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[小于胎龄儿——定义、病因及新生儿期治疗]

[Small for gestational age newborns--definition, etiology and neonatal treatment].

作者信息

Slancheva B, Mumdzhiev Hr

出版信息

Akush Ginekol (Sofiia). 2013;52(2):25-32.

Abstract

Newborns with intrauterine hypotrophy are at particular risk group of neonates. Diagnosis based on an adequate estimated gestational age, compared with accurate anthropometric measurements after birth. Among children born with low birth weight (< 2500 g) stands in one particular group--those small for gestational age SGA (Small for Gestational Age-SGA), whose health problems are studied intensively in recent years. In Bulgaria children with low birth weight in recent years is about 10%, which is well above the European average indicator--6.2%. In 2001. created International Advisory Board, composed of 42 people leading experts in obstetrics, perinatal and neonatal medicine, pediatricians endocrinologists, pharmacologists and epidemiologists, with the following main tasks: the definition of small for gestational age children, diagnosis of SGA, SGA children growth and role of growth hormone in their treatment. Subsequent meetings of this committee discuss consensus on SGA infants who acquire their final form at a meeting in Prague in 2009 Small for gestational age (SGA, SGA), is described children whose body weight and/or height is lower than the average by more than 2 standard deviations (< - 2SD). Some authors use the boundary 3rd, 5th, or 10th percentile, but most believe that the use of indicators (< - 2SD) comprises the largest percentage of newborns with fetal growth disorders. Small for gestational age children are divided into: newborn weight retardation (SGAW), growth retardation (SGAL), matched up in weight and height (SGAWL). "Intrauterine growth retardation" (Intra-Uterine Growth Retardation (IUGR) are born with fetal growth retardation, documented at least two ultrasound scans, one of which in the 1st trimester Intrauterine hypotrophy is the second most common cause of perinatal death after prematurity. Hypotrophy is present in about 53% of premature and stillborn at 26% of full-term stillborn children. The incidence of asphyxia in SGA intrapartum is about 50%. Neonatal care includes effective primary resuscitation, treatment of existing and prevention of complications anticipated adaptation. These children are subject to follow-up for later risk of socially significant diseases in the adult.

摘要

宫内发育迟缓的新生儿是新生儿中的特殊风险群体。诊断基于适当估计的孕周,并与出生后准确的人体测量结果进行比较。在低出生体重(<2500克)的儿童中,有一个特殊群体——小于胎龄儿(Small for Gestational Age-SGA),近年来对其健康问题进行了深入研究。在保加利亚,近年来低出生体重儿童约占10%,远高于欧洲平均指标——6.2%。2001年成立了国际咨询委员会,由42名妇产科、围产期和新生儿医学、儿科医生、内分泌学家、药理学家和流行病学家领域的顶尖专家组成,其主要任务如下:定义小于胎龄儿、诊断SGA、SGA儿童的生长以及生长激素在其治疗中的作用。该委员会随后的会议讨论了关于小于胎龄儿的共识,这些共识在2009年于布拉格举行的一次会议上最终确定。小于胎龄儿(SGA)是指体重和/或身高低于平均水平超过2个标准差(<-2SD)的儿童。一些作者使用第3、5或10百分位数作为界限,但大多数人认为使用(<-2SD)指标涵盖了患有胎儿生长障碍的新生儿的最大比例。小于胎龄儿分为:新生儿体重迟缓(SGAW)、生长迟缓(SGAL)、体重与身高匹配(SGAWL)。“宫内生长迟缓”(Intra-Uterine Growth Retardation,IUGR)是指出生时伴有胎儿生长迟缓,至少通过两次超声扫描记录,其中一次在孕早期。宫内发育迟缓是早产之后围产期死亡的第二大常见原因。发育迟缓在约53%的早产儿和死产儿中存在,在26%的足月死产儿中也存在。SGA分娩时窒息的发生率约为50%。新生儿护理包括有效的初级复苏、治疗现有疾病以及预防预期的适应并发症。这些儿童需要接受随访,以了解其成年后患具有社会意义疾病的后期风险。

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