Michaelis Isabel Alexandra, Krägeloh-Mann Ingeborg, Mazinu Mikateko, Jordaan Esme
Paediatric Department, Walter Sisulu University, Mthatha, South Africa.
University Children's Hospital Tübingen, Tübingen, Germany.
Front Pediatr. 2023 Jan 18;10:1075645. doi: 10.3389/fped.2022.1075645. eCollection 2022.
Very low birth weight (VLBW) and extremely low birth weight (ELBW) infants are known to be at high risk of growth failure and developmental delay later in life. The majority of those infants are born in low and middle income countries.
Growth monitoring in a cohort of infants born with a VLBW up to 18 months corrected age was conducted in a low resource setting tertiary hospital.
In this prospective cohort study, 173 infants with a birth weight below 1,501 g admitted within their first 24 h of life were recruited and the 115 surviving until discharged were asked to follow up at 1, 3, 6, 12 and 18 months. Weight, height and head circumferences were recorded and plotted on WHO Z-score growth charts.
Of the 115 discharged infants 89 were followed up at any given follow-up point (1, 3, 6, 12 and/or 18 months). By 12 months of corrected age another 15 infants had demised (13.0%). The infants' trends in weight-for-age z-scores (WAZ) for corrected age was on average below the norm up to 12 months (average estimated z-score at 12 months = -0.44; 95% CI, -0.77 to -0.11), but had reached a normal range on average at 18 months = -0.24; 95% CI, -0.65 to 0.19) with no overall difference in WAZ scores weight between males and female' infants ( > 0.7). Similar results were seen for height at 12 months corrected age with height-for-age z-scores (HAZ) of the study subjects being within normal limits (-0.24; 95% CI, -0.63 to 0.14). The mean head circumference z-scores (HCZ) initially plotted below -1.5 standard deviations (S.D.), but after 6 months the z-scores were within normal limits (mean z-score at 7 months = -0.19; 95% CI, -0.45 to 0.06).
Weight gain, length and head circumferences in infants with VLBW discharged showed a catch-up growth within the first 6-18 months of corrected age, with head circumference recovering best. This confirms findings in other studies on a global scale, which may be reassuring for health systems such as those in South Africa with a high burden of children born with low birth weights.
极低出生体重（VLBW）和超低出生体重（ELBW）婴儿在日后的生活中存在生长发育迟缓的高风险。这些婴儿大多出生在低收入和中等收入国家。
在一家资源匮乏的三级医院对一组出生时为极低出生体重的婴儿进行至18个月矫正年龄的生长监测。
在这项前瞻性队列研究中，招募了173名出生体重低于1501克且在出生后24小时内入院的婴儿，其中115名存活至出院的婴儿被要求在1、3、6、12和18个月进行随访。记录体重、身高和头围，并绘制在世界卫生组织Z评分生长图表上。
在115名出院婴儿中，89名在任何给定的随访点（1、3、6、12和/或18个月）接受了随访。到矫正年龄12个月时，又有15名婴儿死亡（13.0%）。矫正年龄的年龄别体重Z评分（WAZ）趋势在12个月前平均低于正常水平（12个月时平均估计Z评分为-0.44；95%可信区间，-0.77至-0.11），但在18个月时平均已达到正常范围（=-0.24；95%可信区间，-0.65至0.19），男婴和女婴的WAZ评分体重无总体差异（>0.7）。矫正年龄12个月时身高情况类似，研究对象的年龄别身高Z评分（HAZ）在正常范围内（-0.24；95%可信区间，-0.63至0.14）。平均头围Z评分（HCZ）最初绘制在低于-1.5标准差（S.D.）处，但6个月后Z评分在正常范围内（7个月时平均Z评分为-0.19；95%可信区间，-0.45至0.06）。
出院的极低出生体重婴儿的体重增加、身长和头围在矫正年龄的前6至18个月内出现追赶生长，头围恢复情况最佳。这证实了全球其他研究的结果，这可能会让南非等低出生体重儿童负担较重的卫生系统放心。
