Postnatal growth and development in the preterm and small for gestational age infant.

Richard J Cooke
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引用次数: 23

Abstract

A clear relationship exists between undernutrition, poorer growth and poor development in term and preterm infants. However, preterm infants are at greater risk than term infants. Undernutrition is more common and 'programmed' growth rates are almost six times faster. Thus, even short periods of nutritional deprivation may have significant effects. Recent advances have led to an improvement in early growth but very low birthweight infants remain small for gestational age at hospital discharge. Studies suggest that a 'window of opportunity' exists after hospital discharge, in that better growth between discharge and 2-3 months corrected age is paralleled by better development, and poorer growth is associated with poorer development. However, interventions aimed at improving growth and development have yielded varying results. This may partly be related to differences in study design as well as the composition of the nutrient-enriched formulas. Irrespective, one point is concerning, i.e. infant boys appear to be at a developmental disadvantage when fed a term infant formula after discharge. A single study has also suggested that dietary intervention can improve brain growth in term and preterm infants with perinatal brain injury. However, concern has been expressed about rapid 'catch-up' growth in preterm infants and the development of insulin resistance and visceral adiposity. Data from our group do not support the idea of increased or altered adiposity in preterm infants fed a nutrient-enriched formula after hospital discharge.

出生后生长发育以早产儿和小胎龄婴儿为例。
足月和早产儿营养不良、生长不良和发育不良之间存在明显的关系。然而,早产儿比足月婴儿有更大的风险。营养不良更为常见,“程序化”的生长速度几乎快了六倍。因此,即使是短时间的营养剥夺也可能产生重大影响。最近的进展已经导致早期生长的改善,但非常低的出生体重婴儿在出院时仍然小于胎龄。研究表明,出院后存在“机会之窗”,因为出院至2-3个月矫正年龄之间的较好生长与较好的发育是平行的,而较差的生长与较差的发育有关。然而,旨在改善增长和发展的干预措施产生了不同的结果。这可能部分与研究设计的差异以及营养丰富配方的组成有关。无论如何,有一点值得关注,即男婴在出院后用足月婴儿配方奶粉喂养,似乎处于发育劣势。一项单独的研究也表明,饮食干预可以改善围产期脑损伤的足月和早产儿的大脑发育。然而,人们对早产儿的快速“追赶”增长以及胰岛素抵抗和内脏肥胖的发展表示担忧。我们小组的数据不支持在出院后喂养营养丰富的配方奶粉的早产儿肥胖增加或改变的观点。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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