Gao Wenying, Zhang Taomei, Wang Qihui, Tang Xiaoli, Zhang Ying
Shanghai Jiao Tong University, School of Nursing, Shanghai, China.
Shanghai Jiao Tong University, School of Medicine, Shanghai Children's Medical Center, Department of Neonatology, Shanghai, China.
Int J Nurs Sci. 2023 Mar 25;10(2):206-214. doi: 10.1016/j.ijnss.2023.03.016. eCollection 2023 Apr.
Growth retardation is a risk for premature infants. In addition to demographic and perinatal factors, preterm infants' physical growth may be affected by neonatal intensive care unit (NICU) stress, maternal postpartum depression, and mother-infant interaction. This study aimed to investigate the trajectories of physical growth in 4 months corrected age among preterm infants discharged from the NICU and the impactors on these trajectories.
A prospective study was conducted among 318 preterm infants from September 2019 to April 2021 in Shanghai, China. Latent growth modeling was applied to identify the weight, length, and head circumference growth trajectories in 4 months corrected age and explore the effects of demographic and medical characteristics, infant stress during NICU stay, maternal postpartum depression, and mother-infant interaction on each trajectory.
Unconditional latent growth models showed curve trajectories with increasingly slower growth in weight, length, and head circumference until 4 months of corrected age. Conditional latent growth models showed that a longer length of stay in the NICU and more skin punctures were negatively associated with weight at 40 weeks corrected gestational age ( = -0.43 and -0.19, respectively, < 0.05). The maternal postpartum depression between 40 weeks corrected gestational age and 1 month corrected postnatal age was associated with a lower growth rate of length ( = -0.17, = 0.040), while between 2 and 3 months corrected postnatal age, there were lower growth rates of weight and head circumference ( = -0.15 and -0.19, respectively, < 0.05). The mother-infant interaction scores between 40 weeks corrected gestational age and 1 month corrected postnatal age negatively predicted the growth rate of weight ( = -0.19, = 0.020).
The physical growth trajectories of preterm infants discharged from the NICU were influenced by infant stress during the NICU stay, maternal postpartum depression and mother-infant interaction.
生长发育迟缓是早产儿面临的一个风险。除了人口统计学和围产期因素外，早产儿的身体生长可能会受到新生儿重症监护病房（NICU）压力、母亲产后抑郁以及母婴互动的影响。本研究旨在调查从NICU出院的早产儿在矫正年龄4个月时的身体生长轨迹以及这些轨迹的影响因素。
2019年9月至2021年4月在中国上海对318名早产儿进行了一项前瞻性研究。应用潜在生长模型来确定矫正年龄4个月时的体重、身长和头围生长轨迹，并探讨人口统计学和医学特征、NICU住院期间的婴儿压力、母亲产后抑郁以及母婴互动对每个轨迹的影响。
无条件潜在生长模型显示，体重、身长和头围的曲线轨迹在矫正年龄4个月之前增长越来越缓慢。条件潜在生长模型显示，NICU住院时间较长和更多的皮肤穿刺与矫正胎龄40周时的体重呈负相关（分别为-0.43和-0.19，P<0.05）。矫正胎龄40周和矫正出生后1个月之间的母亲产后抑郁与身长生长速率较低有关（β=-0.17，P=0.040），而在矫正出生后2至3个月之间，体重和头围的生长速率较低（分别为β=-0.15和-0.19，P<0.05）。矫正胎龄40周和矫正出生后1个月之间的母婴互动得分对体重生长速率有负向预测作用（β=-0.19，P=0.020）。
从NICU出院的早产儿的身体生长轨迹受到NICU住院期间的婴儿压力、母亲产后抑郁和母婴互动的影响。
