Klevebro S, Lundgren P, Hammar U, Smith L E, Bottai M, Domellöf M, Löfqvist C, Hallberg B, Hellström A
Clinical Sciences, Intervention, and Technology, Karolinska Institutet, Stockholm, Sweden.
Sachs' Children and Youth Hospital, South General Hospital, Stockholm, Sweden.
BMJ Open. 2016 Nov 17;6(11):e012872. doi: 10.1136/bmjopen-2016-012872.
To examine differences in growth patterns in preterm infants developing major morbidities including retinopathy of prematurity (ROP), bronchopulmonary dysplasia (BPD), necrotising enterocolitis (NEC) and intraventricular haemorrhage (IVH).
Cohort study of 2521 infants born at a gestational age (GA) of 23-30 weeks from 11 level III neonatal intensive care units in USA and Canada, and 3 Swedish population-based cohorts.
Birth weight and postnatal weight gain were examined relative to birth GA and ROP, BPD, NEC and IVH development.
Among infants with a birth GA of 25-30 weeks, birth weight SD score and postnatal weight were lower in those developing ROP and BPD. Infants developing ROP showed lower growth rates during postnatal weeks 7-9 in the 23-24 weeks GA group, during weeks 4-6 in the 25-26 weeks GA group and during weeks 1-5 in the 27-30 weeks GA group. Infants with BPD born at 27-30 weeks GA showed lower growth rates during postnatal weeks 3-5. Infants with NEC had lower growth rates after postnatal week 6 in all GA groups, with no significant differences in birth weight SD score. IVH was not associated with prenatal or postnatal growth.
In this cohort study of extremely preterm infants, we found that the postnatal growth pattern was associated with morbidities such as ROP, BPD and NEC as well as with gestational age at birth.
研究发生包括早产儿视网膜病变（ROP）、支气管肺发育不良（BPD）、坏死性小肠结肠炎（NEC）和脑室内出血（IVH）等主要疾病的早产儿的生长模式差异。
对来自美国和加拿大11个三级新生儿重症监护病房的2521例孕龄（GA）为23 - 30周的婴儿以及3个瑞典人群队列进行队列研究。
出生体重和出生后体重增加情况与出生GA以及ROP、BPD、NEC和IVH的发生情况相关。在出生GA为25 - 30周的婴儿中，发生ROP和BPD的婴儿出生体重标准差评分和出生后体重较低。在孕龄23 - 24周组中，发生ROP的婴儿在出生后第7 - 9周生长速率较低；在25 - 26周组中，在第4 - 6周生长速率较低；在27 - 30周组中，在第1 - 5周生长速率较低。孕龄27 - 30周出生的患有BPD的婴儿在出生后第3 - 5周生长速率较低。患有NEC的婴儿在所有GA组中出生后第6周后生长速率较低，出生体重标准差评分无显著差异。IVH与产前或产后生长无关。
在这项对极早产儿的队列研究中，我们发现出生后生长模式与ROP、BPD和NEC等疾病以及出生时的孕龄相关。
