极低出生体重或极早出生婴儿在急诊室出院后的尺寸和生长
Mandy B Belfort1, Lucy T Greenberg2,3, Danielle E Y Ehret2,4
1Department of Pediatrics, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
Pediatrics
|September 4, 2025
概括
极低出生体重 (ELBW) 和极早产 (EPT) 婴儿在新生儿重症监护室 (NICU) 退院后显示出显著的追赶增长. 然而,这些易受伤害的儿童在18-24个月的年龄内仍然比同龄人小.
科学领域:
- 新生儿科和儿科
- 增长与发展研究
- 公共卫生和流行病学
背景情况:
- 极低出生体重 (ELBW) 和极早产 (EPT) 的婴儿是需要专门监测生长的脆弱群体.
- 了解新生儿重症监护室 (NICU) 的成长轨迹和尺寸指标对于长期健康结果至关重要.
- 识别影响 ELBW/EPT 婴儿生长的因素可以为有针对性的干预提供信息.
研究的目的:
- 描述18-24个月的ELBW/EPT婴儿的尺寸指标.
- 分析从NICU出院到18-24个月的成长模式.
- 检查婴儿和母亲影响体型和成长结果的决定因素.
主要方法:
- 使用了77家佛蒙特牛津医院的7301名ELBW/EPT儿童的数据.
- 使用世卫组织标准对18-24个月的年龄进行校正,评估尺寸指标 (体重,身高,头周长,BMIz分数).
- 通过z评分量化体重和头周的变化,从NICU释放到使用多变量回归的随访.
主要成果:
- 从NICU出院到18-24个月的婴儿体重的中位数增加了0. 74z.
- 尽管追赶增长,婴儿在随访时仍然比参考标准轻 (中位数z分数- 0. 26).
- 诸如怀孕年龄相对小 (SGA) 状态,新生儿重症监护室体重不稳定和手术性死肠炎等因素预测体重增加速度更快,但最终尺寸更小.
结论:
- 在新生儿重症监护室退院和18-24个月的校正年龄之间, ELBW/EPT婴儿表现出显著的,但不完整的追赶增长.
- 持续存在的体型缺陷凸显了早产和低出生体重的长期影响.
- 进一步研究优化这一高风险群体的增长和发展是有必要的.
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