Department of Obstetrics and Gynaecology, Mercy Perinatal, University of Melbourne, Mercy Hospital for Women, Heidelberg, Australia.
Mercy Hospital for Women, Heidelberg, Australia.
J Matern Fetal Neonatal Med. 2022 Dec;35(25):8400-8406. doi: 10.1080/14767058.2021.1974835. Epub 2021 Sep 9.
To assess the growth trajectory of preterm small-for-gestational-age (SGA) neonates compared to preterm non-small-for-gestational age neonates in the neonatal intensive care unit and special care nursery.
We conducted a retrospective cohort study at a large tertiary hospital in Victoria, Australia, examining neonates ≤34 weeks' gestation admitted to the neonatal intensive care unit or special care nursery between 2013 and 2017. We categorized neonates according to their birth weight centile: <10th centile (small-for-gestational age) and ≥10th centile (non-small-for-gestational age). Growth trajectory was tracked based on serial weights obtained in the neonatal intensive care unit and special care nursery, using -scores derived from Fenton preterm growth charts. Our primary outcome was the change in weight -score from birth to discharge from neonatal intensive care unit or special care nursery.
Of the 910 babies included, 88 were small-for-gestational age and 822 were appropriate-for gestational age. Both groups had a reduction in their weight -score; however, SGA babies had a significantly smaller reduction (-0.62 SD compared to -0.85 SD, < .0001). Small-for-gestational-age neonates were four times more likely to experience an increase in their weight -score across their admission compared to neonates who were not small-for-gestational age (OR 4.04, 95% CI 2.23-7.48, < .0001). Small-for-gestational-age neonates had an increased median length of stay, increased incidence of necrotizing enterocolitis but a reduced incidence of intraventricular hemorrhage.
Preterm SGA babies experience a smaller reduction in their weight trajectory compared to their appropriately grown counterparts in the neonatal intensive care unit or special care nursery.
评估与早产儿非小胎龄儿相比，小胎龄儿在新生儿重症监护病房和特别护理室的生长轨迹。
我们在澳大利亚维多利亚州的一家大型三级医院进行了一项回顾性队列研究，检查了 2013 年至 2017 年间在新生儿重症监护病房或特别护理室住院的≤34 周早产儿。我们根据出生体重百分位数将新生儿分为两类：<第 10 百分位数（小胎龄儿）和≥第 10 百分位数（非小胎龄儿）。使用 Fenton 早产儿生长图表得出的 Z 评分，根据新生儿重症监护病房和特别护理室获得的连续体重跟踪生长轨迹。我们的主要结局是从出生到从新生儿重症监护病房或特别护理室出院时体重 Z 评分的变化。
在 910 名婴儿中，88 名是小胎龄儿，822 名是适于胎龄儿。两组的体重 Z 评分均降低；然而，小胎龄儿的降低幅度明显较小（-0.62SD 比-0.85SD， < .0001）。与非小胎龄儿相比，小胎龄儿在住院期间体重 Z 评分增加的可能性大四倍（OR 4.04，95%CI 2.23-7.48， < .0001）。小胎龄儿的中位住院时间延长，坏死性小肠结肠炎的发生率增加，但脑室出血的发生率降低。
与在新生儿重症监护病房或特别护理室中正常生长的早产儿相比，小胎龄儿的体重轨迹下降幅度较小。
