MRC Centre of Epidemiology for Child Health, UCL Institute of Child Health, , London, UK.
Arch Dis Child Fetal Neonatal Ed. 2014 Jan;99(1):F34-40. doi: 10.1136/archdischild-2012-303536. Epub 2013 Aug 9.
To describe birth weight and postnatal weight gain in a contemporaneous population of babies born <32 weeks' gestation, using routinely captured electronic clinical data.
Anonymised longitudinal weight data from 2006 to 2011.
National Health Service neonatal units in England.
Birth weight centiles were constructed using the LMS method, and longitudinal weight gain was summarised as mean growth curves for each week of gestation until discharge, using SITAR (Superimposition by Translation and Rotation) growth curve analysis.
Data on 103 194 weights of 5009 babies born from 22-31 weeks' gestation were received from 40 neonatal units. At birth, girls weighed 6.6% (SE 0.4%) less than boys (p<0.0001). For babies born at 31 weeks' gestation, weight fell after birth by an average of 258 g, with the nadir on the 8th postnatal day. The rate of weight gain then increased to a maximum of 28.4 g/d or 16.0 g/kg/d after 3 weeks. Conversely for babies of 22 to 28 weeks' gestation, there was on average no weight loss after birth. At all gestations, babies tended to cross weight centiles downwards for at least 2 weeks.
In very preterm infants, mean weight crosses centiles downwards by at least two centile channel widths. Postnatal weight loss is generally absent in those born before 29 weeks, but marked in those born later. Assigning an infant's target centile at birth is potentially harmful as it requires rapid weight gain and should only be done once weight gain has stabilised. The use of electronic data reflects contemporary medical management.
利用常规捕获的电子临床数据，描述<32 孕周出生的同期婴儿的出生体重和生后体重增加情况。
2006 年至 2011 年的匿名纵向体重数据。
英国国民保健署新生儿单位。
采用 LMS 法构建出生体重百分位数，并使用 SITAR（平移和旋转叠加）生长曲线分析，将每个孕周的纵向体重增加情况总结为平均生长曲线，直至出院。
从 40 个新生儿单位收到了 5009 名 22-31 孕周出生的 103194 个体重数据。男婴出生时比女婴轻 6.6%（SE 0.4%）（p<0.0001）。31 孕周出生的婴儿出生后平均体重下降 258g，最低点出现在第 8 天。此后，体重增加速度加快，3 周后达到每日 28.4g 或 16.0g/kg/d 的最大值。相比之下，22 至 28 孕周出生的婴儿出生后平均没有体重减轻。在所有胎龄中，婴儿的体重都有至少 2 周的时间向下穿过体重百分位数。
在极早产儿中，平均体重至少向下穿过两个百分位数通道宽度。胎龄<29 周出生的婴儿通常没有体重减轻，但胎龄较大的婴儿体重减轻明显。在出生时就给婴儿指定目标百分位数可能是有害的，因为这需要快速增加体重，只有在体重增加稳定后才能这样做。电子数据的使用反映了当代的医疗管理。
