中晚期早产儿出院时宫外生长发育迟缓危险因素的分析
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海南省基金课题(1601032034A2004)


Analysis of risk factors for extrauterine growth retardation in mid⁃late preterm infants discharged from hospital
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    摘要:

    目的:分析中晚期早产儿出院时宫外生长发育迟缓(extrauterine growth retardation,EUGR)的发生率及相关危险因素,为今后EUGR 的防治提供参考依据。方法:收集海南省妇女儿童医学中心2016年1月—2018年6月NICU 住院的中晚期早产儿1 374例的临床资料,按照出院时体重分为EUGR 组和非EUGR组,比较两组患儿的各项指标,所有数据采用SPSS22.0软件进行统计学分析。结果:中期早产儿EUGR发生率为26.74%,晚期早产儿EUGR发生率为26.14%,中期早产儿与晚期早产儿EUGR发生率差异无统计学意义(χ2=0.033,P=0.855);出生体重越低EUGR发生率越高,不同出生体重早产儿 EUGR 发生率差异有统计学意义(χ2 =81.746,P < 0.001);EUGR 组脑损伤、败血症及早产儿视网膜病变发生率均高于非EUGR 组,两组差异有统计学意义(P均<0.05);EUGR 组全肠内营养时间、吸氧时间、禁食时间及住院时间均长于非EUGR 组,两组差异有统计学意义(P均<0.001);EUGR 组妊娠期高血压、多胎、宫内生长迟缓(intrauterine growth retardation,IUGR)、脐带异常发生率高于非EUGR 组,两组差异有统计学意义(P均<0.05);EUGR组胎儿出生体重显著低于非EUGR组,两组差异有统计学意义(P<0.05);Logistic 回归分析显示,多胎、IUGR、脐带异常、出生体重及住院时间均为 EUGR 发生的独立危险因素。结论:中晚期早产儿EUGR的发生与多胎、IUGR、脐带异常、较低出生体重及较长住院时间有关。加强围生保健工作,预防低体重儿的出生,合理的营养支持,积极防治高危因素,减少出生后各种并发症的发生,是降低中晚期早产儿 EUGR 发生的重要措施。

    Abstract:

    Objective:This study aims to analyze the incidence of extrauterine growth retardation(EUGR) and related risk factors of late-term premature infants discharged from hospital,so as to provide reference for prevention and treatment of EUGR in the future. Methods:The clinical data of 1 374 mid-late preterm infants enrolled in the NICU from January 2016 to June 1818 in Hainan Maternal and Children’s Medical Center were collected. Infants were divided into EUGR group and non-EUGR group according to the body weight at discharge,and indexes of EUGR group and non-EUGR group were compared. All data were statistically analyzed using SPSS22.0 software. Results:The incidence of EUGR was 26.74% in mid-term preterm infants and 26.14% in late preterm infants. There was no significant difference in the incidence of EUGR between mid-term preterm infants and late preterm infants (χ2 =0.033,P=0.855).The lower the birth weight was,the higher the incidence of EUGR was. The differences in the incidence of EUGR in preterm infants with different birth weights were statistically significant(χ2 =81.746,P < 0.001);incidences of brain injury,sepsis and retinopathy of prematurity in the EUGR group were higher than those in the non-EUGR group(P < 0.05);total enteral nutrition time,oxygen inhalation time,fasting time and hospitalization time were longer in EUGR group than in non-EUGR group(P < 0.001). Incidences of gestational hypertension,multiple births,IUGR(intrauterine growth retardation) and umbilical cord abnormalities were higher in EUGR group than in non-EUGR group(P < 0.05). The fetal weight of EUGR group was significantly lower than that of non-EUGR group(P < 0.05);Logistic regression analysis showed that multiple births,IUGR,umbilical cord abnormalities,birth weight and hospital-stay time were independent risk factors for EUGR. Conclusion:The occurrence of EUGR in mid-late preterm infants is related to multiple births,IUGR,abnormal umbilical cord,low birth weight and long hospital stay. Strengthening perinatal health care,preventing the birth of low-weight infants,reasonable nutritional support,actively preventing high-risk factors and reducing various complications after birth are important measures to reduce the occurrence of EUGR in mid-late preterm infants.

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曹 祥,韦 伟,黄晓燕,羊 玲.中晚期早产儿出院时宫外生长发育迟缓危险因素的分析[J].南京医科大学学报(自然科学版),2019,(9):1345-1349

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  • 收稿日期:2018-12-11
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  • 在线发布日期: 2019-09-29
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