Bagga Nitasha, Panigrahi Nalinikanta, Germain Aaron, Namazova Ilhama, Rahman Md Mozibur, Saugstad Ola Didrik, Maheshwari Akhil
Department of Neonatology, Rainbow Children's Hospital, Hyderabad, Telangana, India; Global Newborn Society, Maryland, United States of America.
Department of Neonatology, Johns Hopkins All Children's Maternal, Fetal, and Neonatal Institute, St. Petersburg, Florida, United States of America.
Newborn (Clarksville). 2023 Jul-Sep;2(3):198-202. doi: 10.5005/jp-journals-11002-0072. Epub 2023 Sep 25.
Neonates show considerable variation in growth that can be recognized through serial measurements of basic variables such as weight, length, and head circumference. If possible, measurement of subcutaneous and total body fat mass can also be useful. These biometric measurements at birth may be influenced by demographics, maternal and paternal anthropometrics, maternal metabolism, preconceptional nutritional status, and placental health. Subsequent growth may depend on optimal feeding, total caloric intake, total metabolic activity, genetic makeup, postnatal morbidities, medications, and environmental conditions. For premature infants, these factors become even more important; poor growth can be an important reason for spontaneous or induced preterm delivery. Later, many infants who have had intrauterine growth restriction (IUGR) and are born small for gestational age (SGA) continue to show suboptimal growth below the 10th percentile, a condition that has been defined as extrauterine growth restriction (EUGR) or postnatal growth restriction (PNGR). More importantly, a subset of these growth-restricted infants may also be at high risk of abnormal neurodevelopmental outcomes. There is a need for well-defined criteria to recognize EUGR/PNGR, so that correctional steps can be instituted in a timely fashion.
新生儿的生长存在显著差异，通过对体重、身长和头围等基本变量进行连续测量可以识别出来。如果可能的话，测量皮下脂肪和全身脂肪量也会有所帮助。出生时的这些生物测量可能会受到人口统计学因素、父母的人体测量学数据、母亲的新陈代谢、孕前营养状况以及胎盘健康状况的影响。随后的生长可能取决于最佳喂养、总热量摄入、总代谢活动、基因组成、产后疾病、药物治疗以及环境条件。对于早产儿来说，这些因素更为重要；生长不良可能是自然早产或引产的一个重要原因。后来，许多患有宫内生长受限（IUGR）且出生时小于胎龄（SGA）的婴儿继续表现出低于第10百分位的生长欠佳情况，这种情况被定义为宫外生长受限（EUGR）或产后生长受限（PNGR）。更重要的是，这些生长受限婴儿中的一部分可能也面临神经发育异常结局的高风险。需要有明确的标准来识别EUGR/PNGR，以便能够及时采取纠正措施。
