Short-midterm outcomes of preoperative extrauterine growth restriction in premature infants with critical congenital heart disease after surgery.

IF 2 3区 医学 Q2 PEDIATRICS
Yuan Li, Zhi-Ye Yao, Liang Chen, Jin Zhong, Man-Li Zheng, Xi-Meng Wang, Yan-Ling Chen, Xin Sun, Yu-Mei Liu, Shao-Ru He
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Abstract

Objective: To assess the factors associated with early occurrence of extrauterine growth restriction (EUGR) in preterm infants with critical congenital heart disease (CCHD) and their short-midterm outcomes.

Methods: This was a single-center retrospective study including a cohort of all premature infants (< 37weeks) undergoing surgery for CCHD at Guangdong Provincial People's Hospital from 2011 to 2022. According to the diagnostic and exclusion criteria, the subjects were divided into malnourished and un-malnourished groups. The clinical characteristics and nutrition outcomes of patients were collected and compared.

Results: Among the entire cohort of 118 preterm neonates with critical congenital heart disease (CCHD), 46 (39.0%) were malnourished before the operation, and 72 (61.0%) were non-malnourished. The BWZ (birth weight Z-score) [OR = 0.041, (0.012, 0.143), P < 0.001] of preoperative extrauterine growth restriction (EUGR) was lower. In addition, the preoperational non-EUGR group had earlier operation age [OR = 1.076, (1.032, 1.122), P = 0.001] and less liquid volume [OR = 1.032, (1.000, 1.066), P = 0.050]. After surgery, the preoperative EUGR group fasted [(5.28 ± 0.933) vs. (3.92 ± 0.411) days, P = 0.021] and hospitalized [(43.10 ± 3.683) vs. (31.89 ± 2.301) days, P = 0.007] for a longer time. The WAZ (weight of age Z-score) of the preoperative EUGR group was lower at discharge [(-3.84 ± 0.166) vs. (-1.75 ± 0.138), P < 0.001] and more of them were still malnourished [13(38.2%) vs. 4(5.6%), P = 0.006] till 2-year follow-up. We found 14.41% mortality total, of which 11.86% was in hospital.

Conclusion: Preoperative low weight-for-age, influenced by both congenital (e.g., SGA) and postnatal factors, predicts prolonged recovery and persistent growth deficits in preterm infants with CCHD. Comprehensive nutritional strategies must address both intrauterine and extrauterine contributors to growth failure.

危重型先天性心脏病早产儿手术后术前子宫外生长受限的中短期结局
目的:探讨危重型先天性心脏病(CCHD)早产儿早期发生宫外生长受限(EUGR)的相关因素及其中短期预后。方法:本研究为单中心回顾性研究,纳入所有早产儿队列。结果:在118例重症先天性心脏病(CCHD)早产儿队列中,46例(39.0%)术前营养不良,72例(61.0%)未营养不良。BWZ(出生体重z评分)[OR = 0.041, (0.012, 0.143), P]结论:术前低年龄体重,受先天性(如SGA)和出生后因素的影响,预测CCHD早产儿恢复时间延长和持续生长缺陷。综合营养策略必须解决宫内和宫外因素对生长衰竭的影响。
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来源期刊
BMC Pediatrics
BMC Pediatrics PEDIATRICS-
CiteScore
3.70
自引率
4.20%
发文量
683
审稿时长
3-8 weeks
期刊介绍: BMC Pediatrics is an open access journal publishing peer-reviewed research articles in all aspects of health care in neonates, children and adolescents, as well as related molecular genetics, pathophysiology, and epidemiology.
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