新生儿重症监护室出院早产儿1143例0～24月龄生长状况分析

Study on the 0-24 month growth development of 1 143 preterm infants discharged from neonatal intensive care unit

目的描述和分析NICU出院早产儿0～24月龄生长状况,为开展早产儿生长监测和营养管理提供依据。方法回顾性分析2013年1月-2017年12月在上海市儿童医院NICU住院、出院后在本院早产儿随访门诊接受系统管理的早产儿体格随访数据,了解不同性别、出生胎龄早产儿0～24月龄身长和体重增长情况。结果共纳入早产儿1 143例,构成以极早和早期早产儿占比最多,两者合计占36.8%,中期早产儿占29.6%,晚期早产儿占33.6%。早产儿平均出生胎龄(32.2±2.4)周,男、女童出生胎龄构成差异无统计学意义(χ~2=2.048,P=0.562)。校正0月龄时,各组早产儿平均身高、体重超过足月儿;校正足月后整体追赶生长良好,但身高、体重始终低于足月儿均值;各组早产儿的追赶生长趋势,以早期早产男童组最不理想。结论 NICU出院早产儿可实现良好追赶生长,需重点关注早期早产男童;对早产儿开展出院后系统管理有助于适宜追赶。

Objective To analyze the growth status of preterm infants discharged from neonatal intensive care unit(NICU) at the age of 0-24 months,in order to provide evidence for growth monitoring and nutrition management of preterm infants. Methods The data of growth development of preterm infants discharged from NICU in Children′s Hospital of Shanghai were retrospectively collected from January 2013 to December 2017. The body length and weight of preterm infants aged 0-24 months in different gender and age groups were analyzed. Results A total of 1 143 cases were included, and the extremely early and early term infants account for the largest proportion of premature group, which was 36.8%.Moderately preterm accounted for 29.6% and late preterm accounted for 33.6%.The average gestational age was(32.2±2.4) weeks, and there was no significant difference in the composition of birth age in gender(χ~2=2.048,P=0.562).The average height and weight of preterm infants at adjusted age of 0 month exceeded that of the full-term infants.Preterm infants at adjusted age of 1 month achieved catch-up growth, but the height and body weight of preterm infants were still lower than those of full-term infants.Besides, the catch-up growth of preterm male infants was undesirable.Conclusions Appropriate catch-up growth is the goal of nutrition management for preterm infants after discharge,and the preterm male infants should be paid more attention to. Also,systematic nutrition management will facilitate appropriate catch-up growth.