真实世界不同出生体重早产儿体格生长规律的研究  

Real world research on the growth pattern of preterm children with different birth weight

作　　者：高洁[1] 徐雪丽 徐铣明 韦秋宏 张站站[1] 程茜[1] Gao Jie;Xu Xueli;Xu Ximing;Wei Qiuhong;Zhang Zhanzhan;Cheng Qian(Department of Child Health Care,Children′s Hospital of Chongqing Medical University,National Clinical Research Center for Child Health and Disorders,Ministry of Education Key Laboratory of Child Development and Disorders,China International Science and Technology Cooperation Base of Child Development and Critical Disorders,Chongqing Key Laboratory of Pediatrics,Chongqing 400014,China;School of Statistics and Data Science,Nankai University,Tianjin 300071,China)

机构地区：[1]重庆医科大学附属儿童医院儿保科,国家儿童健康与疾病临床医学研究中心儿童发育疾病研究教育部重点实验室,儿童发育重大疾病国家国际科技合作基地,儿科学重庆市重点实验室,400014 [2]南开大学统计与数据科学学院,天津300071

出　　处：《中华儿科杂志》2021年第8期665-671,共7页Chinese Journal of Pediatrics

摘　　要：目的分析不同出生体重早产儿0~4岁体格生长特点和规律。方法按真实世界研究方法,选择2010年12月至2017年12月重庆医科大学附属儿童医院儿童保健科电子病历信息登记系统中的8496例早产儿横断面数据进行回顾性研究,以同期随访203123名足月儿作为对照。早产儿按出生体重分为正常出生体重(NBW)组、低出生体重(LBW)组和极低出生体重(VLBW)组;观察不同组别男、女童48月龄内的体重、身高(长)变化,并构建数值表,分析其生长水平、生长速度和匀称度,组间比较采用t检验或χ^(2)检验。结果8496例早产儿中男4839例、女3657例,其中VLBW组525例,出生体重(1.28±0.14)kg;LBW组3862例,出生体重(2.07±0.28)kg;NBW组4109例,出生体重(2.86±0.35)kg。NBW组2~<3月龄体重[男(5.61±0.96)比(5.64±0.78)kg,女(5.11±0.67)比(5.18±0.71)kg]和8~<10月龄身长[男(70.3±2.4)比(70.6±2.4)cm,女(68.9±2.2)比(68.9±2.4)cm]与足月组差异均无统计学意义(均P>0.05);LBW组24月龄前体格指标随年龄增长与足月差距减小,24月龄后接近足月平均水平,体重相差0.64~0.95 kg,身高相差1.3~1.7 cm;VLBW组48月龄体重、身高仍低于足月平均水平,体重轻2.80~2.86 kg、身高低3.3~4.3 cm。VLBW组2~12月龄体重增长值分别高于LBW、NBW组0.35、0.71 kg;但在0~2月龄、12~48月龄VLBW组体重增长值分别低于LBW、NBW组(0.64、0.76)kg,(1.04、1.49)kg。24~<36月龄时,VLBW组生长迟缓、低体重、消瘦检出率最高,NBW组低于LBW组(P均<0.01);NBW组超重或肥胖率最高,VLBW组低于LBW组(P<0.01)。结论4岁前,不同出生体重早产儿体格指标达到足月儿平均水平时间不同,有必要对早产儿生长的校正胎龄时间深入研究。正常出生体重早产儿超重肥胖发生率高,极低出生体重早产儿生长障碍发生率高,两者都是值得重视的营养不良高危人群。Objective To investigate the physical indices and growth status of preterm children aged 0 to 4 years with different birth weight.Methods Following the real world research approach,the current study retrospectively collected e-chart information of 8496 preterm children from the child health care system of the Children′s Hospital of Chongqing Medical University from December 2010 to December 2017,with 203123 full-term children followed up during the same period as controls.Premature children were divided into normal birth weight(NBW)group,low birth weight(LBW)group,and very low birth weight(VLBW)group based on their birth weights.The weight and length development within 48 months of age of preterm boys and girls in each group were measured and recorded to establish a numerical table and analyze the growth levels,growth rate,and proportionality.The t-test or chi-square test was used for between-group comparison.Results Of the 8496 preterm children,4839 were girls and 3657 boys,including 525 in the VLBW group,with an average birth weight of(1.28±0.14)kg,3862 in the LBW group,with an average birth weight of(2.07±0.28)kg,and 4109 in the NBW group,with an average birth weight of(2.86±0.35)kg.The weight at the actual age of 2-<3 months((5.61±0.96)vs.(5.64±0.78)kg in boys,(5.11±0.67)vs.(5.18±0.71)kg in girls)and the length at the actual age of 8-<10 months((70.3±2.4)vs.(70.6±2.4)cm in boys,(68.9±2.2)vs.(68.9±2.4)cm in girls)in the NBW group reached the average weight and length of full-term children.The difference of physical growth before 24 months of age between LBW and control group decreased as children age,with that of LBW group approaches the average of full-term children after 24 months of age,with a weight difference of 0.64-0.95 kg and height difference of 1.3-1.7 cm.The weight and height of the VLBW group were lower than those of full-term infants(2.80-2.86 kg and 3.3-4.3 cm,respectively)at 48 months of age.During 2-12 months of age,the corresponding values of the VLBW group were higher than that o

关 键 词：婴儿 早产儿 出生体重 体格生长 

分 类 号：R722.6[医药卫生—儿科]