早产儿宫外生长发育迟缓及危险因素分析

Incidence and risk factors of extrauterine growth retardation in premature infants

目的探讨早产儿宫外生长发育迟缓(EUGR)的发生情况及相关危险因素,为早产儿制定更为合理的营养支持策略提供指导。方法选择2010年6月-2012年10月本院出生在NICU住院的早产儿162例,分别在出生时及出院时监测体重、身长、头围,分别计算EUGR的发生率;应用Logistic多元回归分析法,分析EUGR的相关危险因素。结果 162例早产儿出院时以体重、身长、头围为指标的EUGR发生率分别为43.83%、33.33%、10.49%。Logistic多元回归分析表明,与EUGR有关的高危因素包括:低出生体重(OR=25.15)、宫内生长受限(OR=2.87)、喂养不耐受(OR=2.42)及生后并发症(OR=4.12)、胎膜早破(OR=3.17)、母妊高症(OR=3.23)。结论 NICU中早产低出生体重儿EUGR发生率很高,应引起新生儿科医务人员的高度重视。EUGR的发生与多因素有关,其相关的危险因素有低出生体重、宫内生长受限、喂养不耐受、胎膜早破、母妊高症及住院期间并发症。应做好妊期保健,尽量减少孕期并发症,减少过低胎龄及低体重的发生,预防IUGR发生;生后应尽早给予足量的静脉营养,保证足够的热卡,及时治疗生后出现的并发症,以减少EUGR发生,提高早产儿的生存质量。

Objective To study the incidence and risk factors in premature neonates associated with extrauterine growth retardation （ EUGR） .Methods 162 premature neonates admitted in our NICU from June 2010 to October 2012 were chosen for this study.The body weight,body length and head circumference of each infant were monitored at birth and on discharge . The incidence of EUGR in each growth was calculated respectively .The logistic multiple regression analysis was applied to in-vestigate the risk factors correlated with EUGR .Results The incidence of EUGR was 43.83%,33.33%,10.49% assessed by body weight ,body length and head circumference respectively .The risk factors correlated with EUGR were low birth weight （OR=25.15）,intrauterine growth restriction（OR =2.87）,feeding intolerance（OR=2.42）, premature rupture of mem-branes（OR=3.17）,gestational hypertension（OR=3.23） and the complications after birth（OR=4.12）.Conclusion The incidence of EUGR in preterm /low-birth-weight infants is still high .The risk factors correlated with EUGR are multiple inclu-ding low birth weight ,intrauterine growth restriction ,feeding intolerance ,premature rupture of membranes ,gestational hyperten-sion and the complications after birth .Health care should be improved to reduce complications during pregnancy and prevent low gestational age and low weight .