Chen Wenhao, Yang Changyi, Chen Hanqiang, Zhang Baoquan
Department of Orthopedics, Fujian Medical University Union Hospital.
Department of Neonatology, Affiliated Hospital of Fujian Medical University, Fujian Maternity and Children Hospital, Fuzhou, China.
Medicine (Baltimore). 2018 Oct;97(42):e12861. doi: 10.1097/MD.0000000000012861.
The present study aims to analyze the risk factors for metabolic bone disease (MBD) of prematurity.A total of 238 preterm infants who were born at <34 weeks of gestation and were hospitalized for at least 6 weeks in the Department of Neonatology, Fujian Maternity and Children Hospital between January 1, 2011 and November 30, 2015 were enrolled in the study. Sixteen preterm infants diagnosed with MBD were selected as the case group, and 32 non-MBD preterm infants were matched 2:1 at admission into the study. The 2 groups were compared to examine the differences in maternal obstetric conditions, conditions during parturition, neonatal conditions, and neonatal diseases and treatments. The risk factors for MBD of prematurity were analyzed using t tests, χ tests, and a logistic regression model.The mean gestational age and birth weight of the case group were significantly lower (P < .05) than those of the control group. Compared with the control group, the case group had a significantly higher ratios of small-for-gestational-age infants, antenatal maternal corticosteroids use, sedative use, ventilator use, aminophylline use, diuretic use, liver function impairment, vitamin D (VitD) supplementation at more than 14 days of age, achievement of total enteral nutrition (TEN) beyond 28 days of age, and feeding intolerance.Logistic regression analysis showed that birth at <30 weeks of gestation, VitD supplementation at >14 days of age, and achievement of TEN beyond 28 days of age were independent risk factors for MBD (P < .05).Level of Evidence: IV.
本研究旨在分析早产代谢性骨病（MBD）的危险因素。选取2011年1月1日至2015年11月30日在福建省妇幼保健院新生儿科住院至少6周、孕周<34周的238例早产儿纳入研究。选择16例诊断为MBD的早产儿作为病例组，按入院时2∶1配比32例非MBD早产儿作为对照组。比较两组产妇产科情况、分娩情况、新生儿情况及新生儿疾病与治疗情况的差异。采用t检验、χ检验及logistic回归模型分析早产MBD的危险因素。病例组的平均孕周和出生体重显著低于对照组（P<0.05）。与对照组相比，病例组小于胎龄儿、产前使用糖皮质激素、使用镇静剂、使用呼吸机、使用氨茶碱、使用利尿剂、肝功能损害、出生14天以后补充维生素D（VitD）、出生28天以后实现完全肠内营养（TEN）及喂养不耐受的比例显著更高。Logistic回归分析显示，孕周<30周、出生14天以后补充VitD及出生28天以后实现TEN是MBD的独立危险因素（P<0.05）。证据级别：IV级。
