早产儿宫外发育迟缓及其相关因素167例分析

Analysis on extrauterine growth restriction and related factors in 167 cases of premature infants

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 of extrauterine growth restriction （EUGR） in premature infants disharged from hospital,and provide clinical basis for preventing occurrence of EUGR. Methods The premature infants born from February 2012 to February 2013 in NICU were selected. Growth restriction was defined asmeasured growth values≤10^th percentile of the values of growth expectation based on estimated postmenstrual age. Results The incidence of EUGR in weight less than equal to 1 500 g group was 66.2% ,the incidence of EUGR in weight greater than 1 500 g group was 37.8% ,the difference was significant （P〈0.05）. The incidence of EUGR in less than 34 weeks gestational age group was 71.3%, the incidence of EUGR in the greater than or equal to 34 weeks gestational age group was 44.8 %, the difference was significant （P〈0.01）. It was showed that risk factor related to EUGR were intrauterine growth retardation （ IUGR ） and infection,the lasting time of weight decrease after birth. Conclusions EUGR is closely related to gestational age and birth weight. The cause of EUC-R are multifacorial,so complications should be prevented and treated actively. Early attention to nutrition,shorten the lasting time of weight decrease after birth,is tile key to avoiding EUGR.