CAJ | 학술논문

目的调查珠江三角洲地区超低/极低出生体重儿(extremely/very low birth weight infants,ELBWI/VLBWI)出生时宫内发育迟缓(intrauterine growth retardation,IUGR)和出院时宫外发育迟缓(extrauterine growth retardation,EUGR)的发生率,为其出院后进行生长发育监测和干预提供依据.方法回顾性调查广东省珠江三角洲地区9个城市的9家医院新生儿科于2010年7月1日至2011年6月30日期间出院的ELBWI/VBWI的住院资料,分别以出生时、出院时的体重在相应宫内生长速率期望值的第10百分位水平以下(生长曲线的第10百分位)定义为IUGR、EUGR,分别计算各胎龄组、各体重组、单胎与多胎组的IUGR、EUGR发生率,并计算各组EUGR较IUGR增加的发生率.生长曲线参照“Fenton生长曲线2003一胎儿、婴儿生长曲线(供早产儿参考)(WHO生长标准版)”.结果 318例ELBWI/VLBWI出生时IUGR发生率为33.3％(106例),出院时EUGR发生率为70.8％(225例).以出生胎龄(＜30周、＜32周、≥32周)进行分组统计,EUGR发生率分别为55.7％ (68/122)、66.9％ (79/113)、94.0％ (79/83)(x2=34.964,P=0.000),较IUGR发生率分别增加49.2％ (60/122)、51.3％ (58/113)、1.2％ (1/83) (x2 =63.024,P=0.000)；以出生体重(≤1200 g、≤1350 g、＞1350 g)进行分组统计,EUGR发生率分别为83.8％ (88/105)、65.3％ (66/101)、63.4％ (71/112) (x2=13.009,P=0.001),较IUGR发生率分别增加42.9％ (45/105)、35.6％ (36/101)、33.9％(38/112)(x2=2.045,P=0.360)；以单胎和多胎进行分组比较,则IUGR、EUGR及EUGR较IUGR增加的发生率,组间差异均无统计学意义(P＞0.05).结论 ELBWI/VLBWI出院时EUGR发生率仍然很高,出院时EUGR发生率随出生胎龄的增加或出生体重的降低而升高,且出院时EUGR较出生时IUGR增加的发生率随出生胎龄的降低而升高,但EUGR发生率与胎数无明显相关性.
목적 조사주강삼각주지구초저/겁저출생체중인(extremely/very low birth weight infants,ELBWI/VLBWI)출생시궁내발육지완(intrauterine growth retardation,IUGR)화출원시궁외발육지완(extrauterine growth retardation,EUGR)적발생솔,위기출원후진행생장발육감측화간예제공의거.방법 회고성조사광동성주강삼각주지구9개성시적9가의원신생인과우2010년7월1일지2011년6월30일기간출원적ELBWI/VBWI적주원자료,분별이출생시、출원시적체중재상응궁내생장속솔기망치적제10백분위수평이하(생장곡선적제10백분위)정의위IUGR、EUGR,분별계산각태령조、각체중조、단태여다태조적IUGR、EUGR발생솔,병계산각조EUGR교IUGR증가적발생솔.생장곡선삼조“Fenton생장곡선2003일태인、영인생장곡선(공조산인삼고)(WHO생장표준판)”.결과 318례ELBWI/VLBWI출생시IUGR발생솔위33.3％(106례),출원시EUGR발생솔위70.8％(225례).이출생태령(＜30주、＜32주、≥32주)진행분조통계,EUGR발생솔분별위55.7％ (68/122)、66.9％ (79/113)、94.0％ (79/83)(x2=34.964,P=0.000),교IUGR발생솔분별증가49.2％ (60/122)、51.3％ (58/113)、1.2％ (1/83) (x2 =63.024,P=0.000)；이출생체중(≤1200 g、≤1350 g、＞1350 g)진행분조통계,EUGR발생솔분별위83.8％ (88/105)、65.3％ (66/101)、63.4％ (71/112) (x2=13.009,P=0.001),교IUGR발생솔분별증가42.9％ (45/105)、35.6％ (36/101)、33.9％(38/112)(x2=2.045,P=0.360)；이단태화다태진행분조비교,칙IUGR、EUGR급EUGR교IUGR증가적발생솔,조간차이균무통계학의의(P＞0.05).결론 ELBWI/VLBWI출원시EUGR발생솔잉연흔고,출원시EUGR발생솔수출생태령적증가혹출생체중적강저이승고,차출원시EUGR교출생시IUGR증가적발생솔수출생태령적강저이승고,단EUGR발생솔여태수무명현상관성.
Objective To research the incidences of intrauterine growth retardation(IUGR) and extrauterine growth retardation (EUGR) of extremely and very low birth weight infants,which would be helpful to growth monitoring and therapeutic intervention after hospital discharge.Methods Clinical data of extremely and very low birth weight preterm infants,who discharged from July 1 st,2010 to June 30th,2011,were collected retrospectively from 9 neonatal intensive care units of 9 cities in Pearl River Delta,Guangdong province.The body weight at birth and on discharge of each infant was compared to the expected value based on the intrauterine growth data and postmenstrual day on discharge.Growth retardation was defined as measured body weight ≤ 10 th percentile of the expected value.In each specific group,the number of infants with ≤10 th percentile was counted and the percentages of patients who had values≤ 10 th percentile at birth and on discharge were calculated.And the increasing incidence from IUGR to EUGR in each specific group was also calculated.The growth curve used for assessing body weight of different gestational age infants was Fetal-infant Growth Chart for Preterm Infants (WHO Growth Standards version).Results Three hundred and eighteen cases of extremely and very low birth weight infants were enrolled in this research.The incidence of IUGR was 33.3％ (106/318),while the incidence of EUGR was 70.8％ (225/318).In each group divided by gestational age (＜ 30 week、＜ 32 week 、≥ 32 week),the incidence of EUGR were 55.7 ％ (68/122),66.9％ (79/113) and 94.0％ (79/83) (x2 =34.964,P =0.000),which increased by 49.2％ (60/122),51.3％ (58/113) and 1.2％ (1/83) from IUGR (x2 =63.024,P =0.000).In each group divided by birth weight(≤ 1200 g、≤ 1350 g、＞ 1350 g),the incidence of EUGR were 83.8％ (88/105),65.3％ (66/101)and 63.4％ (71/112) (x2 =13.009,P =0.001),which increased by 42.9 ％ (45/105),35.6 ％ (36/101) and 33.9％ (38/112) from IUGR (x2 =2.045,P =0.360).But there were no significant difference between single fetus and multiple fetuses (P ＞ 0.05).Conelusion EUGR was still a serious problem in extremely and very low birth weight infants.The incidence of EUGR increased while the gestational age was increasing or birth weight was decreasing.And the increasing incidence from IUGR to EUGR increased while gestational age was decreasing.But there was no significant association with the number of fetus.