芬顿与INTERGROWTH对比:早产婴儿<32周的21st图表:图表选择对生长分类的影响
Amaia Merino-Hernández1,2, Elena Rodríguez-Corrales3,4, Cristina Ramos-Navarro3,4
1Department of Neonatology, Hospital General Universitario Gregorio Marañón, Calle O'Donnell 48, 28009, Madrid, Spain. ammerino@ucm.es.
European journal of pediatrics
|January 30, 2026
概括
增长图的选择对早产婴儿的分类有很大的影响. 国际增长21世纪 (IG-21) 图表使用更严格的静态指标,而芬顿图表则识别出更动态的增长下降. 结合这两种评估有助于准确的评估和营养指导.
科学领域:
- 新生儿科学 新生儿科学
- 儿童生长监测 儿童生长监测
- 营养科学 营养科学
背景情况:
- 产后生长监测对于早产婴儿来说至关重要,以识别子宫外生长限制 (EUGR) 和指导营养.
- 芬顿和INTERGROWTH-21st (IG-21) 图表是常用的,但有不确定的协议和临床相关性.
- 在早产婴儿 (<32周妊娠期) 的生长分类在图表之间有显著差异,使临床解释复杂化.
研究的目的:
- 为了在早产婴儿 (<32周妊娠期) 中比较芬顿和IG-21图表之间的产后生长评估.
- 使用这些图表来评估静态和动态增长分类中的差异.
- 评估图表选择对确定EUGR和指导营养管理的影响.
主要方法:
- 158名早产婴儿 (<32周妊娠期) 的前性单中心队列研究.
- 测量体重,长度和头周在出生时,15天,1个月,和排泄.
- 使用Fenton和IG-21图表计算Z-score;与世卫组织标准进行比较;统计分析包括Wilcoxon,McNemar和线性混合效应模型.
主要成果:
- 在IG-21分类的婴儿中,更多的婴儿出生时比妊娠年龄小 (20%对13%) 和出院时患有小头症 (14%对3%).
- 与IG-21 (31%对25%) 相比,增长迟缓更频繁,而Fenton检测到更多的婴儿具有显著的z-score下降.
- 两个图表都低估了EUGR流行率 (WHO 63%);随着时间的推移,体重,长度和头周长的显著下降得到证实 (p<0.001).
结论:
- 增长图表的选择对早产婴儿的分类有很大影响,IG-21使用更严格的静态值,Fenton识别了更动态的下降.
- 两个图表都不能完全捕捉成长模式;两者都低估了EUGR的流行率.
- 整合静态和纵向生长评估可以加强评估,并支持非常早产婴儿的个性化营养决策.
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