极低出生体重早产儿校正月龄12个月内体格生长情况及影响因素分析

摘要/Abstract

摘要： 目的探究极低出生体重（very low birth weight,VLBW)早产儿校正月龄12个月内体重、身长、头围追赶生长特征及相关影响因素，为临床干预提供依据。方法采用回顾性研究，摘录2014年1月一2016年3月就诊于上海市某妇婴保健院新生儿重症监护室（neonatal intensive care unit,BICU)符合纳入和排除标准的VLBW早产儿的临床资料。分别与Fenton(2003)早产儿生长曲线及疾病预防控制中心（Centers for Disease Control adm Prevention,CDC）足月儿生长曲线进行比较，探究VLBW早产儿校正月龄6个月及12个月体格生长发育的影响因素。结果共纳入113例VLBW早产儿，其中106例随访至校正月龄3个月及以上。与早产儿及足月儿相比，VLBW早产儿的身长、体重、头围差异均有统计学意义（P<0.05)。单因素分析显示，校正月龄6个月时，VLBW男婴身长发育不良与住院时间长、开始经口喂养月龄大、全经口喂养月龄大、开始经口母乳喂养月龄大相关，其体重发育不理想与住院时间长、开始经口母乳喂养月龄大相关（P<0.05)。校正月龄12个月时，VLBW女婴头围发育与母亲年龄和校正月龄6个月纯配方奶喂养有关，其体重发育不良与母亲年龄有关（P<0.05)。VLBW男婴头围发育不良与开始经口喂养及全经口喂养胎龄大有关，其身长发育不良与住院期间纯母乳喂养有关（P<0.05)。结论尽早过渡到全经口喂养，住院及随访期间母乳和早产儿配方奶混合喂养对VLBW早产儿体格生长起积极作用，提示患儿BICU住院期间及随访期间喂养指导的重要性。

关键词: 婴儿, 出生时低体重, 生长和发育, 危险因素, 喂养, 影响因素分析

Abstract: Objective To identify the Geatures o￡ catch-up growth o￡ weight, length and head circumGerence in very low birth weight (VLBW) preterm infants in 12 months of corrected age and to explore the influencing factors. Methods We conducted a retrospective review o￡ medical records o￡ the VLBW preterm in￡ants who were in compliance with inclusion and exclusion criteria and admitted to neonatal intensive care unit (NICU) from January 2014 to March 2016 in one maternity and infant hospital in Shanghai. Infants’ growth chat from Fenton (2003) and Centers for Disease Control and Prevention (CDC) were used for development outcome comparison. We also analyzed the influencing factors of physical growth outcome at 6 and 12 months corrected age. Results A total of 113 VLBW preterm infants were included in this study!of which 106 cases were followed up to 3 months. The outcomes of physical growth in VLBW preterm infants showed significant difference (P<0.05), comparing with other preterm and term infants. For male VLBW preterm infants at 6 months corrected age!longer length of stay, initiating oral feeding later!achieving full oral feeding later and initiating oral feeding with breast milk later were associated with non-optimal length growth & non-optimal weight growth was associated with prolonged length of stay and initiation of oral feeding later (P<0.05). For female VLBW preterm infants at 12 months corrected age!older maternal age and feeding with preterm formulas had negative association with the growth of head circumference (P<0.05 )& older maternal age in NICU was factors influencing weight growth (P<0.05). For male VLBW preterm infants at 12 months corrected age! initiating oral feeding and achieving full oral feeding later negatively impacted on the growth of head circumference (P<0.05) while exclusively feeding with breast milk in NICU was negatively related to length growth (P<0.05). Conclusion Transition to full oral feeding earlier and providing mixed feeding both in-hospital and post-discharge period played important role in VLBW infants’ physical growth. The results suggested feeding counselling in NICU and during follow-up periods is essential for successful catch-up growth in VLBW preterm infants.

Key words: Infant,Very Low Birth Weight, Growth and Development, Risk Factors, Feeding, Root Cause Analysis

丁文雯向奕瑾马佳莉张莹. 极低出生体重早产儿校正月龄12个月内体格生长情况及影响因素分析[J]. 中华护理杂志, 2019, 54(1): 52-57.

DING Wenwen, XIANG Yijin, MA Jiali, ZHANG Ying. Analysis on features and related factors of physical growth in very low birth weight preterm infants in 12 months of corrected age[J]. Chinese Journal of Nursing, 2019, 54(1): 52-57.

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极低出生体重早产儿校正月龄12个月内体格生长情况及影响因素分析

Analysis on features and related factors of physical growth in very low birth weight preterm infants in 12 months of corrected age

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