Fenton Tanis R, Cormack Barbara, Goldberg Dena, Nasser Roseann, Alshaikh Belal, Eliasziw Misha, Hay William W, Hoyos Angela, Anderson Diane, Bloomfield Frank, Griffin Ian, Embleton Nicholas, Rochow Niels, Taylor Sarah, Senterre Thibault, Schanler Richard J, Elmrayed Seham, Groh-Wargo Sharon, Adamkin David, Shah Prakesh S
Community Health Sciences, Institute of Public Health, Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
Nutrition Services, Alberta Health Services, Calgary, AB, Canada.
J Perinatol. 2020 May;40(5):704-714. doi: 10.1038/s41372-020-0658-5. Epub 2020 Mar 25.
Preterm infants are increasingly diagnosed as having "extrauterine growth restriction" (EUGR) or "postnatal growth failure" (PGF). Usually EUGR/PGF is diagnosed when weight is <10th percentile at either discharge or 36-40 weeks postmenstrual age. The reasons why the phrases EUGR/PGF are unhelpful include, they: (i) are not predictive of adverse outcome; (ii) are based only on weight without any consideration of head or length growth, proportionality, body composition, or genetic potential; (iii) ignore normal postnatal weight loss; (iv) are usually assessed prior to growth slowing of the reference fetus, around 36-40 weeks, and (v) are usually based on an arbitrary statistical growth percentile cut-off. Focus on EUGR/PGF prevalence may benefit with better attention to nutrition but may also harm with nutrition delivery above infants' actual needs. In this paper, we highlight challenges associated with such arbitrary cut-offs and opportunities for further refinement of understanding growth and nutritional needs of preterm neonates.
越来越多的早产儿被诊断为患有“宫外生长受限”（EUGR）或“出生后生长失败”（PGF）。通常，当婴儿在出院时或孕龄36 - 40周时体重低于第10百分位数时，会被诊断为EUGR/PGF。EUGR/PGF这两个术语没有帮助的原因包括：（i）不能预测不良结局；（ii）仅基于体重，而没有考虑头围或身长的增长、比例、身体成分或遗传潜力；（iii）忽略了出生后的正常体重减轻；（iv）通常在参考胎儿生长放缓之前，即36 - 40周左右进行评估；（v）通常基于任意的统计生长百分位数临界值。关注EUGR/PGF的患病率可能会因更好地关注营养而受益，但也可能因提供超过婴儿实际需求的营养而造成伤害。在本文中，我们强调了与这种任意临界值相关的挑战，以及进一步完善对早产儿生长和营养需求理解的机会。
