET是否优于抗生素预防。
材料与方法：这项前瞻性，随机，对照，多中心，为期1年的随访研究纳入了77个婴儿（55个男孩，22个女孩）<8个月大且VUR为4-5级（n = 30 / n = 47）。 。在婴儿中，有52名（68％）患有双侧VUR。 39名被随机分配至抗生素预防性治疗，38名被随机分配至ET（预防性治疗直至消退）。在研究开始时和1年后进行了膀胱膀胱心电图，超声检查，肾闪烁显像和自由排尿观察，以评估VUR等级以及肾和膀胱功能。
结果：在随访中，内窥镜检查组的22名（59％）婴儿中观察到VUR≤2，而预防组中的8例（21％）观察到VUR≤2（p = 0.0014）。内窥镜检查组的成功率在单侧4级中为100％，在双侧5级中降至31％（p = 0.0094）。相应地，预防组的结果从4年级的40％降至双边5年级的0％（p = 0.037）（表）。 Logistic回归分析确定ET，VUR 4级，单侧性和基线尿液残留低是VUR降级至≤2的阳性预测指标（ROC曲线下面积为0.88）。一例注射后有4例反流消退的患者，在1年的随访中再次发生了扩张性反流。一名患者的尿路感染可能与ET有关。在我们的材料中，四名患者需要重新植入，其中一名在注射后阻塞。
讨论：有机会为小婴儿提供高级别的VUR，这是儿科泌尿外科的一大进步。在这一高危人群中，双侧VUR 5级膀胱功能差且解决机会低，因此脱颖而出。成功的ET后扩张VUR的复发率与以前的研究一致。局限性在于患者人数相对较少且随访时间短。
结论：婴幼儿高危型VUR可以通过注射疗法治疗，其分辨率高于预防性治疗。并发症发生率低，VUR 4级，单侧性和残留尿少有利于VUR的分解和降级。

BACKGROUND & AIMS: :Presurgical infant orthopedics (PSIO) is done to reduce the size of the cleft defect along with improving the arch alignment and nasolabial aesthetics in patients with cleft lip and palate, leading to an improvement of nasolabial aesthetics allowing for a tidier and more aesthetic reparative procedure and postsurgical scar. Since the 2000s, clear aligners have slowly and steadily treaded their way as an acceptable orthodontic modality, with their usage and acceptability increasing considerably over the past decade. Thus, from the knowledge gathered in its 10 years working with 3-dimensional (3-D) diagnosis, treatment planning, and 3-D Printing services, Compass 3D (Belo Horizonte, Brazil) developed the OrthoAligner NAM system. This case series highlights one of the world's first documented cases of PSIO treated with a series of clear aligners.

背景与目标： ：进行术前婴儿矫形术（PSIO）可以减少唇裂和pa裂患者的唇裂的大小，并改善弓形排列和鼻唇美学，从而改善鼻唇美学，从而使整形手术和整形手术更加美观和术后疤痕。自2000年代以来，透明矫正器已逐渐稳定地成为可接受的正畸治疗方式，在过去十年中，其用途和可接受性大大提高。因此，Compass 3D（巴西贝洛哈里桑塔，巴西）利用在10年间从事3维（3D）诊断，治疗计划和3D打印服务所积累的知识，开发了OrthoAligner NAM系统。本案例系列重点介绍了世界上最早记录的PSIO案例，该案例使用一系列清晰的对准器进行了处理。

BACKGROUND & AIMS: BACKGROUND:Pneumococcal conjugate vaccine (PCV) immunization of children decreases their risk of nasopharyngeal acquisition of vaccine serotypes. We studied the impact of routine infant PCV immunization alone on the epidemiology of nasopharyngeal pneumococcal colonization among a rural African community with high prevalence of HIV positivity. METHODS:Two cross-sectional surveys were undertaken in a rural South African community from May to October 2009 (period 1) and 2011 (period 2). Seven-valent PCV was introduced into the public immunization program for infants in April 2009, without catch-up campaign for older children. Randomly selected households with at least 1 child<2 years of age were recruited. Nasopharyngeal swabs from all consenting household members were obtained for Streptococcus pneumoniae culture and serotyping by Quellung method. RESULTS:The median ages (SD) of children enrolled were 4.32 (SD, 3.4) and 3.80 (SD, 3.4) years in periods 1 and 2, respectively. Overall, the prevalence of vaccine serotype colonization declined from 18.3% (368/2010) in period 1 to 11.4% (418/3659) by period 2 (P<0.0001). This included reductions (adjusted risk ratio) of 50% [95% confidence interval (95% CI): 0.42-0.59], 34% (95% CI: 0.48-0.92) and 64% (95% CI: 0.18-0.74) in age groups<2 years, 6-12 years and adults. The prevalence of vaccine serotype colonization among primary caregivers decreased from 10.2% to 5.4% (P≤0.001) by period 2. The prevalence of nonvaccine serotype colonization increased by 35% (95% CI: 1.17-1.56) among <2-year-old children by period 2, while it declined by 45-54% among adolescents and adults. CONCLUSIONS:An indirect effect of PCV7 was realized in a high HIV prevalence setting within 2 years of PCV introduction. The unexpected decline in nonvaccine serotypes colonization among adolescents/adults may indicate lag in replacement colonization by nonvaccine serotypes in this group.

背景与目标： 背景：对儿童进行肺炎球菌结合疫苗（PCV）免疫可降低其鼻咽获得疫苗血清型的风险。我们研究了单独的常规婴儿PCV免疫对一个HIV阳性高发的非洲农村社区中鼻咽肺炎球菌定植流行病学的影响。
方法：分别于2009年5月至10月（期间1）和2011年（期间2）在南非农村社区进行了两次横断面调查。 2009年4月，七价PCV被引入婴儿的公共免疫计划，而没有针对大龄儿童的追赶运动。招募了至少有1个孩子<2岁的随机选择的家庭。获得所有同意的家庭成员的鼻咽拭子用于肺炎链球菌培养并通过Quellung方法进行血清分型。
结果：在第1和第2阶段，入组儿童的中位年龄（SD）分别为4.32（SD，3.4）和3.80（SD，3.4）岁。总体而言，疫苗血清型定植的发生率从第1阶段的18.3％（368/2010）下降到第2阶段的11.4％（418/3659）（P <0.0001）。其中包括降低50％（调整后的风险比）[95％置信区间（95％CI）：0.42-0.59]，34％（95％CI：0.48-0.92）和64％（95％CI：0.18-0.74） <2岁，6-12岁和成人的年龄段。到第二阶段，初级护理人员中疫苗血清型定植的患病率从10.2％降低到5.4％（P≤0.001）。非疫苗血清型定植的患病率在2年以下的人群中增加了35％（95％CI：1.17-1.56）。到第2阶段的大孩子，而青少年和成人的年龄则下降了45-54％。
结论：PCV 7的间接影响是在PCV引入后2年内在艾滋病高流行的情况下实现的。青少年/成人中非疫苗血清型定殖的出乎意料的下降可能表明该组中非疫苗血清型的替代定植滞后。

BACKGROUND & AIMS: :We estimated infant and early child mortality rates among Palestinian refugees using maternal and child services in Jordan, Gaza, Lebanon, and Syria. Early childhood mortality per 1000 live births was 35 in Jordan, 36 in Gaza, 37 in Lebanon, and 32 in Syria. Infant mortality rates were 32 in Jordan, 33 in Gaza, 35 in Lebanon, and 29 in Syria. :Since 1950, the UN Relief and Works Agency for Palestine Refugees in the Near East has provided education, health, and relief and social services to registered Palestinian refugees in Jordan, Gaza, the West Bank, Lebanon, and Syria. This study estimated infant and early child mortality rates among Palestinian refugees who attended the agency's primary health care facilities. Using a modified version of the Preceding Birth Technique to estimate early childhood and infant mortality rates, it was noted that infant mortality rate was highest in Lebanon, followed by Gaza, Jordan, and Syria. Early childhood mortality per 1000 live births was 35 in Jordan, 36 in Gaza, 37 in Lebanon, and 32 in Syria. Infant mortality rates registered in Jordan were 32, 33 in Gaza, 35 in Lebanon, and 29 in Syria.

背景与目标： ：我们估算了约旦，加沙，黎巴嫩和叙利亚使用孕产妇和儿童服务的巴勒斯坦难民的婴幼儿死亡率。约旦每千名活产婴儿的早期死亡率为35，约旦为36，黎巴嫩为37，叙利亚为32。约旦的婴儿死亡率为32，加沙为33，黎巴嫩为35，叙利亚为29。
：自1950年以来，联合国近东巴勒斯坦难民救济和工程处一直为约旦，加沙，西岸，黎巴嫩和叙利亚的注册巴勒斯坦难民提供教育，保健，救济和社会服务。这项研究估计了参加该机构主要卫生保健设施的巴勒斯坦难民的婴儿和幼儿死亡率。使用先前的出生技术的修改版本来估计幼儿和婴儿死亡率，注意到婴儿死亡率在黎巴嫩最高，其次是加沙，约旦和叙利亚。约旦每千名活产婴儿的早期死亡率为35，约旦为36，黎巴嫩为37，叙利亚为32。约旦的婴儿死亡率为32，加沙为33，黎巴嫩为35，叙利亚为29。

BACKGROUND & AIMS: :Prenatal exposure to ethanol on gestation Days 19-20, but not 17-18, increases ethanol acceptance in infant rats. This effect seems to be a conditioned response acquired prenatally, mediated by the opioid system, which could be stimulated by ethanol's pharmacological properties (mu-opioid receptors) or by a component of the amniotic fluid from gestation-day 20 (kappa-inducing factor). The latter option was evaluated administering non-ethanol chemosensory stimuli on gestation Days 19-20 and testing postnatal intake and palatability. However, prenatal exposure to anise or vanilla increased neither intake nor palatability of these tastants on postnatal Day 14. In experiment 2, the role of ethanol's pharmacological effect was tested by administering ethanol and selective antagonists of mu and kappa opioid receptors prenatally. Blocking the mu-opioid receptor system completely reversed the effects on intake and palatability, while antagonizing kappa receptors only partially reduced the effects on palatability. This suggests that the pharmacological effect of ethanol on the fetal mu opioid system is the appetitive reinforcer, which induces the prenatally conditioned preference detected in the preweanling period.

背景与目标： ：妊娠第20-20天（而非17-18天）的产前暴露于乙醇会增加婴儿大鼠的乙醇接受度。这种作用似乎是由阿片样物质系统介导的产前条件性反应，可能由乙醇的药理特性（μ阿片样物质受体）或妊娠第20天的羊水成分（κ诱导因子）刺激。 。在妊娠的第20-20天，对非酒精性化学感应刺激进行了评估，并测试了出生后的摄入量和适口性，对后一种选择进行了评估。但是，在产后第14天，产前暴露于茴香或香草的情况下，这些促味剂的摄入量或适口性均未增加。在实验2中，通过在产前施用乙醇以及mu和kappa阿片受体的选择性拮抗剂来测试乙醇的药理作用。阻断μ-阿片受体系统完全逆转了对摄入和适口性的影响，而拮抗κ受体仅部分降低了对适口性的影响。这表明乙醇对胎儿μ阿片样物质系统的药理作用是食欲增强剂，它诱导了在断奶前期检测到的产前条件性偏爱。

BACKGROUND & AIMS: OBJECTIVE:Whereas there are numerous reports in the literature relating the impact of maternal nutritional status on subsequent birth outcome, much less is known about the long-term impact on infant growth after birth. Therefore, we conducted a prospective cohort study to investigate the association of maternal micronutrient status (vitamins A, C and E, folate) and oxidative stress status in pregnancy with infant growth during the first year of life. DESIGN:Prospective cohort study. SETTING:Outpatient clinic of obstetrics, Ewha Womans University Hospital, Seoul, South Korea. SUBJECTS AND METHODS:Two groups were constructed for this study - the Ewha pregnancy cohort (n = 677) and the infant growth cohort comprising follow-up live newborns of all the recruited pregnant women (n = 317). Maternal serum vitamin and urinary oxidative stress levels were collected and infant weights and heights were measured at birth and at 6 and 12 months after birth. RESULTS:Division of the subjects into folate-deficient and normal groups revealed that infant weight and height at 0, 6 and 12 months were adversely affected by folate deficiency. High maternal vitamin C was associated with increased infant weight and height at birth and after birth. CONCLUSION:Our findings indicate the importance of preventing folate deficiency and supplementing vitamin C during pregnancy.

背景与目标： 目的：尽管在文献中有许多关于孕产妇营养状况对随后分娩结果的影响的报道，但对出生后对婴儿生长的长期影响知之甚少。因此，我们进行了一项前瞻性队列研究，以调查孕妇出生后第一年中婴儿微量营养素状况（维生素A，C和E，叶酸）与氧化应激状况之间的关系。
设计：前瞻性队列研究。
地点：韩国首尔梨花女子大学附属医院妇产科门诊。
研究对象和方法：本研究分为两组-梨花妊娠队列（n = 677）和婴儿生长队列，其中包括所有新招募孕妇的随访活新生儿（n = 317）。收集母亲的血清维生素和尿液氧化应激水平，并在出生时以及出生后6个月和12个月时测量婴儿的体重和身高。
结果：将受试者分为叶酸缺乏组和正常组，发现0、6和12个月的婴儿体重和身高受到叶酸缺乏的不利影响。母体维生素C含量高与婴儿出生时和出生后体重和身高的增加有关。
结论：我们的研究结果表明了预防怀孕期间叶酸缺乏和补充维生素C的重要性。

BACKGROUND & AIMS: BACKGROUND:Testing for HIV at birth has the potential to identify infants infected in utero, and allows for the possibility of beginning treatment immediately after birth; point of care (POC) testing allows rapid return of results and faster initiation on treatment for positive infants. Eswatini piloted birth testing in three public maternities for over 2 years. METHODS:In order to assess the acceptability of POC birth testing in the pilot sites in Eswatini, interviews were held with caregivers of HIV-exposed infants who were offered birth testing (N = 28), health care workers (N = 14), and policymakers (N = 10). Participants were purposively sampled. Interviews were held in English or SiSwati, and transcribed in English. Transcripts were coded by line, and content analysis and constant comparison were used to identify key themes for each respondent type. RESULTS:Responses were categorized into: knowledge, experience, opinions, barriers and challenges, facilitators, and suggestions to improve POC birth testing. Preliminary findings reveal that point of care birth testing has been very well received but challenges were raised. Most caregivers appreciated testing the newborns at birth and getting results quickly, since it reduced anxiety of waiting for several weeks. However, having a favorable experience with testing was linked to having supportive and informed family members and receiving a negative result. Caregivers did not fully understand the need for blood draws as opposed to tests with saliva, and expressed the fears of seeing their newborns in pain. They were specifically grateful for supportive nursing staff who respected their confidentiality. Health care workers expressed strong support for the program but commented on the high demand for testing, increased workload, difficulty with errors in the testing machine itself, and struggles to implement the program without sufficient staffing, especially on evenings and weekends when phlebotomists were not available. Policymakers noted that there have been challenges within the program of losing mothers to follow up after they leave hospital, and recommended stronger linkages to community groups. CONCLUSIONS:There is strong support for scale-up of POC birth testing, but countries should consider ways to optimize staffing and manage demand.

背景与目标： 背景：在出生时进行艾滋病毒检测有可能鉴定出子宫内感染的婴儿，并有可能在出生后立即开始治疗。即时护理（POC）测试可快速返回结果并更快地开始治疗阳性婴儿。埃斯瓦蒂尼（Eswatini）在三个公共场所试行了出生测试超过2年。
方法：为了评估Eswatini试点中POC出生测试的可接受性，对接受HIV暴露婴儿进行了出生测试（N = 28），医护人员（N = 14）和护理人员进行了访谈。决策者（N = 10）。参加者是有目的的抽样。采访以英语或SiSwati进行，并以英语抄录。笔录按行进行编码，然后使用内容分析和常量比较来确定每种受访者类型的关键主题。
结果：响应分类为：知识，经验，意见，障碍和挑战，促进者和改善POC出生测试的建议。初步发现表明，护理点出生测试已广受好评，但提出了挑战。大多数照护者都喜欢对新生儿进行测试，并能尽快获得结果，因为它减少了等待数周的忧虑。但是，拥有良好的测试经验与拥有支持和知情的家庭成员并获得负面结果有关。照护者并不完全理解抽血的需要，而不是唾液测试，并表示担心看到自己的新生儿感到疼痛。他们特别感谢支持护理人员的保密工作。医护人员表示对该计划的大力支持，但对测试的需求高，工作量增加，测试机本身存在错误的困难以及在没有足够人员配备的情况下难以实施该计划的情况进行了评论，尤其是在没有抽血医生的晚上和周末。政策制定者指出，在计划中，母亲流失后仍面临很多挑战，因此建议与社区团体建立更紧密的联系。
结论：有大力支持扩大POC出生测试的范围，但各国应考虑优化人员配备和管理需求的方法。

BACKGROUND & AIMS: OBJECTIVE:To review existing data on nutritional requirements of extremely low birth weight (ELBW) and very low birth weight (VLBW) preterm infants (those who weigh < 1000 g and 1000-1500 g at birth, respectively), and the effects of diseases on these nutritional requirements.

DATA SOURCES:A literature search was conducted on applicable articles related to nutritional requirements of preterm ELBW and VLBW infants and the effects of diseases in these infants on their nutritional and metabolic requirements.

DATA SYNTHESIS:The literature was analyzed to determine nutritional requirements of preterm ELBW and VLBW infants, to select the most common diseases that have significant and important effects on nutrition and metabolism in these infants, and to make recommendations about diagnostic and therapeutic approaches to nutritional problems as affected by diseases in ELBW and VLBW infants.

CONCLUSIONS:Many diseases unique to preterm infants, either directly or by enhancing the effects of stress on the metabolism of such infants, provide important changes in the nutrient requirements. The overriding observation from all studies, however, is that ELBW and VLBW preterm infants are underfed during the early postnatal period and that this condition, combined with additional stresses from various diseases, increases the risk of long-term neurological sequelae. The value of achieving a specific body composition and growth weight is less certain. There remains a critical need for determining the right quality as well as quantity of nutrients for these infants.

背景与目标： 目标：回顾有关极低出生体重（ELBW）和极低出生体重（VLBW）早产儿（分别出生时体重<1000 g和1000-1500 g的婴儿）营养需求的现有数据），以及疾病对这些营养需求的影响。

数据来源：对与早产ELBW和VLBW婴儿的营养需求及其相关影响的相关文章进行了文献检索这些婴儿的营养和代谢需求方面的疾病。

数据综合：对文献进行分析，以确定早产ELBW和VLBW婴儿的营养需求，以选择最常见的患有以下疾病的婴儿：对这些婴儿的营养和代谢具有重要意义和重要意义，并就ELBW和VLBW婴儿疾病所致营养问题的诊断和治疗方法提出建议。

结论：Ma直接或通过增强应激对此类婴儿代谢的影响，早产婴儿所特有的任何疾病都会使营养需求发生重大变化。然而，所有研究的最主要观察结果是，ELBW和VLBW早产儿在产后早期营养不足，并且这种状况加上各种疾病带来的额外压力增加了长期神经系统后遗症的风险。实现特定的身体成分和体重增长的价值还不确定。仍然迫切需要确定这些婴儿的正确质量和营养素数量。