Department of Pediatric Surgery, University of Eastern Finland and Kuopio University Hospital, Puijonlaaksontie 2, 70210, Kuopio, Finland.
Department of Pediatric Surgery, University of Turku and Turku University Hospital, Turku, Finland.
Eur J Pediatr. 2023 Dec;182(12):5615-5623. doi: 10.1007/s00431-023-05217-4. Epub 2023 Oct 11.
Normal childhood growth is an indicator of good health, but data addressing the growth of children born with abdominal wall defects (AWDs) are limited. The detailed growth phenotypes of children born with gastroschisis or omphalocele are described and compared to peers without AWDs from birth to adolescence. Data from 183 gastroschisis and 144 omphalocele patients born between 1993 and 2017 were gathered from Finnish nationwide registers and electronic health records. Weight (n = 3033), length/height (n = 2034), weight-for-length (0-24 months, n = 909), and body mass index measures (2-15 years, n = 423) were converted into sex- and age-specific Z-scores. Linear mixed models were used for comparisons. Intrauterine growth failure was common in infants with gastroschisis. Birth weight Z-scores in girls and boys were - 1.2 (0.2) and - 1.3 (0.2) and length Z-scores - 0.7 (0.2) and - 1.0 (0.2), respectively (p < 0.001 for all comparisons to infants without AWDs). During early infancy, growth failure increased in infants with gastroschisis, and thereafter, catch-up growth was prominent and faster in girls than in boys. Gastroschisis children gained weight and reached their peers' weights permanently at 5 to 10 years. By 15 years or older, 30% of gastroschisis patients were overweight. Infants with omphalocele were born with a normal birth size but grew shorter and weighing less than the reference population until the teen-age years.
Children with gastroschisis and omphalocele have distinct growth patterns from fetal life onwards. These growth trajectories may also provide some opportunities to modulate adult health.
• Intrauterine and postnatal growth failure can be seen frequently in gastroschisis and they often show significant catch-up growth later in infancy. It is assumed that part of the children with gastroschisis will become overweight during later childhood.
• The longitudinal growth of girls and boys with gastroschisis or omphalocele is described separately until the teenage years. The risk of gaining excessive weight in puberty was confirmed in girls with gastroschisis.
正常的儿童生长是健康的标志,但目前针对腹壁缺陷(AWD)患儿生长情况的数据十分有限。本研究旨在详细描述并比较先天性脐膨出和腹裂患儿与无 AWD 患儿从出生到青春期的生长表型。
研究人员从芬兰全国登记处和电子健康记录中收集了 1993 年至 2017 年间出生的 183 例先天性脐膨出和 144 例腹裂患儿的数据。体重(n=3033)、身长/身高(n=2034)、体重-身长比(0-24 个月,n=909)和体质指数(2-15 岁,n=423)均转换为性别和年龄特异性 Z 评分。采用线性混合模型进行比较。
先天性脐膨出患儿宫内生长受限较为常见。女婴和男婴的出生体重 Z 评分分别为-1.2(0.2)和-1.3(0.2),身长 Z 评分分别为-0.7(0.2)和-1.0(0.2)(与无 AWD 组相比,所有比较均 p<0.001)。在婴儿早期,先天性脐膨出患儿的生长发育迟缓,此后女孩的追赶生长速度快于男孩。先天性脐膨出患儿在 5-10 岁时体重可永久性追上同龄儿,15 岁时,30%的患儿超重。先天性脐膨出患儿出生时体重正常,但在青少年前其身高和体重均小于参考人群。
先天性脐膨出和腹裂患儿从胎儿期开始就存在不同的生长模式,这些生长轨迹可能为调节成年健康提供机会。
• 先天性脐膨出和腹裂患儿常有宫内和生后生长发育迟缓,且常在婴儿后期出现明显追赶生长。据推测,部分先天性脐膨出患儿在儿童期后期会超重。
• 本研究分别描述了先天性脐膨出和腹裂患儿女孩和男孩的纵向生长情况,直至青春期。在先天性脐膨出女孩中,确认了青春期体重过度增加的风险。