Krauel Vidal X, Figueras Aloy J, Natal Pujol A, Iglesias Platas I, Moro Serrano M, Fernández Pérez C, Martín-Ancel A
Servicio de Neonatología, Hospital Sant Joan de Déu, Barcelona, Spain.
An Pediatr (Barc). 2008 Mar;68(3):206-12. doi: 10.1157/13116698.
To analyze postnatal growth restriction in a cohort of very low birth weight (VLBW) infants with gestational age < or = 32 weeks in 55 Spanish neonatal units (SEN 1500 Network) during 2002 and 2003.
Weight, length and head circumference were recorded at birth, and at discharge. Weight was also recorded at 28 days postnatal, and 36 weeks of postmenstrual age. Growth restriction was measured as the shift in weight z score from birth to 28th day.
The study included 2317 VLBW infants. Weight z score at birth, 28 days, 36 weeks of postmenstrual age and discharge were: -0.66 +/- 1.3, -2.54 +/- 1.35, -3.12 +/- 1.7, -1.56 +/- 1.1, respectively. Length z score at birth and at discharge were: -0.88 +/- 1.8, and -1.97 +/- 1.56. Head circumference z score at birth and at discharge: -0.83 +/- 1.87, and -0.60 +/- 1.96. Prenatal steroids, gestational age, place of birth, type of hospital, CRIB score, symptomatic patent ductus arteriosus and late-onset bacterial sepsis were related with the shift in weight z score at 28 days (multiple linear regression), but explained very little (14 %) of his change. Weight and length at discharge were under the 10th percentile in 77 % and 80 % of the infants, respectively.
VLBW infants < or = 32 GA suffer postnatal growth restriction with respect to intrauterine growth pattern, which is more relevant in the first 28 days of life, in patients with more severe illnesses, and differs among neonatal units. Perinatal and neonatal items evaluated are poorly related with restriction.
分析2002年至2003年期间西班牙55家新生儿重症监护病房（SEN 1500网络）中胎龄小于或等于32周的极低出生体重（VLBW）婴儿的出生后生长受限情况。
记录婴儿出生时、出院时的体重、身长和头围。还记录出生后28天和月经龄36周时的体重。生长受限通过出生至第28天体重Z评分的变化来衡量。
该研究纳入了2317名极低出生体重婴儿。出生时、28天、月经龄36周和出院时的体重Z评分分别为：-0.66±1.3、-2.54±1.35、-3.12±1.7、-1.56±1.1。出生时和出院时的身长Z评分分别为：-0.88±1.8和-1.97±1.56。出生时和出院时的头围Z评分分别为：-0.83±1.87和-0.60±1.96。产前使用类固醇、胎龄、出生地点、医院类型、CRIB评分、有症状的动脉导管未闭和晚发性细菌性败血症与出生后28天体重Z评分的变化相关（多元线性回归），但对其变化的解释很少（14%）。77%和80%的婴儿出院时的体重和身长分别低于第10百分位。
胎龄小于或等于32周的极低出生体重婴儿相对于宫内生长模式存在出生后生长受限，这在生命的前28天、病情较重的患者中更为明显，且在不同新生儿重症监护病房之间存在差异。所评估的围产期和新生儿项目与生长受限的相关性较差。
