目的 研究超低出生体重儿住院期间及出院后随访阶段追赶生长的情况。方法 回顾性分析本院2005年1月1日-2014年12月31日存活出院的超低出生体重儿住院期间及出院后随访资料,评价体格生长参数及不同随访阶段生长迟缓发生率。结果 十年间存活出院并规律随访至校正月龄6个月以上的超低出生体重儿50例。住院期间平均体重增长速度(17.9±2.8)g/(kg·d)。出院时体重、身长、头围Z评分均较出生时Z评分明显降低。生长迟缓比例最低的时期为校正月龄0～3个月,以体重、身长、头围计算分别为20%,26%和22%,至校正月龄24个月,生长迟缓比例又出现升高趋势。根据出生时是否为SGA,胎龄(≤28周和＞28周),出生体重(≤750 g和＞750 g)及出生时间段(2004-2009年和2010-2014年)分组比较校正月龄满6个月及24个月的生长迟缓发生率,SGA组及胎龄大于28周组校正月龄6个月时生长迟缓率明显高于对应组,校正月龄24个月时出生体重≤750 g,以头围计的生长迟缓率高于出生体重＞750 g组。结论 本组超低出生体重儿宫内生长迟缓的比例较高,至出院时又表现出更多的宫外生长迟缓。经过近年来积极的营养支持及出院后喂养干预及指导,多数早产儿在校正月龄3个月内完成体重的追赶性生长。SGA及出生体重≤750 g的超低出生体重儿可能更容易发生生长迟缓。
Abstract
Objectives To study the catch up growth of extremely low birth weight (ELBW) infants during hospitalization and after discharge. Methods Retrospectively analyzed the clinical data of ELBW infants in our hospital from 2005 to 2014 and evaluated growth retardation rate. Results Fifty ELBW infants were followed up for over 6 months.The average weight gain was (17.9±2.8)g/(kg·d) during hospitalization.Z scores for weight,length and head circumference at discharge were lower than that at birth.The period with the lowest growth retardation rate was at 0～3 months of corrected age(CA),which was respectively 20%,26% and 22% by weight,length and head circumference.By the time 24 months of CA,the rate of growth retardation showed a little increase.These infants were divided into groups according to SGA or not,the gestational age at birth(≤28 weeks and >28 weeks),birth weight (≤750g and > 750g) and the period at birth(2004～2009 and 2010～2014),and the growth retardation rates were compared between groups at 6 and 24 months of corrected age.The SGA group and >28 weeks group had higher growth retardation rate at 6 months of corrected age.By the time of 24 months of CA,growth retardation rate (by head circumference) was higher in the group with birth weight≤750 g. Conclusions ELBW infants shows high rate of intrauterine growth retardation and with even higher rates of extra-uterine growth retardation.With more aggressive nutritional support recent years,the majority of preterm infants accomplished catch up growth by 3 months of CA.ELBW infants who are SGA at birth or with birth weight ≤750 g may be more prone to show growth retardation.
关键词
婴儿 /
超低出生体重儿 /
生长和发育 /
追赶生长
Key words
extremely low birth weight infants /
growth retardation /
catch-up growth
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参考文献
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基金
北京协和医院中青年科研基金(pumch-2013-079)
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