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极低出生体重儿出生后生长情况的评估:新生儿科医生的困境

Evaluation of postnatal growth in very low birth weight infants: a neonatologist's dilemma.

作者信息

Bertino E, Boni L, Rossi C, Coscia A, Giuliani F, Spada E, Milani S, Fabris C

机构信息

Neonatal Intensive Care Unit, Department of Pediatrics, Turin University, Turin, Italy.

出版信息

Pediatr Endocrinol Rev. 2008 Sep;6(1):9-13.

Abstract

Very low birth weight (VLBW) infants' survival has greatly increased in the last few decades thanks to the improvement in obstetrical and neonatal care. The correct evaluation of postnatal growth of these babies is nowadays of primary concern, although the definitions of their optimal nutrition and postnatal growth pattern are still controversial. It is known that VLBW infants have a specific postnatal growth pattern markedly different from that of higher birthweight full-term infants. Prospective longitudinal studies are needed to trace VLBW infants growth charts for weight, length and head circumference. These charts will be a useful tool to monitor postnatal growth of VLBW infants both during hospitalisation and after discharge, up to 2 or 3 years of age. A useful tool in VLBW infants growth evaluation could also be absolute velocity charts that, allowing a better and earlier identification of growth anomalies, could permit the observation of phenomena not yet visible on distance charts. Very low birth weight (VLBW) infants' survival has greatly increased in the last few decades thanks to the improvement in obstetrical and neonatal care. These neonates represent about 1-1.5% of all live born infants in developed countries (1) and they constitute the large majority of the population in neonatal intensive care units (NICUs). For this reason, the correct evaluation of their postnatal growth is of primary concern nowadays although the definitions of optimal nutrition and postnatal growth pattern are still controversial.

摘要

在过去几十年中,由于产科和新生儿护理的改善,极低出生体重(VLBW)婴儿的存活率大幅提高。如今,对这些婴儿出生后生长情况的正确评估成为首要关注点,尽管其最佳营养和出生后生长模式的定义仍存在争议。众所周知,极低出生体重婴儿具有特定的出生后生长模式,明显不同于出生体重较高的足月儿。需要进行前瞻性纵向研究来绘制极低出生体重婴儿体重、身长和头围的生长图表。这些图表将成为监测极低出生体重婴儿住院期间及出院后直至2至3岁生长情况的有用工具。在评估极低出生体重婴儿生长方面,绝对速度图表也是一种有用的工具,它能更好、更早地识别生长异常,从而观察到距离图表上尚未显现的现象。在过去几十年中,由于产科和新生儿护理的改善,极低出生体重(VLBW)婴儿的存活率大幅提高。在发达国家,这些新生儿约占所有活产婴儿的1 - 1.5%(1),并且构成了新生儿重症监护病房(NICU)中的大多数人群。因此,尽管最佳营养和出生后生长模式的定义仍存在争议,但如今对其出生后生长情况的正确评估成为首要关注点。

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