早产儿786例体格生长的纵向随访研究

目的 探讨出生至矫正6月龄早产儿体格生长规律,为早产儿保健提供指导。方法 对786例有完整随访资料的早产儿进行分析,所有研究对象均进行早期综合干预,定期随访至矫正6月龄。按出生胎龄(<32、32~33⁺⁶、34~35⁺⁶、36~36⁺⁶周)和出生体重与胎龄关系(小于、适于、大于胎龄儿)分别进行分组,使用混合效应模型分析早产儿体重、身长和头围的变化趋势。结果 四组不同出生胎龄早产儿体重、身长和头围的组间效应(F值分别为11.88、29.91、19.19)和时点效应(F值分别为7 678.78、11 922.57、7 913.78)的差异有统计学意义(P均<0.001);小于、适于和大于胎龄儿体重、身长和头围的组间效应(F值分别为88.01、79.36、50.27,P均<0.001)和时点效应(F值分别为1 192.38、1 836.58、1 225.71)的差异有统计学意义(P均<0.001)。矫正6月龄时,50%以上早产儿的三项指标处于我国足月儿参考值的第25至75百分位。结论 早产儿的体格生长与出生胎龄和体重密切相关,早期综合干预可促进早产儿体格生长。

Follow-up study on physical growth of 786 premature infants

Objective To explore physical growth of premature infants under corrected age of 6 months and to provide guidance on health care for premature infants. Methods A total of 786 premature infants with complete follow-up data were enrolled.All premature infants were offered early comprehensive intervention and followed up until corrected age of 6 months.Premature infants were divided into different groups according to gestational age (<32、32~33⁺⁶、34~35⁺⁶、36~36⁺⁶ weeks) and the relationship between gestational age and birth weight (small,appropriate and large for gestational age),respectively.Linear mixed model was used to assess changes in physical growth of premature infants. Results Weight,length and head circumference among different gestational age groups (F values were 11.88,29.91 and 19.19,respectively) and different corrected age points (F values was 7678.78,11922.57 and 7913.78,respectively) were significantly different(all P<0.001);Significant difference was also found on weight,length and head circumference among SGA,AGA and LGA infants (F values were 88.01,79.36 and 50.27,respectively,all P<0.001) and different corrected age points (F values were 1 192.38,1 836.58 and 1 225.71,respectively,all P<0.001).At corrected age of 6 months,more than 50% of premature infants were between the 25^th and the 75^th percentices of Chinese full-term infant reference. Conclusions Physical growth of premature infants is closely related to gestational age and birth weight.Early comprehensive intervention has positive effect on promoting physical growth of premature infants.