Liu Jing, Wang Xiao-Feng, Wang Yan, Wang Hua-Wei, Liu Ying
From the Department of Neonatology and NICU, Bayi Children's Hospital Affiliated to Beijing Military General Hospital, Beijing 100700, China (JL, X-FW, YW, H-WW, YL); Graduate School of Anhui Medical University, Hefei 230033, China (X-FW, H-WW, YL); Graduate School of Southern Medical University, Guangzhou 510515, China (YW).
Medicine (Baltimore). 2014 Dec;93(27):e210. doi: 10.1097/MD.0000000000000210.
To investigate the incidence and high-risk factors of fetal growth restriction (FGR) in Mainland China and determine the adverse effects of this condition on fetal-neonatal health. This study was a retrospective chart review. We investigated the incidence rate of FGR using a retrospective analysis of clinical data obtained from mothers and newborns from 7 hospitals in Mainland China from January 1 to December 31, 2011. The short-term outcomes of FGR were analyzed based on data obtained from the neonatal intensive-care unit (NICU) of Bayi Children's Hospital. The long-term outcomes of FGR were determined after a follow-up study of 125 cases of FGR in children at 18 months. The physical development index, mental development index (MDI), and psychomotor development index (PDI) were compared between FGR patients and controls. The incidence of FGR was 8.77%. The incidence of FGR was significantly higher in females than in males (9.80% vs 7.84%, P < 0.05). The incidence of FGR in preterm infants was higher than that in full-term infants (16.43% vs 7.87%, P < 0.01). Chronic hypertension, abnormal amniotic fluid, and umbilical cord abnormalities were independent factors of FGR. A significantly higher incidence of complications, including hypoglycemia, asphyxia, hypoxic-ischemic encephalopathy, gastrointestinal bleeding, congenital malformations, polycythemia, lung hemorrhage, apnea, congenital heart disease, and disseminated intravascular coagulation, was observed in FGR patients than in controls. The FGR prolonged the duration of the hospital stay and markedly increased hospitalization expenses (P < 0.05). Children with FGR showed catch-up growth, which reached the level of the control group after 1.5 years, but these individuals still had lower MDI and PDI scores. The incidence rate of FGR in Mainland China was 8.77%. It has a significantly adverse effect on fetal-neonatal health and cognitive development.
调查中国大陆胎儿生长受限（FGR）的发生率及高危因素，并确定该状况对胎儿-新生儿健康的不良影响。本研究为回顾性病历审查。我们通过对2011年1月1日至12月31日期间来自中国大陆7家医院的母亲和新生儿的临床数据进行回顾性分析，调查FGR的发生率。基于从八一儿童医院新生儿重症监护病房（NICU）获得的数据，分析FGR的短期结局。对125例FGR儿童进行18个月的随访研究后，确定FGR的长期结局。比较FGR患者与对照组的身体发育指数、智力发育指数（MDI）和心理运动发育指数（PDI）。FGR的发生率为8.77%。女性FGR的发生率显著高于男性（9.80%对7.84%，P<0.05）。早产儿FGR的发生率高于足月儿（16.43%对7.87%，P<0.01）。慢性高血压、羊水异常和脐带异常是FGR的独立因素。与对照组相比，FGR患者出现低血糖、窒息、缺氧缺血性脑病、胃肠道出血、先天性畸形、红细胞增多症、肺出血、呼吸暂停、先天性心脏病和弥散性血管内凝血等并发症的发生率显著更高。FGR延长了住院时间，并显著增加了住院费用（P<0.05）。FGR儿童出现追赶生长，1.5年后达到对照组水平，但这些儿童的MDI和PDI评分仍然较低。中国大陆FGR的发生率为8.77%。它对胎儿-新生儿健康和认知发育有显著不良影响。
