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1. 重庆医科大学附属永川医院儿科,重庆,402160
2. 重庆医科大学附属儿童医院新生儿诊治中心,重庆,400014
3. 重庆医科大学附属永川医院中心实验室,重庆,402160
纸质出版日期:2013,
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王 敏, 邓 春, 龚 放, 等. 极低出生体质量儿宫外生长迟缓的危险因素分析[J]. 重庆医科大学学报, 2013,36(8):838-842.
WANG Min, DENG Chun, GONG Fang, et al. Risk factors of extrauterine growth retardation among infants with very low birth weight[J]. Journal of Chongqing Medical University, 2013,36(8):838-842.
目的:回顾极低出生体质量儿(very low birth weight infant,VLBWI)宫外生长迟缓(extrauterine growth retardation,EU-GR)发生情况并分析发生EUGR的相关因素。方法:选择2009年9月至2011年6月在重庆医科大学附属儿童医院新生儿重症监护病房住院成活VLBWI 87例进行回顾性分析。入选标准:出生体质量<1 500 g,入院时间<24 h且住院天数≥14 d,不伴有影响生长发育的先天畸形或遗传代谢性疾病。排除标准:住院天数<14 d,住院期间放弃治疗或死亡。将入选病例分为EUGR组和非EUGR组。计数资料比较采用卡方检验,正态分布的计量资料比较用t检验,非正态分布计量资料采用秩和检验,EUGR相关危险因素用二元logistic回归分析。结果:2009年9月至2011年6月符合纳入标准的VLBWI 87例,其中EUGR为74例(85.1%),非EUGR为13例(14.9%);EUGR组宫内生长迟缓(intrauterine growth retardation,IUGR)发生率(27.6%)比非EUGR组(0%)高,平均出生胎龄(31.21周/29.27周)和出院日龄(36.82周/34.00周)较大,恢复至出生体质量时间(10.54 d/6.69 d)和开始肠内营养时间(3.82 d/1.85 d)较长(P<0.05),而出院时口服热卡[91.96 kcal/(kg·d)/146.23 kcal/(kg·d)较低(P<0.05)];logistic回归结果显示IUGR(OR=0.77)、开始肠内营养时间晚(OR=12.081)、恢复至出生体质量时间长(OR=48.404)是EUGR发生的危险因素(P<0.05)。结论:IUGR、开始肠内营养时间晚、恢复至出生体质量时间长是VLBWI发生EUGR的危险因素。
Objective:To review the phenomenon of extrauterine growth retardation(EUGR) and to analyze its risk causing factors a-mong very low birth weight infants(VLBWI). Methods:A retrospective review was conducted for hospitalized premature infants from September 2009 to June 2011 in neonatal intensive care unit in the Children’s Hospital of Chongqing Medical University. Inclusion criteria:birth weight <1 500 g,admission time <24 h,hospital stays ≥14 d and free of congenital anomalies and heredity metabolic diseases which have a bad impact on individual growth and development. Exclusion criteria:hospital stays <14 d,abandoning treat-ment or dying before discharge. Selected infants were divided into EUER group and non-EUGR group. Chi-square test,t-test,rank-sum test and binary logistic regression were adopted for statistical analysis. Results:Among included 87 cases of VLBWI,there were 74 cases(85.1%) of EUGR and 13 cases(14.9%) of non-EUGR. Incidence of intrauterine growth retardation(IUGR) was higher in EUGR group(27.6%) than in non-EUGR group(0%). Average gestational age,average discharge age,time of returning to birth weight and time of starting enteral nutrition were longer in EUGR group than in non-EUGR group(P<0.05),however discharge oral energy was lower in EUGR group than in non-EUGR group(P<0.05). According to the logistic regression,risk factors causing EUGR includ-ed:IUGR(OR=0.77),delayed enteral nutrition(OR=12.081),delayed returning to birth weight(OR=48.404)(P<0.05). Conclusions:IUGR,delayed enteral nutrition and delayed returning to birth weight are risk factors of EUGR among VLBWI.
宫外生长迟缓极低出生体质量儿营养
extrauterine growth retardationvery low birth weight infantnutrition
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