胎龄<34周早产适于胎龄儿宫外生长迟缓的影响因素分析  

Risk Factors Analysis of Extrauterine Growth Retardation in Preterm Infants with Gestational Age Less than 34 Weeks

作　　者：王永明 武沙沙 罗靖侠 马利勇 王荣 WANG Yongming;WU Shasha;LUO Jingxia;MA Liyong;WANG Rong(Yinchuan Women and Children Healthcare Hospital,Ningxia 750001,China)

机构地区：[1]银川市妇幼保健院,银川750001

出　　处：《宁夏医科大学学报》2024年第11期1146-1151,共6页Journal of Ningxia Medical University

基　　金：宁夏自然科学基金项目(2022AAC03747)。

摘　　要：目的分析胎龄<34周早产适于胎龄儿宫外生长迟缓的影响因素。方法选择2022年7月至2023年6月在银川市妇幼保健院分娩收住新生儿重症监护室且胎龄<34周早产适于胎龄儿为研究对象。依据Fenton早产儿生长曲线图(2013年版),以早产儿出院时或矫正胎龄至36周时体质量低于同期同胎龄儿平均生长参数的第10百分位数纳入宫外生长迟缓(EUGR)组44例,非EUGR组61例。收集两组患儿一般情况、治疗情况、孕母相关合并症情况,采用Logistic回归分析早产儿发生EUGR的影响因素。结果EUGR组早产儿输注红细胞次数≥2次、呼吸暂停、动脉导管未闭(hs-PDA)、支气管发育不良(BPD)的发生率均高于非EUGR组(P均<0.05),出生体质量、入院第1周平均热量均低于非EUGR组(P均<0.05),无创通气时间、总吸氧时间、总禁食时间、达到全胃肠道喂养时长、肠外营养(PN)持续时长、开始添加母乳强化剂时间、抗生素使用时长、住院时间均长于非EUGR组(P均<0.05);两组患儿在高血糖、低血糖、坏死性小肠结肠炎(NEC)、早产儿视网膜病(ROP)、颅内出血(IVH)、新生儿呼吸窘迫综合征(NRDS)、早发败血症(EOS)、晚发败血症(LOS)、PN开始时间、第2周平均热量、生后年龄、孕周、有创通气时间、开始喂养时间、恢复至出生体质量时间、母乳强化剂完全强化时长、体质量下降程度、分娩方式、多胎、辅助生殖、产前未用糖皮质激素、院内感染、妊娠糖尿病、妊娠高血压病、母亲妊娠合并甲状腺功能低下、母亲体质量指数方面差异均无统计学意义(P均>0.05)。Logistic回归分析显示出生体质量(OR=0.993,95%CI:0.989~0.997)、总禁食时间(OR=1.025,95%CI:1.001~1.050)是早产儿发生EUGR的影响因素;EUGR早产儿母乳强化剂添加时间延迟(OR=1.255,95%CI:1.064~1.480)。结论出生体质量、禁食时间长是胎龄<34周早产适于胎龄儿发生EUGR的影响因素,EUGR早产儿母乳Objective To analyze the risk factors of extrauterine growth retardation in preterm infants with gestational age less than 34 weeks.Methods The subjects were selected from July 2022 to June 2023 in the neonatal intensive care unit at Yinchuan Women and Children Healthcare Hospital with a gestational age of less than 34 weeks which were premature and suitable for gestational age.According to the Fenton Growth Curves for Preterm Infants(2013 Edition),the 10 th percentile of premature infants whose body weight was lower than the average growth parameters of the same gestational age at discharge or the corrected gestational age of 36 weeks included in the extrauterine growth retardation group(EUGR,n=44)and the non-EUGR group(n=61).The two groups'general condition,treatment,complications,and mother-related clinical indexes were collected and analyzed by SPSS 25.0 statistical software.Logistic regression was used to analyze the risk factors of EUGR in premature infants.Results The incidences of blood transfusion≥2 times,as well as apnea,hemodynamically significant patent ductus arteriosus(hs-PDA),and bronchopulmonary dysplasia(BPD)in the EUGR group were higher than those in the non-EUGR group(P all<0.05).In contrast,the birth weight and the average calorie intake in the first week of admission in the EUGR group were lower than those of the non-EUGR group(P all<0.05).The non-invasive ventilation time,total oxygen inhalation time,total fasting time,total gastrointestinal feeding time,parenteral nutrition(PN)duration,starting breast milk fortifier time,antibiotic use time and hospital stay in the non-EUGR group were higher than those in the non-EUGR group.There were no significant differences in hyperglycemia,hypoglycemia,necrotizing enterocolitis(NEC),retinopathy of prematurity(ROP),intracranial hemorrhage(IVH),neonatal respiratory distress syndrome(NRDS),early-onset septicemia(EOS),late-onset septicemia(LOS),starting time of parenteral nutrition(PN),average calorie of the second week,postnatal age,gestational week,inv

关 键 词：早产儿 适于胎龄儿 宫外生长迟缓 影响因素 

分 类 号：R722.6[医药卫生—儿科]