高危儿体格发育情况影响因素分析及胰岛素样生长因子1和胰岛素样生长因子结合蛋白3对高危儿体格发育的预测价值

Analysis of influencing factors of physical development of high-risk infants and the predictive value of insulin-like growth factor 1 and insulin-like growth factor binding protein 3 for physical development

目的 分析高危儿体格发育情况的影响因素及胰岛素样生长因子1(IGF-1)、胰岛素样生长因子结合蛋白3(IGFBP-3)对高危儿体格发育的预测价值。方法 选取2021年10月—2022年8月北京大学第一医院宁夏妇女儿童医院产科出生的105例高危儿为研究对象,统计高危儿体格发育情况,检测高危儿IGF-1、IGFBP-3水平。结果 105例高危儿中,74例体格发育正常,占70.48%。单因素分析显示:与体格发育正常高危儿相比,体格发育不良高危儿出生体质量<1.5 kg(35.14%vs.74.19%)、出生身长<47 cm(39.19%vs.77.42%)、未添加营养补充剂(28.38%vs.58.06%)、母乳喂养(24.32%vs.41.94%)、人工喂养(18.92%vs.38.71%)、母亲文化程度高中及以下(33.78%vs.61.29%)、无多个看护人(36.49%vs.64.52%)、IGF-1<200 ng/ml(29.73%vs.74.19%)、IGFBP-3<5.0μg/ml(33.78%vs.70.97%)比例较高(均P<0.05)。多因素logistic回归分析结果显示:出生体质量、出生身长、是否添加营养补充剂、喂养方式、母亲文化程度、多个看护人、IGF-1、IGFBP-3为影响高危儿体格发育情况的主要因素(均P<0.05)。与IGF-1、IGFBP-3单项诊断相比,两项联合预测高危儿体格发育不良的灵敏度(58.06%vs.77.42%vs.93.55%)、准确度(72.38%vs.64.76%vs.90.48%)较高(均P<0.05)。结论 出生体质量、出生身长、是否添加营养补充剂、喂养方式、母亲文化程度、多个看护人、IGF-1、IGFBP-3为高危儿体格发育情况的影响因素,IGF-1、IGFBP-3联合检测对高危儿体格发育不良的预测价值较高。

Objective To analyze the influencing factors of physical development of high-risk infants and the predictive value of insulin-like growth factor 1(IGF-1) and insulin-like growth factor-binding protein 3(IGFBP-3) for physical development.Methods A total of 105 high-risk infants born in Obstetrics Department of Ningxia Women and Children's Hospital of Peking University First Hospital from October 2021 to August 2022 were selected as research subjects.The physical development status of high-risk infants were recorded,and the levels of IGF-1 and IGFBP-3 were detected.Results Among the 105 high-risk infants,74 infants had normal physical development,accounting for 70.48%.Univariate analysis showed that compared with normal physical development of high-risk infants,birth weight<1.5 kg(35.14% vs.74.19%),birth length<47 cm(39.19% vs.77.42%),no nutritional supplements(28.38% vs.58.06%),breastmilk feeding(24.32% vs.41.94%),artificial feeding(18.92% vs.38.71%),mother's educational level of high school or below(33.78% vs.61.29%),no multiple caregivers(36.49% vs.64.52%),IGF-1<200 ng/ml(29.73% vs.74.19%),IGFBP-3<5.0 μg/ml(33.78% vs.70.97%) were relatively high(P< 0.05).Multivariate logistic regression analysis showed that birth weight,birth length,whether to add nutritional supplements,feeding methods,mother's educational level,multiple caregivers,IGF-1,and IGFBP-3 were the main factors affecting physical development of high-risk infants(P<0.05).Compared with the single diagnosis of IGF-1 and IGFBP-3,the sensitivity(58.06% vs.77.42% vs.93.55%) and the accuracy(72.38% vs.64.76% vs.90.48%) of combined diagnosis to predict physical dysplasia in high-risk infants were higher(P<0.05).Conclusion Birth weight,birth length,whether nutritional supplements are added,feeding methods,maternal educational level,multiple caregivers,IGF-1,and IGFBP-3 are influencing factors for physical development of high-risk infants.The combined detection of IGF-1 and IGFBP-3 has high predictive value for physical development of high-risk infants.