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目的分析影响早产儿出院时宫外发育迟缓(extrauterine growth restriction,EUGR)发生的相关因素,为制定预防早产儿发生EUGR的策略提供临床依据。方法对本院NICU 2012年2月-2013年2月出生的早产儿为研究对象。出院胎龄(周)=入院胎龄+住院天数/7;宫内生长曲线值采用中国15个城市不同胎龄新生儿出生体重值;宫外生长发育迟缓定义为生长指标≤P10(生长曲线的第10百分位)。结果出生体重≤1 500g的早产儿组EUGR发生率为66.2%,体重>1 500g的早产儿组EUGR发生率为37.8%,两组比较差异有统计学意义(P<0.05);胎龄<34周的早产儿组EUGR发生率为71.3%,胎龄≥34周的早产儿组EUGR发生率为44.8%,两组比较差异有统计学意义(P<0.05)。Logistic回归中,宫内发育迟缓、感染、生后体重下降时间是发生EUGR的危险因素。结论胎龄及出生体重越小,发生EUGR的可能性越大。导致EUGR的因素是多重的,其中IUGR及感染、生后体重下降时间对EUGR影响最大,应积极预防及治疗并发症,重视早产儿早期营养,缩短患儿的体重下降时间是避免EUGR的关键。
Objective To analyze the related factors that affect the occurrence of extrauterine growth restriction (EUGR) in preterm infants and to provide a clinical basis for the strategy of preventing EUGR in premature infants. Methods Preterm infants born in NICU from February 2012 to February 2013 in our hospital were studied. The gestational age (week) = gestational age at admission + days of hospitalization / 7; intrauterine growth curve values were adopted for birth weight of neonates of different gestational age in 15 cities in China; ectopic growth retardation was defined as growth index ≤ P10 10th percentile). Results The incidence of EUGR in preterm infants with birth weight ≤1 500g was 66.2%, while the incidence of EUGR in preterm infants weighing> 1500g was 37.8%, the difference was statistically significant (P <0.05) The incidence of EUGR was 71.3% in preterm newborns and 44.8% in preterm newborns with gestational age ≥34 weeks. The difference between the two groups was statistically significant (P <0.05). Logistic regression, intrauterine growth retardation, infection, postnatal weight loss is the occurrence of EUGR risk factors. Conclusion The smaller the gestational age and birth weight, the greater the possibility of EUGR. The factors leading to EUGR are multiple. The duration of weight loss in IUGR and postnatal weight loss has the greatest impact on EUGR. Prevention and treatment of complications should be actively followed. Early nutrition of premature infants and shortening the weight loss time of children are the keys to avoid EUGR.