在极低出生体重的婴儿中,在2岁时纠正后的产后生长和神经发育
David A Nyakotey1, Angelica M Clarke1, Barbara E Cormack1,2
1Liggins Institute, University of Auckland, Auckland, 1023, New Zealand.
Pediatric research
|February 10, 2024
概括
极低出生体重 (ELBW) 婴儿产后生长迟缓与发育迟缓有关,特别是运动迟缓. 然而,增长参考很难预测这些延迟在两年校正的年龄.
科学领域:
- 新生儿科学 新生儿科学
- 发育儿科 发育儿科
- 增长监测 增长监测 增长监测
背景情况:
- 在早产婴儿中,产后生长迟缓与不良的神经发育有关.
- 预测这些婴儿神经发育的最佳生长参考仍然不清楚.
- 本研究探讨了极低出生体重 (ELBW) 婴儿的增长迟缓和发育迟缓之间的关联.
研究的目的:
- 检查 ELBW 婴儿生长迟缓和发育迟缓之间的关联.
- 为了比较神经发育结果的不同生长参考的预测值.
- 识别与发育迟缓相关的生长迟缓的关键时期.
主要方法:
- 使用z-score下降 (体重/长度≥0.8,头周长>1) 在出生,4周,36周的月经后年龄和2年纠正年龄之间进行了分类.
- 使用胎儿 (芬顿,英国-世卫组织,奥尔森) 和健康早产 (INTERGROWTH-21st) 的生长参考数据.
- 使用二进制逻辑回归和AUC分析了与发育迟缓的关联.
主要成果:
- 奥尔森图表确定了体重,长度和头部周长度中增长迟缓的最高流行率.
- 在4至36周的月经后年龄之间,增长不稳定与发育迟缓 (OR 2.0-4.7) 有较强的关联,特别是运动迟缓.
- 所有的生长参考表现出2年后发育迟缓的预测能力较差 (AUC ≤0.62).
结论:
- 在ELBW婴儿中,产后生长不稳定与发育迟缓有关,但在2岁校正年龄时,这是一个糟糕的预测因素.
- 不同的增长参考导致分类失速增长的显著差异.
- 在月经后4-36周之间的生长迟缓与随后的发育迟缓,特别是运动缺陷最为密切相关.
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