简介：BackgroundPulseoximetryscreening(POS)hasbeenproposedasaneffective,noninvasive,inexpensivetoolallowingearlierdiagnosisofcriticalcongenitalheartdisease(CCHD).However,mostneonatesaredischargedfromthehospitalwithoutthisevaluationinChina.ThisstudyaimedatassessingthefeasibilityofPOSfornewbornsindetectingCCHDinthedepartmentofobstetricsandneonatalintensivecareunit(NICU).MethodsPOSwasperformedin355neonatesborninthedepartmentofobstetricsoradmittedtotheNICUbetweenJanuary2015andJune2015.Theseneonatesweredividedintonormalgroup,mildcongenitalheartdiseasegroup(MCHD)andCCHDgroup,accordingtotheresultofechocardiographyorcomputerizedtomography(CT).Thegestationalage,birthweightandarterialoxygensaturation(SpO_2)werecomparedamongthethreegroups.TheSpO_2valueanddiagnosistimeoftheCCHDcaseswereclassifiedandanalyzed.ResultsTheprematurebirthandlowbirthweightwerethehighriskfactorsofmildcongenitalheartdisease.Therewasnodifference(P>0.05)inSpO_2betweentheMCHDgroupandthenormalgroup.SignificantdifferenceintheSpO_2appearedbetweentheCCHDgroupandthenormalgroup(P<0.05).CombinationofPOSandclinicalexaminationcanreducethemissingdiagnosisrateinscreeningforCCHD.ConclusionsPOSincursverylowcostandriskofharmandisnotrequiredforspecialtraining,therefore,aneffectivewaytoidentifyCCHDinneonates.

简介：AbstractImportance:There are a variety of musculoskeletal malformations and injuries that can occur in newborns. These can be a significant cause of perinatal death or a reason for miscarriage and can lead to long-term functional issues if not managed appropriately. There is no systematic and well-established screening program for neonatal musculoskeletal malformations and injuries in China now.Objective:To report the incidence and types of congenital musculoskeletal malformations in two hospitals in Shenzhen City, to explore and discuss the details of the screening procedure and improve future prevention and treatment.Methods:From October 2013 to May 2014, 2564 one-day-old newborns were screened by a pediatric orthopedic physical examination, in combination with ultrasonography when required, and the incidence and variety of diseases were recorded statistically.Results:Among 2564 screened newborns, the following musculoskeletal conditions were identified: congenital muscular torticollis (CMT) (seven cases, 0.27%), hip subluxation (four cases, 0.16%), hip dysplasia (47 cases, 1.83%), congenital talipes equinovarus (CTEV) (two cases, 0.08%), congenital talipes calcaneovalgus (15 cases, 0.58%), polydactyly (nine cases, 0.35%), syndactyly (one case, 0.04%), and spinal hemivertebra (one case, 0.04%). Additionally, there were five (0.19%) neonates with birth injuries.Interpretation:It is feasible to carry out neonatal screening and identification of musculoskeletal malformations and birth injuries in China. This is helpful as timely detection and early intervention for many of these conditions can avoid permanent functional impairment in these children.

简介：AbstractBackground:Although congenital hypothyroidism (CH) has been widely studied in Western countries, CH incidence at different administrative levels in China during the past decade remains unknown. This study aimed to update the incidence and revealed the spatial pattern of CH incidence in the mainland of China, which could be helpful in the planning and implementation of preventative measures.Methods:The data used in our study were derived from 245 newborns screening centers that cover 30 provinces of the Chinese Newborn Screening Information System. Spatial auto-correlation was analyzed by Global Moran I and Getis-Ord Gi statistics at the provincial level. Kriging interpolation methods were applied to estimate a further detailed spatial distribution of CH incidence at city level throughout the mainland of China, and Kulldorff space scanning statistical methods were used to identify the spatial clusters of CH cases at the city level.Results:A total of 91,921,334 neonates were screened from 2013 to 2018 and 42,861 cases of primary CH were identified, yielding an incidence of 4.66 per 10,000 newborns screened (95% confidence interval [CI]: 4.62-4.71). Neonates in central (risk ratio [RR] = 0.84, 95% CI: 0.82-0.85) and western districts (RR = 0.71, 95% CI: 0.69-0.73) had lower probability of CH cases compared with the eastern region. The CH incidence indicated a moderate positive global spatial autocorrelation (Global Moran I value = 0.394, P < 0.05), and the CH cases were significantly clustered in spatial distribution. A most likely city-cluster (log-likelihood ratio [LLR]= 588.82, RR = 2.36, P < 0.01) and 25 secondary city-clusters of high incidence were scanned. The incidence of each province and each city in the mainland of China was estimated by kriging interpolation, revealing the most affected province and city to be Zhejiang Province and Hangzhou city, respectively.Conclusion:This study offers an insight into the space clustering of CH incidence at provincial and city scales. Future work on environmental factors need to focus on the effects of CH occurrence.