Gao Xiao-Yan, Feng Lin, Xu Jing, Pan Xin-Nian
Department of Neonatology, Maternal and Child Health Care Hospital of Guangxi Zhuang Autonomous Region, Nanning 530000, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2018 Jun;20(6):438-443. doi: 10.7499/j.issn.1008-8830.2018.06.002.
To investigate the catch-up growth of preterm infants within a corrected age of 6 months and the risk factors for extrauterine growth retardation (EUGR).
A total of 321 preterm infants who were discharged after treatment in the neonatal intensive care unit and had regular follow-up documents with complete follow-up records were enrolled. According to the Prenatal Health Care Norms in 2015, these infants were divided into low-risk group with 69 infants and high-risk group with 252 infants. The Z-score method was used to evaluate body weight, body length, and head circumference, and the catch-up growth of the preterm infants within a corrected age of 6 months was analyzed. A multivariate logistic regression analysis was performed to identify the risk factors for EUGR at the corrected age of 6 months.
The percentage of preterm infants with Z scores of body weight, body length, and head circumference of < -2 (not reach the standard for catch-up growth) in both groups decreased gradually with increasing corrected age. At the corrected age of 6 months, the percentages of preterm infants whose body weight, body length, and head circumference did not reach the standard for catch-up growth in the low-risk group were reduced to 1.4% (1/69), 2.9% (2/69), and 1.4% (1/69) respectively, while in the high-risk group, these percentages were reduced to 1.2% (3/252), 1.6% (4/252), and 3.6% (9/252) respectively. The high-risk group had a significantly higher incidence rate of EUGR at the corrected age of 6 months than the low-risk group (28.2% vs 15.9%, P=0.039). The multivariate logistic regression analysis showed that multiple birth (OR=2.68, P=0.010), low birth weight (<1 000 g: OR=14.84, P<0.001; 1 000-1 499 g: OR=2.85, P=0.005), and intrauterine growth retardation (IUGR) (OR=11.41, P<0.001) were risk factors for EUGR at the corrected age of 6 months, while nutritional enhancement after birth (OR=0.25, P<0.001) reduced the risk of EUGR.
Most preterm infants can achieve catch-up growth at the corrected age of 6 months. High-risk preterm infants have a high incidence rate of EUGR at the corrected age of 6 months. Multiple birth, low birth weight, and IUGR are risk factors for EUGR, while rational nutritional enhancement after birth can reduce the incidence rate of EUGR in preterm infants.
探讨出生后6个月校正年龄内早产儿的追赶生长情况及宫外生长迟缓(EUGR)的危险因素。
选取321例在新生儿重症监护病房治疗后出院且有完整随访记录的早产儿。根据《2015年产前保健规范》,将这些婴儿分为低风险组69例和高风险组252例。采用Z评分法评估体重、身长和头围,并分析出生后6个月校正年龄内早产儿的追赶生长情况。进行多因素logistic回归分析以确定出生后6个月校正年龄时EUGR的危险因素。
两组中体重、身长和头围Z评分< -2(未达到追赶生长标准)的早产儿百分比随校正年龄增加而逐渐降低。在出生后6个月校正年龄时,低风险组体重、身长和头围未达到追赶生长标准的早产儿百分比分别降至1.4%(1/69)、2.9%(2/69)和1.4%(1/69),而高风险组这些百分比分别降至1.2%(3/252)、1.6%(4/252)和3.6%(9/252)。高风险组在出生后6个月校正年龄时EUGR的发生率显著高于低风险组(28.2%对15.9%,P = 0.039)。多因素logistic回归分析显示,多胎妊娠(OR = 2.68,P = 0.010)、低出生体重(<1000g:OR = 14.84,P < 0.001;1000 - 1499g:OR = 2.85,P = 0.005)和宫内生长迟缓(IUGR)(OR = 11.41,P < 0.001)是出生后6个月校正年龄时EUGR的危险因素,而出生后营养强化(OR = 0.25,P < 0.001)可降低EUGR风险。
多数早产儿在出生后6个月校正年龄时可实现追赶生长。高风险早产儿在出生后6个月校正年龄时EUGR发生率较高。多胎妊娠、低出生体重和IUGR是EUGR的危险因素,而出生后合理的营养强化可降低早产儿EUGR的发生率。