Department of Pediatrics, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India.
Department of Pediatrics, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India. Correspondence to: Dr Padmasani Venkat Ramanan, Professor, Department of Pediatrics, Sri Ramachandra Medical College and Research Institute, Chennai, Tamil Nadu 600116, India.
Indian Pediatr. 2024 Jun 15;61(6):540-544. Epub 2024 Apr 22.
To study the postnatal growth at 64 weeks postmenstrual age (PMA) in preterm neonates born at ≤ 34 weeks gestational age.
A cross-sectional study was conducted between August, 2019 and November, 2021, wherein, we took anthropometric measurements of neonates (delivered at ≤ 34 weeks' gestation) at 64 (± 2) weeks PMA. The rapidity of postnatal growth was categorized according to change in the z-score of anthropometric measures, viz, weight-for-age, length-for-age and head circumference-for-age, between birth and 64 weeks PMA. For each of the growth parameters, growth rate was categorized according to the change in z-score (z-score at 64 weeks PMA minus z-score at birth) as slow (< -0.67), acceptable (-0.67 to < 0.67), and rapid (≥ 0.67).
Out of the 156 preterm neonates evaluated, weight gain was slow, acceptable and rapid in 95 (60.8%), 45 (28.9%), and 16 (10.3%), respectively. Length gain was slow, acceptable, and rapid in 87 (55.7%), 49 (31.4%), and 20 (12.9%) infants, respectively. Head circumference gain was slow, acceptable and rapid in 103 (66.5%), 42 (26.5%), and 11 (7.0%) infants, respectively. The risk [aOR (95% CI)] for slow weight gain increased with early initiation of complementary feeding [8.0 (3.5, 18.0)] and decreased with a longer duration of EBF [0.4 (0.2, 0.6), P < 0.001]. The risk for rapid weight gain also decreased with the longer duration of EBF [0.27 (0.1, 0.5), P < 0.001]. Gestational age < 32 weeks ,weight for gestation at birth, and re-hospitalization following discharge were the other key factors influencing the growth rate.
Among babies born preterm (≤ 34 weeks), more than half had slow gain in weight, length and head circumference. EBF till 6 months corrected age was protective against slow and rapid weight gain.
研究胎龄≤34 周的早产儿在出生后 64 周（校正后胎龄）的生长情况。
这是一项在 2019 年 8 月至 2021 年 11 月期间进行的横断面研究，对胎龄≤34 周的新生儿在出生后 64（±2）周时进行人体测量。根据出生至 64 周校正胎龄时体重、身长和头围的人体测量指标 z 分数的变化，将新生儿的生长速度分为体重与年龄的关系、身长与年龄的关系和头围与年龄的关系。对于每个生长参数，根据 z 分数的变化将生长速度分为慢（＜-0.67）、可接受（-0.67 至＜0.67）和快（≥0.67）。
在 156 例早产儿中，体重增长缓慢、可接受和快速的比例分别为 95（60.8%）、45（28.9%）和 16（10.3%）。体重增长缓慢、可接受和快速的比例分别为 87（55.7%）、49（31.4%）和 20（12.9%）。头围增长缓慢、可接受和快速的比例分别为 103（66.5%）、42（26.5%）和 11（7.0%）。早期开始补充喂养的风险[aOR（95%CI）]为 8.0（3.5，18.0），较长的纯母乳喂养时间风险为 0.4（0.2，0.6），两者均增加了体重增长缓慢的风险，差异均有统计学意义（P＜0.001）。较长的纯母乳喂养时间也降低了体重快速增长的风险[aOR（95%CI）为 0.27（0.1，0.5）]，差异有统计学意义（P＜0.001）。胎龄＜32 周、出生时的胎龄体重和出院后再次住院是影响生长速度的其他关键因素。
在出生时胎龄≤34 周的早产儿中，超过一半的体重、身长和头围增长缓慢。纯母乳喂养至 6 个月校正年龄可预防体重增长缓慢和快速增长。
