Division of Neonatology, Department of Pediatrics, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Pediatrics, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC.
Department of Radiation Oncology, National Yang Ming Chiao Tung University Hospital, Yilan, Taiwan, ROC.
Pediatr Neonatol. 2024 Mar;65(2):177-182. doi: 10.1016/j.pedneo.2022.05.022. Epub 2023 Nov 10.
Extrauterine growth restriction (EUGR) is common in very-low-birth-weight-infants and may be associated with poor neurodevelopment. The growth velocity of preterm infants is increasing over decades, but the relationship between growth velocity, EUGR, and morbidities of preterm infants remains unknown.
A total of 263 infants born between 2012 and 2020, with birthweight <1500 g and gestational age of 24-33 weeks, were included. Birthweight and weight on day of evaluation point (corrected gestational age 36 weeks or discharged, whenever comes first) were converted to age-specific and gender-specific Z-scores and analyzed by multivariable modeling. The average growth velocity was calculated by the exponential model.
Average growth velocity from birth to the evaluation point was 11.8 ± 0.3 g/kg/day. The maximum growth velocity from birth to week 8 postnatal occurred at week 4 postnatal (16.4 ± 0.9 g/kg/day). Infants with smaller birth weight, higher gestational age, and indication of intestinal surgery or those who need more days to achieve full enteral feeding were more favorable to have a weight lower than the 10th centile at the evaluation point. By contrast, most comorbidities of prematurity did not affect either lower age-specific weight Z-scores on the evaluation point or larger change in weight Z-score between birth and evaluation point.
EUGR was associated with gestational age and birth weight. Infants with moderate-to-severe bronchopulmonary dysplasia, high-grade intraventricular hemorrhage, or retinopathy of prematurity tend to have slower growth velocity at 3-5 weeks postnatal, but these did not contribute to EUGR.
宫外生长受限（EUGR）在极低出生体重儿中很常见，可能与神经发育不良有关。几十年来，早产儿的生长速度一直在增加，但生长速度、EUGR 与早产儿发病率之间的关系尚不清楚。
共纳入 263 名 2012 年至 2020 年出生、出生体重<1500g 且胎龄 24-33 周的婴儿。出生体重和评估点时的体重（校正胎龄 36 周或出院，以先到者为准）被转换为年龄特异性和性别特异性 Z 分数，并通过多变量模型进行分析。平均生长速度通过指数模型计算。
从出生到评估点的平均生长速度为 11.8±0.3g/kg/天。从出生到产后 8 周的最大生长速度发生在产后第 4 周（16.4±0.9g/kg/天）。出生体重较小、胎龄较高、有肠道手术指征或需要更多天数才能实现完全肠内喂养的婴儿，在评估点时体重低于第 10 百分位的可能性更大。相比之下，大多数早产儿的合并症并没有影响评估点时的年龄特异性体重 Z 分数较低或出生到评估点之间体重 Z 分数的变化较大。
EUGR 与胎龄和出生体重有关。中重度支气管肺发育不良、高级别颅内出血或早产儿视网膜病变的婴儿在生后 3-5 周时的生长速度往往较慢，但这并不导致 EUGR。
