极低出生体重儿宫外生长发育状况因素分析

Analysis of factors affecting extrauterine growth and development in very low birth weight infants

目的了解极低出生体重儿住院期间宫外生长发育状况,并探讨影响极低出生体重儿宫外生长迟缓(EUGR)的相关危险因素。方法选择2013年1月~2015年12月于潍坊市妇幼保健院新生儿重症监护病房住院治疗的极低出生体重儿,应用回顾性分析的试验方法,观察至患儿出院,分析影响患儿宫外发育迟缓的因素。结果经单因素分析,患儿发生宫外生长迟缓的主要影响因素包括出生胎龄、出生体重、母孕期高血压及糖尿病、多胎发生率、体重恢复时间、坏死性小肠结肠炎、开始肠内营养时间、完全肠内营养时间、肠外营养持续时间以及宫内生长迟缓。经多因素logistic回归分析显示出生胎龄、出生体重、宫内生长迟缓、开始肠内营养时间、恢复至出生体重时间均为EUGR的独立危险因素(P<0.05)。结论出生胎龄及出生体重是影响极低出生体重儿日后生长发育的重要因素,因此注重母孕期保健,降低宫内生长迟缓发生率,出生后尽早开始肠内营养等可有效降低极低出生体重儿EUGR的发生率,改善患儿的生长发育情况。

Objective To investigate the extra-uterine growth and development status of very low birth weight infants during hospitalization,and explore the related risk factors affecting extrauterine growth retardation of very low birth weight infants.Methods From January 2013 to December 2015,very low birth weight infants hospitalized in the neonatal intensive care unit of Weifang Maternal and Child Health Hospital were selected and the retrospective analysis method were performed to observe the child until discharge and analyze the impact factors of the child’s extrauterine stunting.Results Through single factor analysis,the main impact factors of children with extrauterine growth retardation include gestational age at birth,birth weight,hypertension and diabetes during maternal and pregnancy,incidence of multiple births,time to weight recovery,necrotizing enter colitis,and time to enter enteral nutrition,time for complete enteral nutrition,duration of parenteral nutrition,and intrauterine growth retardation.Multivariate logistic regression analysis showed that birth gestational age,birth weight,intrauterine growth retardation,initiation of enteral nutrition,and return to birth weight were independent risk factors for EUGR(P<0.05).Conclusion Gestational age and birth weight are important factors affecting the growth and development of very low birth weight infants.Therefore,placing a very high value on maternal health care,reducing the incidence of intrauterine growth retardation,starting early enteral nutrition after birth can effectively reduce the birth rate of very low birth weight infants and improve the children’s growth and development.