Yoo Suk Dong, Hwang Eun-Ha, Lee Yeoun Joo, Park Jae Hong
Department of Pediatrics, Pusan National University School of Medicine, Yangsan, Korea.
Pediatr Gastroenterol Hepatol Nutr. 2013 Dec;16(4):261-8. doi: 10.5223/pghn.2013.16.4.261. Epub 2013 Dec 31.
To investigate the clinical characteristics and outcomes among infants and toddlers with failure to thrive (FTT).
This retrospective study was done with 123 patients who had visited Pusan National University Children's Hospital during their first two years of life and had received an FTT diagnosis. We compared the clinical characteristics of the patients based on the causes of their FTT and their ages at the time of first hospital visit. We investigated triggering factors, feeding practices, and outcomes in 25 patients with nonorganic FTT (NOFTT).
Eighty cases (65.0%) were NOFTT. The gestational ages, birth weights, and weights at the first visits were significantly lower in patients with organic FTT (OFTT) (p<0.05). Infants who had first visited the clinic at age <6 months had the least z-score. The percentage of patients with severe weight decline was higher in OFTT than in NOFTT (60.0% vs. 17.3%). The z-scores at the follow-up visits were improved after treatment in both of the groups. Preceding infection was the most common triggering factor of NOFTT and persecutory feeding as abnormal behavior of caregiver was observed in 22 cases (88.0%). After treatment with feeding method modification, all patients with NOFTT showed normal growth.
Weight decline is more severe in OFTT patients and in younger patients at the first visit. Infants with FTT can attain normal weight gain growth by treating organic diseases and supplying proper nutrition in OFTT, and by correcting abnormal dietary behavior of caregiver in NOFTT.
探讨婴幼儿生长发育迟缓(FTT)的临床特征及预后。
本回顾性研究纳入了123例在出生后两年内就诊于釜山国立大学儿童医院并被诊断为FTT的患者。我们根据FTT的病因及首次就诊时的年龄对患者的临床特征进行了比较。我们调查了25例非器质性FTT(NOFTT)患者的诱发因素、喂养方式及预后。
80例(65.0%)为NOFTT。器质性FTT(OFTT)患者的孕周、出生体重及首次就诊时的体重显著更低(p<0.05)。首次就诊年龄<6个月的婴儿z评分最低。OFTT患者中重度体重下降的比例高于NOFTT(60.0%对17.3%)。两组患者治疗后随访时的z评分均有所改善。前驱感染是NOFTT最常见的诱发因素,22例(88.0%)观察到照顾者存在迫害性喂养等异常行为。采用改良喂养方法治疗后,所有NOFTT患者均实现正常生长。
OFTT患者及首次就诊时年龄较小的患者体重下降更严重。FTT婴儿可通过治疗器质性疾病并在OFTT中提供适当营养,以及在NOFTT中纠正照顾者的异常饮食行为来实现正常体重增长。