Bertino E, Coscia A, Mombrò M, Boni L, Rossetti G, Fabris C, Spada E, Milani S
Cattedra di Neonatologia, Dipartimento di Scienze Pediatriche e dell'Adolescenza, Università di Torino, Via Ventimiglia 3, 10126 Torino, Italy.
Arch Dis Child Fetal Neonatal Ed. 2006 Sep;91(5):F349-56. doi: 10.1136/adc.2005.090993. Epub 2006 Apr 25.
Only a few studies have dealt with postnatal growth velocity of very low birthweight (VLBW) infants.
To analyse weight growth kinetics of VLBW infants from birth to over 2 years of age.
A total of 262 VLBW infants were selected; inaccurate estimate of gestational age, major congenital anomalies, necrotising enterocolitis, death, and loss to follow up within the first year were the exclusion criteria.
Body weight was recorded daily up to 28 days or up to discontinuation of parenteral nutrition, weekly up to discharge, then at 1, 3, 6, 9, 12, 18, and 24 months of corrected age. Individual growth profiles were fitted with a seven constant, exponential-logistic function suitable for modelling weight loss and weight recovery, two peaks, and the subsequent slow decrease in growth velocity.
After a postnatal weight loss, all infants showed a late neonatal peak of growth velocity between the 7th and 21st weeks; most also experienced an early neonatal peak between the 2nd and 6th week. VLBW infants who were small for gestational age and those with major morbidities grew less than reference VLBW infants who were the appropriate size for gestational age without major morbidities: at 2 years of age, the difference in weight was about 860 g. The more severe growth impairment seen in VLBW infants with major morbidities is almost entirely due to the reduced height of the late neonatal peak of velocity.
The growth model presented here should be a useful tool for evaluating to what extent different pathological conditions or nutritional and medical care protocols affect growth kinetics.
仅有少数研究涉及极低出生体重（VLBW）婴儿的出生后生长速度。
分析VLBW婴儿从出生至2岁以上的体重增长动力学。
共选取262例VLBW婴儿；排除标准为胎龄估计不准确、严重先天性畸形、坏死性小肠结肠炎、死亡以及在第一年失访。
出生后28天内或直至停止肠外营养前每日记录体重，出院前每周记录，然后在矫正年龄1、3、6、9、12、18和24个月时记录。个体生长曲线采用适合模拟体重减轻和体重恢复、两个峰值以及随后生长速度缓慢下降的七常数指数逻辑函数进行拟合。
出生后体重减轻后，所有婴儿在第7至21周出现晚期新生儿生长速度峰值；大多数婴儿在第2至6周也经历了早期新生儿生长速度峰值。小于胎龄的VLBW婴儿和患有严重疾病的婴儿比胎龄合适且无严重疾病的参照VLBW婴儿生长缓慢：在2岁时，体重差异约为860克。患有严重疾病的VLBW婴儿出现的更严重生长障碍几乎完全是由于晚期新生儿生长速度峰值降低所致。
本文提出的生长模型应是评估不同病理状况或营养及医疗护理方案对生长动力学影响程度的有用工具。
