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先天性腹壁裂新生儿生长不良的患病率:一项全州队列研究。

Growth Failure Prevalence in Neonates with Gastroschisis : A Statewide Cohort Study.

机构信息

Division of Neonatology and Developmental Biology, Department of Pediatrics, University of California Los Angeles, Los Angeles, CA.

Division of General Internal Medicine and Health Services Research, Department of Medicine Statistics Core, University of California Los Angeles, Los Angeles, CA.

出版信息

J Pediatr. 2021 Jun;233:112-118.e3. doi: 10.1016/j.jpeds.2021.02.013. Epub 2021 Feb 26.

Abstract

OBJECTIVES

To perform a multicenter study to assess growth failure in hospitalized infants with gastroschisis.

STUDY DESIGN

This study included neonates with gastroschisis within sites in the University of California Fetal Consortium. The study's primary outcome was growth failure at hospital discharge, defined as a weight or length z score decrease >0.8 from birth. Regression analysis was performed to assess changes in z scores over time.

RESULTS

Among 125 infants with gastroschisis, the median gestational age was 37 weeks (IQR 35-37). Length of stay was 32 days (23-60); 55% developed weight or length growth failure at discharge (28% had weight growth failure, 42% had length growth failure, and 15% had both weight and length growth failure). Weight and length z scores at 14 days, 30 days, and discharge were less than birth (P < .01 for all). Weight and length z scores declined from birth to 30 days (-0.10 and -0.11 z score units/week, respectively, P < .001). Length growth failure at discharge was associated with weight and length z score changes over time (P < .05 for both). Lower gestational age was associated with weight growth failure (OR 0.70 for each gestational age week, 95% CI 0.55-0.89, P = .004).

CONCLUSIONS

Growth failure, in particular linear growth failure, is common in infants with gastroschisis. These data suggest the need to improve nutritional management in these infants.

摘要

目的

进行一项多中心研究,评估患有先天性腹壁发育不全的住院婴儿的生长发育迟缓情况。

研究设计

本研究纳入了加利福尼亚大学胎儿联合会各中心的先天性腹壁发育不全新生儿。研究的主要结局是出院时的生长发育迟缓,定义为体重或身长 z 评分较出生时下降>0.8。回归分析用于评估 z 评分随时间的变化。

结果

在 125 例先天性腹壁发育不全婴儿中,中位胎龄为 37 周(IQR 35-37)。住院时间为 32 天(23-60);55%的婴儿在出院时出现体重或身长生长发育迟缓(28%体重生长发育迟缓,42%身长生长发育迟缓,15%体重和身长均生长发育迟缓)。14 天、30 天和出院时的体重和身长 z 评分均低于出生时(所有 P 值均<.01)。体重和身长 z 评分从出生到 30 天逐渐下降(每周分别下降 0.10 和 0.11 z 评分单位,均<.001)。出院时的身长生长发育迟缓与体重和身长 z 评分随时间的变化相关(两者 P 值均<.05)。较低的胎龄与体重生长发育迟缓相关(每增加一周胎龄,OR 为 0.70,95%CI 为 0.55-0.89,P=.004)。

结论

生长发育迟缓,特别是线性生长发育迟缓,在患有先天性腹壁发育不全的婴儿中很常见。这些数据表明需要改善这些婴儿的营养管理。

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