Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea.
PLoS One. 2021 Oct 28;16(10):e0259080. doi: 10.1371/journal.pone.0259080. eCollection 2021.
We aimed to evaluate risk factors for growth failure in very low birth weight (VLBW) infants at 18-24 months of corrected age (follow-up1, FU1) and at 36 months of age (follow-up2, FU2). In this prospective cohort study, a total of 2,943 VLBW infants from the Korean Neonatal Network between 2013 and 2015 finished follow-up at FU1. Growth failure was defined as a z-score below -1.28. Multiple logistic regression was used to analyze risk factors for growth failure after dividing the infants into small for gestational age (SGA) and appropriate for gestational age (AGA) groups. Overall, 18.7% of infants were SGA at birth. Growth failure was present in 60.0% at discharge, 20.3% at FU1, and 35.2% at FU2. Among AGA infants, male sex, growth failure at discharge, periventricular leukomalacia, treatment of retinopathy of prematurity, ventriculoperitoneal shunt status and treatment of rehabilitation after discharge were independent risk factors for growth failure at FU1. Among SGA infants, lower birth weight, pregnancy-induced hypertension, and treatment of rehabilitation after discharge were independent risk factors for growth failure at FU1. Mean weight z-score graphs from birth to 36 month of age revealed significant differences between SGA and non-SGA and between VLBW infants and extremely low birth weight infants. Growth failure remains an issue, and VLBW infants with risk factors should be closely checked for growth and nutrition.
我们旨在评估极低出生体重（VLBW）婴儿在 18-24 个月校正年龄（随访 1，FU1）和 36 个月龄（随访 2，FU2）时生长不良的危险因素。在这项前瞻性队列研究中，2013 年至 2015 年间，韩国新生儿网络共有 2943 名 VLBW 婴儿完成了 FU1 随访。生长不良定义为 z 评分低于-1.28。将婴儿分为小于胎龄儿（SGA）和适于胎龄儿（AGA）组后，采用多因素逻辑回归分析生长不良的危险因素。总体而言，出生时婴儿中有 18.7%为 SGA。出院时生长不良发生率为 60.0%，FU1 时为 20.3%，FU2 时为 35.2%。在 AGA 婴儿中，男性、出院时生长不良、脑室周围白质软化、早产儿视网膜病变治疗、脑室腹腔分流状态和出院后康复治疗是 FU1 时生长不良的独立危险因素。在 SGA 婴儿中，出生体重较低、妊娠高血压和出院后康复治疗是 FU1 时生长不良的独立危险因素。从出生到 36 个月龄的体重 z 评分图显示了 SGA 和非 SGA 以及 VLBW 婴儿和极低出生体重婴儿之间的显著差异。生长不良仍然是一个问题，应密切检查有危险因素的 VLBW 婴儿的生长和营养状况。
