小于等于32周早产儿宫外发育迟缓的相关因素分析

Related factors of extrauterine growth retardation (EUGR) in preterm infants less than 32 week

目的探讨小于等于32周早产儿出院时宫外发育迟缓(EUGR)的发生率及相关危险因素。方法回顾性分析2015年1月至2017年12月在首都医科大学附属北京友谊医院NICU住院的≤32周的64例早产儿的病例资料。研究其EUGR发生的危险因素,并对其阳性结果通过受试者工作曲线(ROC曲线)进行预测分析。结果以体重为准,采纳入组的64例早产儿中,发生EUGR 15例,发生率为23.4%。单因素分析结果显示,出生体重、静脉营养时间、抗生素使用时间、喂养方式、出院矫正胎龄对EUGR的发生明确相关,差异具有统计学意义。进一步进行ROC曲线分析显示,出生体重<1 425 g、抗生素使用时间>24.5 d、静脉营养时间>25 d、出院矫正胎龄>36周的早产儿更容易发生EUGR。结论加强孕期保健,减少早产的发生,尽量减少抗生素使用时间,尽早实现肠道喂养,加强母乳喂养,对于降低EUGR的发生率有较大意义。对于出生体重<1 425 g、抗生素使用时间长、静脉营养时间长、矫正胎龄>36周仍需住院的早产儿,为EUGR高危儿,加强营养支持及生长发育监测更是重中之重。

Objective To investigate the incidence of related factors of extrauterine growth retardation（ EUGR） and related risk factors in preterm infants less than 32 weeks. Methods A retrospective analysis was performed on 64 preterm infants ≤32 weeks who were admitted in NICU from January,2015 to December,2017. Study the risk factors for the occurrence of EUGR,and predict the outcome by ROC curve analysis on positive results. Results Based on body weight,the incidence of EUGR was 23. 4%. The monofactor analysis showed that birth weight,intravenous nutrition time,antibiotic use time,feeding method,discharge corrected gestational age were significantly related to the occurrence of EUGR. Further ROC curve analysis showed that EUGR was more likely to occur in premature infants with birth weight less than 1 425 g,antibiotic using time more than 24. 5 days,intravenous nutrition time more than 25 days,and the discharged corrected gestational age more than 36 weeks.Conclusion Strengthening pregnancy care,reducing the occurrence of preterm birth,minimizing the use of antibiotics,enteral feeding as soon as possible,and strengthening breastfeeding play important roles in reducing the incidence of EUGR. For those premature babies whose birth weight is less than 1 425 g,long antibiotic using time,long intravenous nutrition time,and more than 36 weeks of corrected gestational age when discharge,are in high risk of EUGR. All of them need more nutrition support and growth and development monitoring.