早产儿12月龄体重追赶生长现状及影响因素分析

doi:10.3761/j.issn.0254-1769.2020.08.006

摘要/Abstract

摘要：

目的了解早产儿12月龄体重追赶生长现状并分析影响因素,为探究早产儿追赶生长的科学化管理提供依据。方法 2017年5月—10月采用早产儿一般资料及喂养情况问卷对成都市5所妇幼保健医院儿童保健科行第12月龄常规儿童保健的早产儿及其照护者进行调查,以体重作为追赶生长的结局指标。结果 308例早产儿12月龄体重为6.8~14.0（9.07±1.08） kg,270例（87.7%）体重追赶生长满意,38例（12.3%）体重追赶生长未达满意标准。Logistic回归分析结果显示,早产儿低出生胎龄是其体重追赶生长的危险因素（OR=0.661）,定期儿童保健（OR=4.168）与奶量摄入充足（OR=4.501）是其保护因素。结论早产儿追赶生长情况仍待加强,妇幼保健医院及儿童保健医护团队需重视早产儿追赶生长情况,开展高质量的早产儿保健工作。

关键词: 早产儿, 追赶生长, 现状, 影响因素, 儿科护理学

Abstract:

Objective To explore the current situation and its influencing factors of preterm weight catch-up growth at 12 months,and to provide evidence-based advice for catch-up growth of preterm infants. Methods 308 preterm infants and their caregivers were investigated at 5 maternal and child health hospitals in Chengdu by general and feeding information questionnaires,and their weight was used as the outcome indicator of catching-up growth. Results The average weight of 308 preterm infants at 12 months was 9.07±1.08kg（6.8~14 kg）,among which 270（87.7%） achieved standard of satisfaction and 38（12.3%） failed. Logistic regression analysis showed that low gestational age（OR=0.661） was a risk factor,while regular child health care（OR=4.168） and enough milk volume intake（OR=4.501） were protective factors. Conclusion The current situation of preterm infants’ catch-up growth needs to be improved;maternal and child health hospitals should pay more attention to preterm infants’ catch-up growth,and provide high-quality child health care for premature infants.

Key words: Preterm Infant, Catch-Up Growth, Current Situation, Influencing Factors, Pediatric Nursing

唐孟言, 刘孝美, 彭文涛, 罗碧如. 早产儿12月龄体重追赶生长现状及影响因素分析[J]. 中华护理杂志, 2020, 55(8): 1159-1163.

TANG Mengyan, LIU Xiaomei, PENG Wentao, LUO Biru. The current situation of premature infants’ weight catch-up growth at 12 months and its influencing factors[J]. Chinese Journal of Nursing, 2020, 55(8): 1159-1163.

图/表 2

参考文献 21

[1]	Goldenberg RL, Culhane JF, Iams JD, et al. Epidemiology and causes of preterm birth[J]. Lancet, 2008,371(9606):75-84. URL PMID
[2]	张小松, 赵更力, 杨慧霞, 等. 15家城市医疗机构早产发生情况及影响因素分析[J]. 中华围产医学杂志, 2016,19(6):456-461.
[3]	佃东春, 杨凤娥, 唐凤娇, 等. 低出生体重早产儿出院后追赶性生长的随访观察及分析[J]. 中国医学创新, 2016,13(34):47-50.
[4]	Chen S, Liu ZY, Zhu HJ, et al. Height at three months can indicate overweight at two years in catch-up growth of small for gestational age infants[J]. Sci Rep, 2018,8(1):13411. URL PMID
[5]	van Dommelen P, van der Pal SM, Bennebroek Gravenhorst J, et al. The effect of early catch-up growth on health and well-being in young adults[J]. Ann Nutr Metab, 2014,65(2/3):220-226.
[6]	Ng SM, Pintus D, Turner MA. Extreme premature small for gestational age infants have appropriate catch-up growth at term equivalence compared with extreme premature appropriate for gestational age infants[J]. J Clin Res Pediatr Endocrinol, 2019,11(1):104-108. URL PMID
[7]	熊菲, 霍亭竹, 李平, 等. 宫内发育迟缓儿6月龄免疫功能与追赶生长的队列关系研究[J]. 四川大学学报(医学版), 2015,46(2):253-257.
[8]	Houk CP, Lee PA. Early diagnosis and treatment referral of children born small for gestational age without catch-up growth are critical for optimal growth outcomes[J]. Int J Pediatr Endocrinol, 2012,2012(1):11.
[9]	宋泽宇, 李秀红. 早产儿早期追赶生长对后期发育影响的研究进展[J]. 中国儿童保健杂志, 2017,25(3):265-267.
[10]	Tang A, Slopen N, Nelson CA, et al. Catch-up growth,metabolic,and cardiovascular risk in post-institutionalized Romanian adolescents[J]. Pediatr Res, 2018,84(6):842-848. DOI URL PMID
[11]	《中华儿科杂志》编辑委员会, 中华医学会儿科学分会儿童保健学组, 中华医学会儿科学分会新生儿学组. 早产、低出生体重儿出院后喂养建议[J]. 中华儿科杂志, 2016,54(1):6-12.
[12]	卫生部妇幼保健与社区卫生司, 九市儿童体格发育调查研究协作组, 首都儿科研究所. 中国九市7岁以下儿童体格发育调查研究[M]. 北京: 人民卫生出版社, 2008.
[13]	Itabashi K, Mishina J, Tada H, et al. Longitudinal follow-up of height up to five years of age in infants born preterm small for gestational age,comparison to full-term small for gestational age infants[J]. Early Hum Dev, 2007,83(5):327-333. DOI URL PMID
[14]	王媛, 胡燕. 家长参加儿童健康体检的依从性调查[J]. 中国儿童保健杂志, 2013,21(5):555-558.
[15]	高晓燕, 冯琳, 许靖, 等. 早产儿出院后追赶生长的随访观察及宫外发育迟缓的影响因素[J]. 中国当代儿科杂志, 2018,20(6):11-16.
[16]	刘欣, 卢淑亚. 家庭参与式早产儿预出院病房的建立及效果评价[J]. 中华护理杂志, 2019,54(5):704-708.
[17]	Toftlund LH, Halken S, Agertoft L, et al. Catch-up growth,rapid weight growth,and continuous growth from birth to 6 years of age in very-preterm-born children[J]. Neonatology, 2018,114(4):285-293. URL PMID
[18]	Visuthranukul C, Abrams SA, Hawthorne KM, et al. Premature small for gestational age infants fed an exclusive human milk-based diet achieve catch-up growth without metabolic consequences at 2 years of age[J]. Arch Dis Child Fetal Neonatal Ed, 2019,104(3):F242-247. URL PMID
[19]	丁文雯, 向奕瑾, 马佳莉, 等. 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.
[20]	王晨, 韩露艳, 孙静. 早产儿母乳喂养强化方法的探讨[J]. 中国新生儿科杂志, 2014,29(1):8-13.
[21]	丁国芳. 极低出生体重儿尽早达到足量肠内营养喂养策略:《极低出生体重儿喂养指南》解读[J]. 中国实用儿科杂志, 2016,31(2):85-89.