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小于胎龄早产儿的生长与骨矿化

Growth and bone mineralization in small-for-gestational-age preterm infants.

作者信息

Kitazawa Shigetaka, Itabashi Kazuo, Umeda You, Inoue Makoto, Nishioka Takashi

机构信息

Division of Neonatology, Children's Medical Center, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa, Japan.

出版信息

Pediatr Int. 2014 Feb;56(1):67-71. doi: 10.1111/ped.12189.

Abstract

BACKGROUND

Preterm infants are at risk for metabolic bone disease and suboptimal growth. This study examined the hypothesis that, apart from prematurity, intrauterine growth status (expressed as gestational age-specific birthweight standard deviation score) influences bone mineralization and body composition in early infancy.

METHODS

In this retrospective study, the groups consisted of preterm small-for-gestational-age (SGA) infants (n = 18; SGA group) and preterm appropriate-for-gestational-age (AGA) infants (n = 24; AGA group). Postnatal bone mineralization was measured at term-adjusted age (postmenstrual age, 37-42 weeks). Bone mineral content (BMC) and body composition were determined on dual-energy X-ray absorptiometry of the whole body.

RESULTS

BMC and lean mass were significantly lower in the SGA group than in the AGA group at term-adjusted age (37-42 weeks postmenstrual age). Stepwise regression analysis identified weight at examination as the most significant factor, accounting for 51% of the variance in BMC.

CONCLUSION

Bodyweight at term-adjusted age, rather than intrauterine growth, may affect postnatal bone mineralization in preterm low-birthweight infants. Therefore, promoting an increase in body size might increase postnatal bone mineralization in preterm SGA infants.

摘要

背景

早产儿有患代谢性骨病和生长发育欠佳的风险。本研究检验了以下假设:除早产外,宫内生长状况(以特定孕周出生体重标准差评分表示)会影响婴儿早期的骨矿化和身体组成。

方法

在这项回顾性研究中,研究组包括早产小于胎龄儿(SGA)(n = 18;SGA组)和早产适于胎龄儿(AGA)(n = 24;AGA组)。在足月校正年龄(月经龄,37 - 42周)时测量出生后的骨矿化。通过全身双能X线吸收法测定骨矿物质含量(BMC)和身体组成。

结果

在足月校正年龄(月经龄37 - 42周)时,SGA组的BMC和瘦体重显著低于AGA组。逐步回归分析确定检查时的体重是最显著的因素,占BMC变异的51%。

结论

足月校正年龄时的体重而非宫内生长情况,可能会影响早产低体重儿出生后的骨矿化。因此,促进体重增加可能会增加早产SGA婴儿出生后的骨矿化。

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