Ushida Takafumi, Kotani Tomomi, Nakatochi Masahiro, Kobayashi Yumiko, Nakamura Noriyuki, Imai Kenji, Iitani Yukako, Nakano-Kobayashi Tomoko, Hayakawa Masahiro, Kajiyama Hiroaki
Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan; Division of Perinatology, Center for Maternal-Neonatal Care, Nagoya University Hospital, Nagoya, Japan.
Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan; Division of Perinatology, Center for Maternal-Neonatal Care, Nagoya University Hospital, Nagoya, Japan.
Pregnancy Hypertens. 2022 Jun;28:174-179. doi: 10.1016/j.preghy.2022.05.007. Epub 2022 May 10.
There is growing evidence regarding the association between rapid growth during infancy and metabolic and cardiovascular diseases later in life. We aimed to evaluate postnatal growth trajectories in extremely and very preterm infants exposed to hypertensive disorders of pregnancy (HDP) in utero.
This multicenter retrospective study used a nationwide database of preterm infants weighing ≤1,500 g born between 22 and 31 weeks of gestation between 2003 and 2015.
The Z-scores for height and weight were evaluated at three time points (at birth, corrected age of 1.5 years, and chronological age of 3 years) in 5,144 infants (HDP, n = 1,188; non-HDP, n = 3,956). Univariate and multivariate regression analyses were performed to investigate the associations between HDP exposure and accelerated postnatal growth.
Male and female infants in the HDP group showed increased mean Z-scores for height and weight, whereas those in the non-HDP group showed decreased mean Z-scores. Multivariate analyses showed that HDP were associated with accelerated postnatal growth (Δ Z-scores) in weight in both male and female infants (β coefficient [95% CI]; male 0.17 [0.05-0.30], female 0.27 [0.14-0.39]), but not in height (male 0.02 [-0.09 to 0.13], female 0.04 [-0.06 to 0.15]). An interaction analysis revealed no significant differences in the effects of HDP on postnatal growth between male and female infants.
Intrauterine exposure to HDP contributes to accelerated postnatal weight growth in extremely and very preterm infants during early childhood. In addition, no sex differences were observed in postnatal growth.
越来越多的证据表明婴儿期快速生长与日后的代谢和心血管疾病之间存在关联。我们旨在评估子宫内暴露于妊娠高血压疾病（HDP）的极早产儿和超早产儿的出生后生长轨迹。
这项多中心回顾性研究使用了一个全国性数据库，该数据库包含2003年至2015年期间出生的孕周在22至31周、体重≤1500g的早产儿。
在5144名婴儿（HDP组，n = 1188；非HDP组，n = 3956）的三个时间点（出生时、矫正年龄1.5岁和实际年龄3岁）评估身高和体重的Z评分。进行单变量和多变量回归分析，以研究HDP暴露与出生后加速生长之间的关联。
HDP组的男婴和女婴身高和体重的平均Z评分增加，而非HDP组的平均Z评分下降。多变量分析显示，HDP与男婴和女婴体重的出生后加速生长（Z评分变化）相关（β系数[95%CI]；男婴0.17[0.05 - 0.30]，女婴0.27[0.14 - 0.39]），但与身高无关（男婴0.02[-0.09至0.13]，女婴0.04[-0.06至0.15]）。交互分析显示，HDP对男婴和女婴出生后生长的影响没有显著差异。
子宫内暴露于HDP会导致极早产儿和超早产儿在幼儿期出生后体重加速增长。此外，在出生后生长方面未观察到性别差异。
