Johnson D B, Cheney C, Monsen E R
Department of Pediatrics, University of Washington, Seattle, USA.
J Am Diet Assoc. 1998 Jun;98(6):649-56. doi: 10.1016/S0002-8223(98)00149-7.
To identify nutritional risk factors for growth failure in infants with bronchopulmonary dysplasia (BPD) after initial hospital discharge, and to describe growth in and feeding concerns about these infants after discharge to the community.
A cohort of 40 infants with BPD was followed up for 7 monthly visits after initial hospital discharge. Data on potential risk factors were gathered prospectively.
SUBJECTS/SETTING: Forty infants with BPD were recruited from all 4 tertiary-level neonatal intensive care units in the Puget Sound area of Washington. Exclusionary criteria included congenital or chromosomal anomalies, grade IV intraventricular hemorrhage, and drug or alcohol exposure in utero.
Growth failure defined as weight less than the 5th percentile on National Center for Health Statistics growth curves at 2 or more points in time and a decrease in weight-for-age z score during the study period.
Relative risk of growth failure with exposure to each risk factor was determined. The chi 2 test was used to measure association between growth and development, and change in z scores was used to examine growth patterns.
Growth failure occurred in 8 of 40 infants. Twenty-nine of the infants experienced a drop in weight-for-age z score from the initial to the final study visit. Growth failure was associated with low socioeconomic status (relative risk = 4.0, 95% confidence interval = 1.3, 12.6), postdischarge days of illness (relative risk = 10.5, 95% confidence interval = 1.4, 77.4) and "suspect" development (chi 2 = 7.12, P = .014).
Infants with BPD may benefit from comprehensive postdischarge nutrition and feeding therapy that includes ensuring adequate energy intake, parental support and education, and feeding evaluation and therapy.
确定支气管肺发育不良（BPD）婴儿首次出院后生长发育迟缓的营养风险因素，并描述这些婴儿出院回到社区后的生长情况及喂养问题。
对40例BPD婴儿进行队列研究，首次出院后每月随访7次。前瞻性收集潜在风险因素的数据。
研究对象/研究地点：从华盛顿普吉特海湾地区的所有4家三级新生儿重症监护病房招募了40例BPD婴儿。排除标准包括先天性或染色体异常、IV级脑室内出血以及子宫内药物或酒精暴露。
生长发育迟缓定义为在国家卫生统计中心生长曲线上，体重在两个或更多时间点低于第5百分位数，且在研究期间年龄别体重Z评分下降。
确定接触每种风险因素时生长发育迟缓的相对风险。采用卡方检验衡量生长与发育之间的关联，用Z评分变化检查生长模式。
40例婴儿中有8例出现生长发育迟缓。29例婴儿的年龄别体重Z评分从研究初始至末次随访时下降。生长发育迟缓与社会经济地位低下（相对风险=4.0，95%置信区间=1.3，12.6）、出院后患病天数（相对风险=10.5，95%置信区间=1.4，77.4）以及“可疑”发育情况（卡方=7.12，P=0.014）相关。
BPD婴儿可能受益于出院后的综合营养和喂养治疗，包括确保充足的能量摄入、家长支持与教育以及喂养评估和治疗。
