Qiu Meng-Fan, Zhang Yi, Tang Ying-Zi, Dou Ya-Lan, Wang Yuan, Lyu Tian-Chan, Fan Qiao-Ling, Ma Yue-Lan, Li Fang, Rong Hui, Tang Yun-Fei, Gu Wei-Wei, Chen Xiao-Chun, Liu Dan, Wang Hua, Xiao Juan, Zhang Li-Li, Wang Yan, Ye Ru-Ming, Li Dan, Li Xiao-Xia, Pang Yu, Lin Mei, Lin Mei, Xuan Yan, Hu Xiao-Jing
Fujian Key Laboratory of Neonatal Diseases, Xiamen Key Laboratory of Neonatal Diseases, Xiamen Children's Hospital (Children's Hospital of Fudan University at Xiamen), Xiamen, China.
Neonatal Intensive Care Unit, Children's Hospital of Fudan University, Shanghai, China.
J Glob Health. 2025 Aug 11;15:04168. doi: 10.7189/jogh.15.04168.
BACKGROUND: Family integrated care (FIC) encourages parental involvement in neonatal intensive care units (NICU) and has been found to promote weight gain in preterm infants. Extrauterine growth restriction (EUGR) results from inadequate growth among very low birth weight infants (VLBWI), which has been found to contribute to parental anxiety. To address an existing gap in research, we aimed to examine the impact of parental involvement on EUGR at discharge in VLBWI. METHODS: We conducted a retrospective, multi-centre case-control study involving VLBWIs admitted to 17 NICUs across eight southeastern Chinese provinces and cities from February 2021 to November 2023. We categorised cases and control groups based on the presence of EUGR at discharge and compared their perinatal and hospitalisation characteristics, as well as FIC duration, using a generalised linear mixed model. RESULTS: EUGR in VLBWI at discharge was associated with birth weight (odds ratio (OR) = 0.547; 95% confidence interval (CI) = 0.490, 0.610), gestational week (<28 weeks) (OR = 3.101; 95% CI = 1.909, 5.038), Apgar score at 1 minute ≤7 (OR = 1.525; 95% CI = 1.119, 2.079), being small for gestational age (OR = 3.269; 95% CI = 1.547, 6.908), maternal gestational hypertension (OR = 1.868; 95% CI = 1.270, 2.748), necrotising enterocolitis (OR = 2.254; 95% CI = 1.386, 3.667), and total FIC duration. Based on literature and clinical practice, we divided the total FIC duration into three groups. We found that the lowest OR was associated with >18 hours of care, followed by ≤18 hours, while the highest was associated with 0 hours of care. CONCLUSIONS: We identified higher birth weight and FIC as protective factors against EUGR at discharge in VLBWI. In contrast, we recognised gestational age <28 weeks, an Apgar score ≤7 at 1 minute, small for gestational age, maternal gestational hypertension, and necrotising enterocolitis as risk factors. Nevertheless, further research is required to analyse the relationship between FIC and EUGR at discharge. REGISTRATION: ClinicalTrials.gov (NCT06550440).
背景：家庭综合护理（FIC）鼓励父母参与新生儿重症监护病房（NICU）护理，并且已发现其可促进早产儿体重增加。宫外生长受限（EUGR）是由于极低出生体重儿（VLBWI）生长不足所致，已发现这会导致父母焦虑。为填补现有研究空白，我们旨在研究父母参与对VLBWI出院时EUGR的影响。 方法：我们进行了一项回顾性、多中心病例对照研究，纳入了2021年2月至2023年11月期间在中国东南部八个省市的17个NICU收治的VLBWI。我们根据出院时是否存在EUGR对病例组和对照组进行分类，并使用广义线性混合模型比较他们的围产期和住院特征以及FIC持续时间。 结果：VLBWI出院时的EUGR与出生体重（优势比（OR）=0.547；95%置信区间（CI）=0.490，0.610）、孕周（<28周）（OR=3.101；95%CI=1.909，5.038）、1分钟时阿氏评分≤7（OR=1.525；95%CI=1.119，2.079）、小于胎龄（OR=3.269；95%CI=1.547，6.908）、母亲妊娠期高血压（OR=1.868；95%CI=1.270，2.748）、坏死性小肠结肠炎（OR=2.254；95%CI=1.386，3.667）以及FIC总持续时间有关。根据文献和临床实践，我们将FIC总持续时间分为三组。我们发现最低的OR与护理时间>18小时相关，其次是≤18小时，而最高的与护理时间0小时相关。 结论：我们确定较高的出生体重和FIC是VLBWI出院时预防EUGR的保护因素。相比之下，我们认识到孕周<28周、1分钟时阿氏评分≤7、小于胎龄、母亲妊娠期高血压和坏死性小肠结肠炎是危险因素。然而，需要进一步研究来分析FIC与出院时EUGR之间的关系。 注册信息：ClinicalTrials.gov（NCT06550440）。
Cochrane Database Syst Rev. 2024-5-30
Cochrane Database Syst Rev. 2015-1-30
Cochrane Database Syst Rev. 2018-1-5
Cochrane Database Syst Rev. 2018-3-5
Cochrane Database Syst Rev. 2018-7-24
Cochrane Database Syst Rev. 2024-12-19
Cochrane Database Syst Rev. 2025-5-13
Cochrane Database Syst Rev. 2018-5-9
Cochrane Database Syst Rev. 2023-7-26
J Trop Pediatr. 2023-2-6
Arch Dis Child Fetal Neonatal Ed. 2023-9
J Pediatr Gastroenterol Nutr. 2023-2-1
Cochrane Database Syst Rev. 2020-6-3
Zotero 插件