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纸质出版:2016
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杨琴,张萱,程茜.早产与足月小于胎龄儿第1年体格生长差异的队列研究[J].陆军军医大学学报(原第三军医大学学报),2016,38(14):1664-1668.
Yang Qin,Zhang Xuan,Cheng Qian.Cohort study of physical growth differences between preterm and full-term small for gestational age infants in the first year[J].J Amry Med Univ (J Third Mil Med Univ),2016,38(14):1664-1668.
杨琴,张萱,程茜.早产与足月小于胎龄儿第1年体格生长差异的队列研究[J].陆军军医大学学报(原第三军医大学学报),2016,38(14):1664-1668. DOI:
Yang Qin,Zhang Xuan,Cheng Qian.Cohort study of physical growth differences between preterm and full-term small for gestational age infants in the first year[J].J Amry Med Univ (J Third Mil Med Univ),2016,38(14):1664-1668. DOI:
目的 探讨早产小于胎龄儿(small for gestational age,SGA)在生后1年内的体格生长变化趋势是否与足月SGA存在差异,为早产SGA生后体格生长随访监测提供参考依据。 方法 采用前瞻性队列研究,收集2013年9月至2015年6月在重庆医科大学附属儿童医院儿童保健科随访的早产SGA 54人,足月SGA 181人。分别在1、3、6、12月龄(早产SGA在纠正胎龄的1、3、6、12月龄)测量体质量、身长、头围,采用Z积分计算体格水平和生长速度。 结果 ①早产SGA生后快速追赶生长发生在纠正年龄1月龄后,而足月SGA在生后即开始;早产和足月SGA在前6个月追赶生长率均达63.0%。②早产SGA未纠正胎龄的体质量Z值在6、12月龄(t=-1.189、-0.911,P=0.236、0.363),身长、头围Z值在12月龄(t=-0.855、-1.078,P=0.394、0.282)与足月SGA比较差异无统计学意义。③早产SGA的体质量增长速度在1~3、3~6月龄(t=4.685、3.787,P0.01),身长、头围在1~3、3~6、6~12月龄追赶速度明显快于足月SGA(t=3.487、3.626、4.179,t=5.158、3.001、4.641,P0.01)。但在1月龄内体质量、身长追赶速度均慢于足月SGA(t=-6.384、-4.821,P0.01),甚至低于出生时Z值水平(ΔZ<0)。 结论 早产SGA追赶生长的发生晚于足月SGA,体格生长水平可在1岁时追赶上足月SGA,在1岁内生长潜力大于足月SGA,在纠正年龄1月龄内易发生宫外生长迟缓。
Objective To explore the differences of physical growth trends between preterm and full-term small for gestational age (SGA) infants in the first year. Methods Prospective cohort study was adopted to collect 54 preterm SGA infants and 181 full-term SGA infants
who were followed-up at health care department of children's hospital of Chongqing medical university from September 2013 to June 2015. The weight
length
head circumference and growth rate were measured by using Z scores at the ages of 1 month
3 months
6 months and 12 months
and the preterm SGA infants were measured at the corrected gestational ages of 1 month
3 months
6 months and 12 months. Results Preterm SGA began rapid catch-up growth after corrected age of 1 month
while full-term SGA began after birth. The catch-up growth rates of preterm and full-term SGA reached to 63% in the first 6 months. There were no significant differences in the weight Z score at the not-corrected gestational age of 6 months and 12 months (t=-1.189
-0.911
P=0.236
0.363)
length (t=-0.855
P=0.394) and head circumference Z score in 12 months (t=-1.078
P=0.282) between the preterm SGA infants and full-term SGA infants. The chasing speed of weight (t=4.685
3.787
P0.01) of preterm SGA was obviously faster than that of full-term SGA during 1~3 months and 3~6 months
and the chasing speeds of length (t=3.487
3.626
4.179
P0.01) and head circumference (t=5.158
3.001
4.641
P0.01) in preterm SGA were obviously faster than those of full-term SGA during 1~3 months
3~6 months and 6~12 months. But the chasing speeds of weight and length of preterm SGA were obviously slower than those of full-term SGA within 1 month (t=-6.384
-4.821
P0.01)
even below the Z score at birth (ΔZ0). Conclusion The starting point of catch-up growth of preterm SGA is latter than that of full-term SGA. The physical growth levels of preterm SGA can catch up with full-term SGA at the age of 1 year old. The growth potential of preterm SGA is greater than that of full-term SGA. Extrauterine growth retardation is easier to happen in preterm SGA infants at the corrected age of 1 month.
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