早产儿校正24月龄内生长轨迹研究

Assessment of growth pattern of preterm infants up to a corrected age of 24 months

目的分析早产儿校正24月龄内生长轨迹,以了解早产儿的生长趋势和规律。方法基于互联网+随访系统建立早产儿随访数据库,纳入2018年4月至2021年4月3188例早产儿,收集其出生及校正1、3、6、12、18、24月龄时的身长、体重、头围数据。按不同的围生期因素分组,绘制生长曲线,并与21世纪国际胎儿和新生儿生长联合会(International Fetal and Newborn Growth Consortium for the 21st Century,INTERGROWTH-21st)标准和世界卫生组织(World Health Organization,WHO)标准进行比较。结果按不同的围生期因素分组的各组早产儿体重、身长、头围曲线均在校正6月龄内快速上升,校正6月龄后增长速度减缓。按实际月龄比较,各出生胎龄组早产儿(<28周、28~31^(+6)周、32~33^(+6)周、34~36^(+6)周)身长曲线在实际9月龄后逐渐与WHO曲线重合(P=0.082),<32周早产儿的体重和头围则一直落后于WHO曲线(P<0.001)。校正月龄后,不同出生胎龄组早产儿(<28周、28~31+6周、32~33+6周、34~36+6周)的体格生长曲线基本重合(P>0.05)。超低出生体重儿和小于胎龄儿的身长、体重、头围曲线均低于INTERGROWTH-21st标准和WHO标准(P<0.05)。结论早产儿在校正6月龄内体格增长速度较快,校正6月龄后增长速度减缓。胎龄越小,体重和头围追赶的时间越长。应重点关注超早产儿、超低出生体重儿和小于胎龄儿的体格生长。

Objective To assess the growth of preterm infants up to a corrected age of 24 months,and to understand the growth trend and pattern of preterm infants.Methods A preterm infant follow-up database was established based on the Internet Plus follow-up system.A total of 3188 preterm infants who were born from April 2018 to April 2021 were enrolled.Their length,weight,and head circumference were recorded at birth and at the corrected ages of 1,3,6,12,18,and 24 months.The preterm infants were grouped by perinatal factors.The growth curves of these infants were plotted and compared with the International Fetal and Newborn Growth Consortium for the 21st Century(INTERGROWTH-21st)standard and World Health Organization(WHO)standard.Results The weight,length,and head circumference curves of each group of preterm infants grouped by various perinatal factors all rose rapidly within the corrected age of 6 months,but the growth rate slowed down after the corrected age of 6 months.Based on the actual age for the groups of preterm infants with different gestational ages(<28 weeks,28-31+6 weeks,32-33+6 weeks,and 34-36+6 weeks),the length curve gradually coincided with the WHO curve after the actual age of 9 months(P=0.082),while for the preterm infants with a gestational age of<32 weeks,the weight and head circumference curves were significantly lower than the WHO curves(P<0.001).Based on the corrected age,the physical growth curve of preterm infants with different gestational ages(<28 weeks,28-31+6 weeks,32-33+6 weeks,and 34-36+6 weeks)basically coincided with each other(P>0.05).For the infants with extremely low birth weight and the small-for-gestational-age infants,the length,weight,and head circumference curves were significantly lower than those of the INTERGROWTH-21st standard and the WHO standard(P<0.05).Conclusions The physical growth rate of preterm infants is faster within the corrected age of 6 months,and the growth rate slows down after the corrected age of 6 months.Preterm infants with a smaller gestational age need longer time to catch up in weight and head circumference.More attention should be paid to the physical growth of extremely preterm infants,extremely low birth weight infants,and small-for-gestational-age infants.