Neonatal Intensive Care Unit, Maternal and Neonatal Department, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy.
Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, 16132 Genoa, Italy.
Nutrients. 2024 Feb 3;16(3):449. doi: 10.3390/nu16030449.
Extra-uterine growth restriction (EUGR) is a common complication and a known risk factor for impaired development in very-low-birth-weight (VLBW) neonates. We report a population of 288 patients with no or with low-grade MRI lesions scanned at a term equivalent age (TEA) born between 2012 and 2018. Griffiths Mental Development Scale II (GMDS II) at 2 and 3 years, preterm complications and weight growth were retrospectively analyzed. EUGR was defined for weight z-score ˂ 10 percentile at TEA, 6 and 12 months of correct age or as z-score decreased by 1-point standard deviation (SDS) from birth to TEA and from TEA to 6 months. Multivariate analysis showed that a higher weight z-score at 6 months is protective for the global developmental quotient (DQ) at 2 years (OR 0.74; CI 95% 0.59-0.93; = 0.01). EUGR at 6 months was associated with worse locomotor, personal/social, language and performance DQ at 2 years and worse language and practical reasoning DQ at 3 years. In conclusion, a worse weight z-score at 6 months of age seems to be an independent risk factor for significantly reduced GMDS in many areas. These results suggest that we should invest more into post-discharge nutrition, optimizing family nutritional education.
宫外生长受限（EUGR）是极低出生体重儿（VLBW）常见的并发症和发育受损的已知危险因素。我们报告了 288 例在 2012 年至 2018 年出生的足月（TEA）时无或仅有低级别 MRI 病变的患者人群，他们接受了 Griffiths 精神发育量表 II（GMDS II）在 2 岁和 3 岁时评估，回顾性分析了早产并发症和体重增长情况。EUGR 定义为 TEA 时体重 z 评分<第 10 个百分位数、6 个月和 12 个月的矫正年龄或从出生到 TEA 和从 TEA 到 6 个月时体重 z 评分下降 1 个标准差（SDS）。多变量分析表明，6 个月时较高的体重 z 评分对 2 岁时的总体发育商（DQ）有保护作用（OR 0.74；95%CI 0.59-0.93；P=0.01）。6 个月时的 EUGR 与 2 岁时运动、个人/社会、语言和运动 DQ 更差，以及 3 岁时语言和实用推理 DQ 更差相关。总之，6 个月时体重 z 评分较差似乎是 GMDS 多个领域明显降低的独立危险因素。这些结果表明，我们应该在出院后营养方面投入更多，优化家庭营养教育。
