早产儿宫外生长发育迟缓及相关因素分析  

Extrauterine growth retardation and correlated factors in premature neonates

作　　者：单红梅[1] 蔡威[1] 孙建华[2] 曹云[3] 施婴婴 方炳华[5] 

机构地区：[1]上海交通大学医学院附属新华医院临床营养中心,200092 [2]上海交通大学医学院附属上海儿童医学中心NICU [3]复旦大学附属儿科医院NICU [4]国际和平妇幼保健医院NICU [5]上海交通大学附属儿童医院儿保科

出　　处：《中华儿科杂志》2007年第3期183-188,共6页Chinese Journal of Pediatrics

摘　　要：目的评价上海市早产儿出生时新生儿重症监护病房(NICU)和出院时宫外生长发育迟缓(EUGR)发生率并分析相关因素。方法上海五家医院进行多中心回顾分析研究。入选标准:入院胎龄评分<37周;入院日龄<24 h,出院于同一医院;住院天数≥7 d;排除标准:住院期间死亡及外观有畸形;母亲患有内分泌及代谢性疾病。对宫内外生长迟缓进行描述(≤生长曲线的第10百分位)。计数资料采用卡方检验,正态分布计量资料采用 t 检验,非正态分布计量资料采用秩和检验,疾病危险因素采用 logistic 回归模型。结果 2003年1月至2004年12月,5家医院共计1196例早产儿(男734例,女462例),IUGR 与 EUGR 发生率分别以体重评价为22.7%和49.7%,以头围评价为19.2%和23.1%;各医院间 IUGR 发生率差异均无统计学意义,以出院体重评价的 EUGR 发生率,差异有统计学意义,出院头围评价差异无统计学意义。IUGR 和 EUGR 的发生率均随体重减少而增加;在极低出生体重儿中,EUGR 发生率以体重评价为78.9%,以头围评价为50.0%。住院天数与全肠内营养(EN)日龄在 EUGR 组与非 EUGR 组差异有统计学意义。Logistic 回归中,性别、出生胎龄、出生体重、出生头围、医院间为生长迟缓的危险因素。结论本研究早产儿 EUGR 发生率明显高于国外资料,出生体重越低,EUGR 发生率越高,且不同医院营养支持状况对 EUGR 发生率有影响。Objective Poor growth is a common problem in premature neonates. No sufficient attention has been paid to the nutrition deficit and extrauterine growth retardation in premature neonates in China. The present study aimed to assess the incidences of intrauterine growth retardation （IUGR） and extrauterine growth retardation （EUGR） in premature neonates in Shanghai area and their correlated factors. Methods Data of the neonates discharged between January 1,2003 and December 31,2004 from 5 hospitals （Xinhua Hospital, Shanghai Children＇s Medical Center, Shanghai Children＇s Hospital, Pediatric Hospital Affiliated to Fudan University, and Shanghai International Peace Maternity and Child Health Hospital） were reviewed. The criteria of exclusion were cases who died or had a malformed appearance, the mother had endocrine or metabolic diseases. The criteria for enrollment were （ 1 ） gestational age 〈 37 weeks, （2） admitted less than 24 hours after birth and discharged from the same hospital, （3） duration of hospitalization was ≥ 7 days. The growth values on discharge of each patient were compared to the expected values based on the intrauterine growth data and postmenstrual day on discharge. Growth retardation was defined as measured growth values （weight, head circumference） ≤ 10th percentile of the values （growth expectation based on estimated postmenstrual age）. In each specific group, the number of neonates with ≤ 10^th percentile for each growth parameter was counted and the percentages of patients who had values ≤ 10^th percentile on birth and discharge were calculated. The growth curves used for assessing birth weight and head circumference for different gestational age neonates were those published in 1986. All the data were analyzed using the SPSS statistical software package. The risk factors for extrauterine growth retardation on weight and head circumference were estimated with logistic regression model. Results The subjects included 1196 premature neonates in the fiv

关 键 词：早产儿 宫外生长发育迟缓 相关因素 体重评价 

分 类 号：R722.6[医药卫生—儿科]