目的 分析不同胎龄早产儿在不同时期宫外生长发育迟缓的情况及其影响因素,旨在探讨出更有针对性的营养干预措施,减少早产儿宫外生长发育迟缓的发生率。方法 使用便利抽样方法,共纳入2020年8月—2021年5月于佛山市妇幼保健院儿童营养门诊就诊的0~3岁的早产儿1 839例。调查其喂养情况,并收集其体重、身长指标,统计生后体重低下、生长迟缓、能量摄入不足及喂养困难发生率。结果 1)早产儿生后体重低下发生率为5.7%,生后生长迟缓发生率为4.6%;44.4%可能存在能量摄入不足,6.3%能量摄入不足,25.3%存在喂养困难。2)56.9%出生时体重低下的早产儿生后仍维持体重低下;39.1%出生时生长迟缓生后仍维持生长迟缓。3)生后体重低下的危险因素包括胎龄<32周[OR＝2.396(1.338~4.293),P=0.003]、出生时体重低下[OR＝9.895(4.472~21.895),P＜0.001]、出生时生长迟缓[OR＝12.550(6.836~23.041),P＜0.001]、喂养困难[OR＝2.368(1.409~3.978),P=0.001]。生后生长迟缓的危险因素包括出生时体重低下[OR＝13.950(6.388~30.464),P＜0.001]、出生时生长迟缓[OR＝5.920(2.957~11.855),P＜0.001]、喂养困难[OR＝2.666(1.527~4.654),P=0.001]。结论 营养门诊随访下早产儿宫外生长发育迟缓发生率较低,喂养困难是宫外生长发育迟缓的危险因素。故针对早产儿出院后的营养干预措施中,除需强调能量营养素摄入外,尚需增加纠正喂养困难的指导措施。
Abstract
Objective To investigate the growth of the preterm children and to find out the associated factors, in order to provide more targeted nutritional advice for reducing the prevalence of extra-uterine growth retardation (EUGR). Methods From August 2020 to May 2021, 1 839 preterm infants were enrolled in this study by convenient sampling in Foshan Women and Children Hospital. Feeding practice of the preterm infants were investigated, body weight and length were measured. Ultimately, the prevalence of underweight, stunting, insufficient energy intake and feeding difficulty were calculated. Results 1) The prevalence rates of underweight, EUGR, possibly insufficient energy intake, insufficient energy intake and feeding difficulty in preterm infants were 5.7%, 4.6%, 44.4%, 6.3% and 25.3%, respectively. 2) Totally 56.9% of preterm infants with fetal underweight remained underweight after birth. Simultaneously, 39.1% with fetal stunting maintained stunting. 3) Risk factors of underweight included gestational age<32 weeks (OR=2.396, 95%CI: 1.338 - 4.293, P=0.003), fetal underweight (OR=9.895, 95%CI: 4.472 - 21.895, P＜0.001), fetal stunting(OR=12.550, 95%CI: 6.836 - 23.041,P<0.001) and feeding difficulty(OR=2.368, 95%CI: 1.409 - 3.978, P=0.001). Risk factors of stunting after birth were fetal underweight (OR=13.950, 95%CI: 6.38 8 - 30.464, P<0.001), fetal stunting (OR=5.920, 95%CI: 2.957 - 11.855, P<0.001) and feeding difficulty (OR =2.666, 95%CI: 1.527 - 4.654, P=0.001). Conclusions The prevalence of EUGR in preterm children is relatively low during follow-up in child nutrition clinic. Meanwhile, feeding difficulty is an independent risk factor for EUGR. Therefore, besides emphasizing sufficient nutrients intake, measures to improve feeding difficulty should also be provided when giving nutritional advice to the preterm children.
关键词
早产儿 /
体重低下 /
生长迟缓 /
喂养
Key words
preterm /
underweight /
stunting /
feeding
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基金
广东省医学科学技术研究基金项目(A2020472)
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