定义新生儿重症监护病房中非常早产婴儿的生长迟缓和营养不良
Rachel R Rickman1, Anthony Rudine2,3, Steven A Abrams1,4
1Department of Nutritional Sciences, The University of Texas at Austin, Austin, TX, USA.
概括
体重与年龄的百分比切断线错误地对非常早产婴儿的营养不良进行了分类. Z分数的变化可以更准确地评估极低出生体重和非常低出生体重婴儿的生长问题.
科学领域:
- 新生儿科学 新生儿科学
- 儿童营养学 儿童营养学
- 增长监测 增长监测 增长监测
背景情况:
- 过早出生的婴儿,特别是那些出生时体重极低 (ELBW) 或出生时体重非常低 (VLBW) 的婴儿,存在高发育异常的风险.
- 当前的36周月经后生长评估方法可能无法准确识别所有患有营养不良的婴儿.
研究的目的:
- 为了比较体重对年龄的准确性≤10百分点 (10%ile) 与z-score在36周非常早产婴儿中识别营养不良的变化.
- 在这个脆弱的人群中确定营养不良的预测因素.
主要方法:
- 追溯分析ELBW (n=699) 和VLBW (n=878) 的婴儿出生时间 ≤32周.
- 婴儿分类使用年龄体重≤10%和基于z-score变化的营养不良类别.
- 多重后勤回归用于确定营养不良的预测因素.
主要成果:
- 13%的ELBW和15%的VLBW婴儿被分类为中度/严重营养不良,使用z-score损失,超过10%的临界值.
- 慢性肺病和呼吸机使用与中度/重度营养不良的风险增加有关.
- 损失≤0.8的z-score没有与产后临床风险因素有关.
结论:
- 在36周月经后使用体重与年龄比例≤10%作为生长问题的唯一指标,导致许多早产婴儿的错误分类.
- Z分数的变化为诊断非常早产婴儿营养不良提供了更敏感的方法.
- 可能需要进一步的研究来了解与较小的z-score损失相关的增长模式.
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