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similar with respect to the preference rates for life-sustaining treatments compared with palliative care (46.9% vs 34.4% in the 60% survival group and 50.0% vs 40.6% in the 30% survival group; odds ratio [OR], 0.90; 95% CI, 0.31-2.63). A few patients were not able to formulate a preference (6 patients (18.8%) in the 60% survival group and 3 patients (9.4%) in the 30% survival group; OR, 0.423; 95% CI, 0.08-2.10). An analysis of the patients who formulated a preference showed that an attitude that mere survival is at least as important as quality of life was associated with a preference for life-sustaining treatments (OR, 10.28; 95% CI, 2.94-35.90). Increasing maternal age (OR, 0.77; 95% CI, 0.61-0.98) and childlessness (OR, 0.12; 95% CI 0.01-0.98) were associated with a preference for palliative care. Most patients would decide together with their partners (63 of 64 [98.4%]) and preferred to be empowered by their physicians in the decision-making process (48 of 64 [75%]). Discussion | In this study, it appeared that treatment preferences originated from individual characteristics and values rather than from reasoning about numerical outcome estimates. However, generalizability is limited and the results should be interpreted in light of the methods used. Patients made a one-time decision without personal feedback and patients actually affected might indicate different preferences. More studies are needed to help to improve our understanding of the information that parents facing extremely preterm birth want and need.

Since December 2019, there has been an outbreak of novel coronavirus (2019-nCoV) infection in China. Two cases of neonates with positive 2019-nCoV tests have been reported. Due to the immature immune system and the possibility of vertical transmission from mother to infant, neonates have become a high-risk group susceptible to 2019-nCoV, which emphasize a close cooperation from both perinatal and neonatal pediatrics. In neonatal intensive care unit (NICU), to prevent and control infection, there should be practical measures to ensure the optimal management of children potentially to be infected. According to the latest 2019-nCoV national management plan and the actual situation, the Chinese Neonatal 2019-nCoV expert working Group has put forward measures on the prevention and control of neonatal 2019-nCoV infection.

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Background:With the progress of perinatal medicine and neonatal technology, more and more extremely low birth weight (ELBW) survived all over the world. This study was designed to investigate the short-term outcomes of ELBW infants during their Neonatal Intensive Care Unit (NICU) stay in the mainland of China.Methods:All infants admitted to 26 NICUs with a birth weight (BW) < l000 g were included between January l, 2011 and December 31, 2011. All the data were collected retrospectively from clinical records by a prospectively designed questionnaire. The data collected from each NICU transmitted to the main institution where the results were aggregated and analyzed. Categorical variables were performed with Pearson Chi-square test. Binary Logistic regression analysis was used to detect risk factors.Results:A total of 258 ELBW infants were admitted to 26 NICUs, of whom the mean gestational age (GA) was 28.1 ± 2.2 weeks, and the mean BW was 868 ± 97 g. The overall survival rate at discharge was 50.0%. Despite aggressive treatment 60 infants (23.3%) died and another 69 infants (26.7%) died after medical care withdrawal. Furthermore, the survival rate was significantly higher in coastal areas than inland areas (53.6% vs. 35.3%, P = 0.019). BW < 750 g and GA < 28 weeks were the largest risk factors, and being small for gestational age was a protective factor related to mortality. Respiratory distress syndrome was the most common complication. The incidence of patent ductus arteriosus, intraventricular hemorrhage, periventricular leukomalacia, bronchopulmonary dysplasia, retinopathy of prematurity was 26.2%, 33.7%, 6.7%, 48.1%, and 41.4%, respectively. Ventilator associated pneumonia was the most common hospital acquired infection during hospitalization.Conclusions:Our study was the first survey that revealed the present status of ELBW infants in the mainland of China. The mortality and morbidity of ELBW infants remained high as compared to other developed countries.

Neonatal respiratory failure in the NICU of the provincial cities of China has high mortality and cost that are linked to geographic variability, a male predominance, and low proportion of very preterm infants, characteristic of sociocultural confounding background.

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