| 摘要: |
| 目的探讨影响极低出生体重儿宫外生长迟缓（EUGR）的相关危险因素。方法选择胎龄≤32周且出生体重≤1500g的早产儿276例，根据是否发生EUGR，分成EUGR组104例和非EUGR组172例。比较两组早产儿的基本情况、母孕期合并症、住院期间合并症、体重变化、营养摄入等情况，采用多因素logistic回归分析影响EUGR的相关危险因素。结果两组极低出生体重儿出生胎龄、出生体重、宫内生长迟缓发生率、多胎发生率、体重恢复时间、体重日均增长、出院体重、开始肠内营养时间、完全肠内营养时间、肠外营养持续时间、经鼻持续气道正压通气应用时间、气管插管机械通气时间、住院天数比较差异均有统计学意义（均P＜0.05）；EUGR组极低出生体重儿母孕期妊娠期高血压、妊娠期激素应用、胎膜早破发生率均高于非EUGR组，差异均有统计学意义（均P＜0.05）；EUGR组极低出生体重儿住院期间呼吸窘迫综合征、支气管肺发育不良、酸碱失衡、动脉导管未闭、贫血发生率均高于非EUGR组，差异均有统计学意义（均P＜0.05）。多因素logistic回归分析显示出生胎龄、出生体重、母孕期激素应用、宫内生长迟缓、呼吸窘迫综合征、开始肠内营养时间均为EUGR的独立危险因素（均P＜0.05）。结论出生胎龄及出生体重是影响极低出生体重儿日后生长发育的重要因素，注重母孕期保健、降低宫内生长迟缓发生率、出生后尽早开始肠内营养等可有效降低极低出生体重儿EUGR的发生率。 |
| 关键词: 极低出生体重儿 宫外生长迟缓 影响因素 |
| DOI：10.12056/j.issn.1006-2785.2017.39.16.2017-489 |
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| 基金项目: |
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| Risk factors of extrauterine growth retardation in very low birth weight infants |
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XU Chuancai, ZHU Yilin, ZHU Jiajun, WU Mingyuan
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Women’s Hospital School of Medicine Zhejiang University
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| Abstract: |
| Objective To analyze the risk factors of extrauterine growth retardation (EUGR) in very low birth weight infants. Methods Total 276 newborns with gestational age ≤32 weeks and weight ＜1 500g delivered in Women's Hospital Zhejiang University School of Medicine from January 2015 to December 2016 were enrolled in the study, including 104 cases of EUGR and 172 non-EUGR cases. The general condition, growth data, nutritional information and complications were compared between two groups, and the risk factors of EUGR were analyzed. Results Compared with the non-EUGR group, the gestational age, birth weight, average weight gain, discharged weight were lower, and the starting time of feeding, the time of full enteral feeding, the duration of parenteral nutrition were significantly longer in the EUGR group (all P＜0.05). In the EUGR group, the rate of intrauterine growth retardation, the rate of gestational hypertension, hormone administration during pregnancy, premature rupture of membrane were significantly higher than that in the non-EUGR group (all P ＜0.05). The incidences of respiratory distress syndrome, bronchopulmonary dysplasia, patent ductus arteriosus, anemia, chronic lung disease were significantly different between two groups (all P＜0.05). Multivariate logistic regression showed that gestational age, birth weight, maternal administration
of hormones, intrauterine growth restriction, respiratory distress syndrome, and time of full enteral feeding are independent risk factors of extrauterine growth retardation (all P＜0.05). Conclusion Gestational age, birth weight and intrauterine growth restriction and others are the risk factors of extrauterine growth retardation. Strengthening maternal health care, preventing intrauterine growth retardation and early enteral nutrition may effectively reduce the incidence of extrauterine growth retardation in very low birth weight infants. |
| Key words: Very low birth weight infants Extrauterine growth retardation Related risk factors |
