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目的分析极低出生体重(VLBW)婴儿宫外生长发育迟缓(EUGR)发生率及其影响因素。方法选择我院2013年1月至2015年6月住院治疗的VLBW婴儿,对其临床资料进行回顾性分析,包括胎龄、出生体重等基本资料,对并发症情况及入院前2周营养情况进行记录,并根据出生体重分组,计算EUGR发生率,并比较有、无宫内生长发育迟缓(IUGR)患儿中EUGR及严重EUGR的发生率。结果共纳入345例VLBW婴儿,其中IUGR80例。发生EUGR共285例,发生率为82.6%。IUGR患儿出院时均为EUGR,非IUGR患儿EUGR发生率为77.4%。非IUGR患儿出生体重越低,EUGR及严重EUGR发生率越高。EUGR组出生体重、平均每日体重增长及全经口喂养最大热量小于非EUGR组,胎龄大于非EUGR组。EUGR组前2周末氨基酸、脂肪乳及能量摄入量均低于非EUGR组,两组间并发症比较差异无统计学意义;严重EUGR组呼吸窘迫综合征(RDS)、支气管肺发育不良(BPD)、败血症明显高于非EUGR组,差异有统计学意义。Logistic回归分析结果显示,胎龄、出生体重为EUGR的独立影响因素。结论出生时存在IUGR的患儿EUGR发生率较高。影响EUGR发生的主要因素包括胎龄、出生体重以及生后前2周的氨基酸、脂肪乳及能量的摄入等。存在RDS、BPD、败血症的VLBW婴儿更易发生严重EUGR。
Objective To analyze the incidence and influencing factors of extrauterine growth retardation (EUGR) in very low birth weight (VLBW) infants. Methods The VLBW infants hospitalized from January 2013 to June 2015 in our hospital were retrospectively analyzed. The clinical data including gestational age, birth weight and other basic information were collected. The complication and nutritional status of patients were observed 2 weeks before hospital admission The incidence of EUGR was calculated by grouping according to birth weight, and the incidence of EUGR and severe EUGR in children with intrauterine growth retardation (IUGR) were compared. Results A total of 345 VLBW infants were enrolled, of which 80 were IUGR. A total of 285 cases of EUGR occurred, the incidence was 82.6%. EUGR were discharged from IUGR children and EUGR rate was 77.4% in non-IUGR children. The lower the birth weight of non-IUGR children, the higher the incidence of EUGR and severe EUGR. The birth weight, average daily body weight gain and total oral diet in EUGR group were less than those in non-EUGR group and were higher than those in non-EUGR group. The levels of amino acids, fat emulsion and energy intake in the EUGR group were lower than those in the non-EUGR group in the first two weeks of EUGR. There was no significant difference in complications between the two groups in the EUGR group. Severe respiratory distress syndrome (RDS), bronchopulmonary dysplasia (BPD) ), Septicemia was significantly higher than non-EUGR group, the difference was statistically significant. Logistic regression analysis showed that gestational age and birth weight were independent influencing factors of EUGR. Conclusions The incidence of EUGR in infants with IUGR at birth is higher. The main factors affecting the occurrence of EUGR include gestational age, birth weight and amino acids, fat emulsion and energy intake in the first 2 weeks of life. VLBW infants with RDS, BPD, sepsis are more likely to develop severe EUGR.