评估极低出生体重儿躯体生长的前瞻性观察研究

Dalwinder Janjua, J. Singh, A. Agrawal, D. Jadhav
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引用次数: 1

摘要

背景:出生体重是首次测量的体重;低出生体重的婴儿在童年时期更有可能出现身体发育不良,并在以后的年龄发展出代谢危险因素的标志物。目的:评价极低出生体重儿(VLBW)出院时和经后40周时的体生长情况,并比较小胎龄儿(SGA)和适胎龄儿(AGA)的体生长情况。方法:这项前瞻性观察性研究在一家三级护理医院的新生儿病房和高危随访诊所进行了为期一年的研究。对出生后72小时内入院并存活出院的VLBW婴儿(体重小于1500 g)进行前瞻性随访。基线数据在出院前收集,并对婴儿进行随访,直到月经后40周。结果:入选的53例患儿中,1例患儿有先天性畸形,6例患儿在新生儿重症监护病房期间死亡,4例患儿未随访。最后,42名婴儿被跟踪了40周。平均胎龄为30±2.5周,平均出生体重为1199±216克。出生时体重、身长和头围的平均Z分分别为-0.88、-0.59和-0.64。排出时分别为-1.12,-1.12和-1.11,月经后40周分别为-1.69,-1.03和-0.73。SGA和AGA婴儿在住院期间都表现出生长滞后,从出生到出院这三个参数的Z分数都下降了。纯肠内喂养对于VLBW婴儿是可行的,与给予短期肠外营养的婴儿相比,没有任何生长差异。尽管积极的肠内喂养,只有一个婴儿有NEC,没有一个婴儿发展为晚发性败血症。结论:在我们的研究中,SGA和AGA婴儿在住院期间都表现出生长滞后,从出生到出院这三个参数的Z分数下降表明了这一点。纯肠内喂养对于VLBW婴儿是可行的,与给予短期肠外营养的婴儿相比,没有任何生长差异。此外,在我们的研究人群中,饲料的快速进展没有任何显著的不良影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Prospective observational study to assess the Somatic Growth in Very Low Birth Weight infants
Background: The birth weight is the first weight measured; an infant with low birth weight is more likely to have poor somatic growth during childhood and develop markers of metabolic risk factors at his/her later age. Objectives: To evaluate the somatic growth of very low birth weight (VLBW) infants at discharge and 40 weeks postmenstrual age and to compare the growth of small for gestational age (SGA) and appropriate for gestational age (AGA) babies. Methods: This prospective observational study was conducted over a period of one year at the neonatal unit and high-risk follow-up clinic of a tertiary care hospital. VLBW babies (weight less than 1500 g), admitted within 72 hours of life and discharged alive, were followed up prospectively. The baseline data were collected before discharge from the hospital and babies were followed up till the 40 weeks post-menstrual age. Results: Out of 53 babies enrolled, one baby had a congenital malformation, six died during NICU stay, and four were not followed up. Finally, 42 babies were followed for 40 weeks. The mean gestational age was 30 ± 2.5 weeks and mean birth weight was 1199 ± 216 gm. The mean Z scores for weight, length and head circumference at birth were -0.88, -0.59, and -0.64, respectively. These changed to -1.12, -1.12, and -1.11, respectively at the time of discharge and -1.69, -1.03, and -0.73, respectively at post-menstrual age of 40 weeks. Both SGA and AGA infants exhibited a growth lag during hospital stay as indicated by a fall in Z scores for all three parameters from birth to discharge. Exclusive enteral feeding is feasible for VLBW infants without any difference in growth compared to babies given short term parenteral nutrition. Despite aggressive enteral feeding, only one baby had NEC and none of the babies developed late onset sepsis. Conclusions: In our study, both SGA and AGA infants exhibited a growth lag during hospital stay as indicated by a fall in Z scores for all three parameters from birth to discharge. Exclusive enteral feeding is feasible for VLBW infants without any difference in growth compared to babies given short-term parenteral nutrition. Also, rapid progression of feeds did not have any significant adverse effects in our study population.
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