摘要
目的 研究早产儿宫内外生长迟缓发生率情况;显示该组人群婴儿时期生长模式.方法 回顾分析2002年1月至2009年4月,我院新生儿重症监护病房（Neonatal Intensive Care Unit,NICU）住院治疗,并坚持出院后随访的早产儿.入选标准：胎龄〈37周;单胎;生后24 h内入院;住院时间≥14 d;出院后至少随访至校正年龄3个月.住院期间对早产儿宫内、外生长迟缓、生后2周及校正胎龄38～40周时仍住院患儿生长迟缓（≤生长曲线的第10百分位）情况进行描述,并对随访期早产儿生长迟缓情况及体重增长趋势进行描述.结果 符合纳入标准患儿共计239例（男135例,女104例）,以体重评价,IUGR及出院时EUGR发生率分别为25.5%及40.6%,IUGR及出院时EUGR发生率均随体重减少而增加,未呈现随胎龄增加而降低的趋势.校正胎龄38～40周仍住院者生长迟缓发生率为61.8%.婴儿期校正年龄生长迟缓发生率38～40周20.5%,28 d 15%,61 d 8.8%,91 d17%,122 d 10.4%,152 d 10.1%,183 d 11.9%及274 d 7.4%,校正年龄3个月后生长迟缓发生率未再进一步降低.校正年龄6个月时女童生长迟缓发生率（19.3%）高于男童（3.8%）（x2=6.181,P=0.017）.胎龄〈32周、出生体重≤1500 g者中仅男童胎龄〈32周者于校正年龄2个月及4个月时平均体重高于生长曲线第50百分位,余婴儿期平均体重低于生长曲线第50百分位.结论 早产/低出生体重儿是生长迟缓的高危人群,极低出生体重儿问题较为突出.生长迟缓问题随年龄增加有所减轻,远期预后有待进一步随访.
Objectives To investigate the incidence of intra- and extrauterine growth retardation （EUGR）and growth restriction in premature infants,and to illustrate the growth pattern of them in postnatal and infantile period.Methods All premature infants were admitted to our neonatal intensive care unit （NICU）during the recent 7 years.The criteria for enrollment were（1）gestational age 〈37 weeks;（2）single fetus;（3）admitted within the first 24 hours of life;（4）hospitalization period ≥ 14 days;（5）clinical follow-up persisted till ≥ 3 months of corrected gestational age.Intrauterine growth restriction （IUGR）,EUGR and growth restriction were defined as having a measured growth value（weight）that was ≤10th percentile of Chinese infants＇ growth curve in corrected age on admission,discharge and follow-up period.Results were analyzed by using SPSS 12.0 statistical software package by chi-square test,rank-sum test,and t test.Results Two hundred and thirty nine infants were involved,134 were boys and 105 girls.The incidence of IUGR and EUGR assessed by weight was 25.5% and 40.6%,respectively.The lower the birth weight was,the higher the incidence of IUGR and EUGR was.The percentile of body weight in the growth curve at discharge was lower than that at birth（Z = -7.784,P =0.000）.The incidence of growth restriction assessed by weight was 20.5%,15.0%,8.8%,17.0%,10.4%,10.1%,11.9%,7.0% at corrected gestational age of 38-40 weeks,corrected age of 28 d,61 d,91 d,122 d,152 d,183 d,and 274d,respectively.The incidences of growth restriction were stable when the corrected age was older than 91days.The incidence of growth restriction in female premature infants at 183 days＇ corrected age was higher than that in male children（x2 = 6.181,P =0.017）,the incidence was 19.3% and 3.8% respectively.During the follow-up period,most of the average body weight of premature infants whose gestational age was〈32 weeks or birth weight ≤ 1500 g were lower than the 50th percentile of the growth curve except theaverage body weight of boys whose gestational age 〈32 weeks at corrected age of 2 and 4 months.Conclusions Premature and/or low birth weight infants are at high risk of growth restriction,especially very low birth weight infants.The incidence of growth restriction decreased with growth.Long-term prognosis requires further investigation.
出处
《中华儿科杂志》
CAS
CSCD
北大核心
2010年第9期661-667,共7页
Chinese Journal of Pediatrics
关键词
婴儿
早产
胎儿生长迟缓
体重增长
随访研究
Infant,premature
Fetal growth retardation
Weight gain
Follow-up studies
