Department of Pediatrics, Wayne State University, Children's Hospital of Michigan, Detroit, Michigan.
Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas.
Am J Perinatol. 2014 Mar;31(3):223-30. doi: 10.1055/s-0033-1345264. Epub 2013 May 20.
To characterize postnatal growth failure (PGF), defined as weight < 10th percentile for postmenstrual age (PMA) in preterm (≤ 27 weeks' gestation) infants with severe bronchopulmonary dysplasia (sBPD) at specified time points during hospitalization, and to compare these in subgroups of infants who died/underwent tracheostomy and others.
Retrospective review of data from the multicenter Children's Hospital Neonatal Database (CHND).
Our cohort (n = 375) had a mean ± standard deviation gestation of 25 ± 1.2 weeks and birth weight of 744 ± 196 g. At birth, 20% of infants were small for gestational age (SGA); age at referral to the CHND neonatal intensive care unit (NICU) was 46 ± 50 days. PGF rates at admission and at 36, 40, 44, and 48 weeks' PMA were 33, 53, 67, 66, and 79% of infants, respectively. Tube feedings were administered to > 70% and parenteral nutrition to a third of infants between 36 and 44 weeks' PMA. At discharge, 34% of infants required tube feedings and 50% had PGF. A significantly greater (38 versus 17%) proportion of infants who died/underwent tracheostomy (n = 69) were SGA, compared with those who did not (n = 306; p < 0.01).
Infants with sBPD commonly had progressive PGF during their NICU hospitalization. Fetal growth restriction may be a marker of adverse outcomes in this population.
描述早产儿（胎龄≤27 周）严重支气管肺发育不良（sBPD）患儿在住院期间特定时间点体重低于校正胎龄第 10 百分位（PMA）的生长失败（PGF），并比较死亡/行气管切开术和未行气管切开术患儿的 PGF 情况。
回顾性分析多中心儿童医院新生儿数据库（CHND）的数据。
本队列（n=375）的平均胎龄为 25±1.2 周，出生体重为 744±196g。出生时，20%的婴儿为小于胎龄儿（SGA）；转诊至 CHND 新生儿重症监护病房（NICU）的年龄为 46±50 天。入院时、36、40、44 和 48 周 PMA 的 PGF 发生率分别为 33%、53%、67%、66%和 79%。36-44 周 PMA 期间，70%以上的婴儿接受管饲喂养，三分之一的婴儿接受静脉营养。出院时，34%的婴儿需要管饲喂养，50%的婴儿存在 PGF。与未行气管切开术的患儿（n=306）相比，行气管切开术的患儿（n=69）的 SGA 比例（38%比 17%）显著更高（p<0.01）。
患有 sBPD 的婴儿在 NICU 住院期间常出现进行性 PGF。胎儿生长受限可能是该人群不良结局的标志物。
