早产儿宫外生长发育迟缓的影响因素分析

An analysis of influencing factors for extrauterine growth retardation of preterm infants

目的探讨早产儿宫外生长发育迟缓(EUGR)的影响因素。方法选取100例处于追赶性生长时期的EUGR早产儿(EUGR组)为研究对象,另选取同期50例正常早产儿作为对照组。EUGR组进一步分为高危组(79例,胎龄<34周或出生体重<2000 g,且出生后体重增长缓慢)和低危组(21例,胎龄≥34周或出生体重≥2000 g,且无早期严重合并症)。比较各组早产儿的临床资料,分析早产儿追赶性生长时期EUGR发生的危险因素,并对高危组和低危组早产儿的Z评分进行比较。结果与对照组比较,EUGR组胎龄小、出生体重低、母亲孕期有妊娠合并症比例及宫内发育迟缓比例高(P<0.05)。EUGR组与对照组喂养方式比较差异有统计学意义(P<0.05)。高危组与低危组早产儿胎龄、母亲孕期有妊娠合并症比例、宫内发育迟缓比例、出生体重和喂养方式比较差异有统计学意义(P<0.05)。多因素logistic回归分析结果显示,胎龄小、出生体重低、母亲孕期有妊娠合并症、宫内发育迟缓和人工喂养方式均为早产儿追赶性生长时期EUGR发生的危险因素(P<0.05)。低危组和高危组早产儿体重纠正1个月龄和3个月龄的Z评分分布差异均有统计学意义(P<0.05)。结论胎龄、出生体重、母亲孕期妊娠合并症、宫内发育迟缓和喂养方式是早产儿追赶性生长时期EUGR发生的影响因素,临床上需要在分析早产儿临床资料的基础上及时采取相应的预防和针对性措施。

Objective To explore the influencing factors of extrauterine growth retardation(EUGR)of preterm infants.Methods One hundred cases of EUGR premature babies(group A)in the catch-up growth period and 50 normal preterm babies(group B)were selected.The EUGR premature babies of group A were further divided into two groups of A1(79 cases,gestational age<34 weeks or birth weight<2000 g,and slow weight gain after birth)and A2(21 cases,gestational age≥34 weeks or birth weight≥2000 g,and without early severe comorbidities).The clinical data among three groups were compared.The risk factors of EUGR in preterm infants were analyzed.The catch-up growth period score(Z score)of preterm infants was compared between two groups of A1 and A2.Results Compared with group B,the preterm babies of group A had lower gestational age,lower birth weight,higher proportion of mothers with pregnancy complications and intrauterine growth retardation(P<0.05).There was a significant difference in feeding patterns between groups of A and B(P<0.05).The gestational age,the proportion of mothers with pregnancy complications and intrauterine growth retardation,the birth weight and the feeding pattern had significant differences between groups of A1 and A2(P<0.05).Multivariate logistic regression analysis showed that low gestational age,low birth weight,maternal complications during pregnancy,intrauterine growth retardation,and artificial feeding were the risk factors for the occurrence of EUGR in the catch-up growth period of preterm infants(P<0.05).There was significant difference in the distribution of Z-scores between the 1-month and 3-month premature infants in groups of A1 and A2(P<0.05).Conclusion Gestational age,birth weight,maternal pregnancy complications,intrauterine growth retardation and feeding methods are the influencing factors of EUGR.The clinical prevention and targeted measures should be taken timely on the bases of an analysis of clinical data of the premature infants.