483例早产儿并发症及院内感染病原菌分析

目的：分析不同胎龄及出生体重早产儿并发症情况以及感染病原菌种类。方法将2008年1月至2010年12月在我院住院的483例早产儿根据出生体重分为＜1500 g、1500～2500 g、≥2500 g组,根据胎龄分为＜32周、32～34周、34～37周组,比较各组并发症发生率及感染病原菌种类的差异。结果（1）各系统并发症：呼吸系统并发症最为常见,除神经系统外,胎龄越小,出生体重越低,各系统并发症的发生率越高,差异均有统计学意义（P＜0.05）,而神经系统并发症在不同出生体重的患儿中差异无统计学意义（ P＞0.05）,在32～34周胎龄组及≥2500 g组发生率较其他组为高（ P＜0.05）;（2）疾病种类：呼吸系统疾病、喂养不耐受、贫血、动脉导管未闭、低血糖、电解质紊乱、代谢性酸中毒在不同胎龄及出生体重组之间差异有统计学意义（P＜0.05）,胎龄及出生体重越小,发生率越高;新生儿缺氧缺血性脑病、高胆红素血症在不同胎龄及出生体重组之间差异无统计学意义（P＞0.05）。（3）痰培养阳性率为14.7％（71／483）,以革兰阴性杆菌为主,肺炎克雷白杆菌、假单胞菌属及鲍曼不动杆菌最为常见。不同胎龄及不同出生体重组痰培养阳性率差异有统计学意义（P＜0.05）,胎龄及出生体重越小,阳性率越高。结论早产儿并发症的发生率与胎龄及出生体重有关,胎龄及出生体重越小,发生率越高。病原菌种类以革兰阴性杆菌为主,且胎龄及出生体重越小,阳性率越高。     

新生儿早期血脂水平的调查

为了解新生儿早期血脂水平与性别、孕周、出生体重的关系，检测了93例不同性别、孕周，不同出生体重的新生儿，生后24～48小时内早晨空腹时血清甘油三脂（Tg）、胆固醇（Tc）、载脂蛋白A（apo-A1）、载脂蛋白β（apo-β）。显示生后24～48小时内血清Tg Tc apo-A1 apo-β，男婴与女婴无显著差异，早产适于胎龄儿与足月适于胎龄儿无显著差异，足月不同出生体重的新生儿无显著差异。新生儿早期血脂水平与性别、孕周、出生体重无关。     

早产儿早期血脂代谢特点及与新生儿呼吸窘迫综合征关系探讨

目的：了解早产儿早期血脂代谢特点及其与新生儿呼吸窘迫综合征（RDS）的关系。方法：将100例适于胎龄早产儿按胎龄或出生体重分组,并以40例足月适于胎龄儿作为对照组,于出生后12 h内静脉采血,测定血浆总胆固醇（TC）、甘油三脂（TG）,低密度脂蛋白胆固醇（LDL-C）及高密度脂蛋白胆固醇（HDL-C）水平;另外,分别根据胎龄及出生体重进一步比较发生RDS与未发生RDS早产儿的血脂水平。结果：随胎龄及体重增加,TG水平呈递增趋势,28~30周组及31~33周组早产儿血浆TG水平均明显低于34~36周早产儿及足月儿（P<0.01）;出生体重≤1499 g组及1500~2499 g组早产儿血浆TG水平均明显低于出生体重≥2500 g早产儿及足月儿（P<0.05）,且出生体重≤1499 g组与1500~2499 g组早产儿之间TG水平差异亦有统计学意义（P<0.01）;而各组新生儿HDL-C、LDL-C及TC水平差异无统计学意义。RDS与非RDS早产儿血浆TC、LDL-C及HDL-C水平差异亦无统计学意义;但在胎龄28~30周组,RDS早产儿的TG水平比非RDS早产儿明显降低（P<0.05）;体重≤1499 g RDS早产儿TG水平低于非RDS早产儿（P<0.05）。结论：早产儿血脂水平与胎龄及体重相关,低TG水平可能是胎龄28~30周及体重≤1499 g早产儿出现RDS的原因之一。     

新生儿早期血脂水平的调查

为了解新生儿早期血脂水平与性别、孕周、出生体重的关系,检测了93例不同性别、孕周,不同出生体重的新生儿,生后24～48小时内早晨空腹时血清甘油三脂(Tg)、胆固醇(Tc)、载脂蛋白A(apo-A1)、载脂蛋白β(apo-β).显示生后24～48小时内血清Tg Tc apo-A1 apo-β,男婴与女婴无显著差异,早产适于胎龄儿与足月适于胎龄儿无显著差异,足月不同出生体重的新生儿无显著差异.新生儿早期血脂水平与性别、孕周、出生体重无关.     

新生适于胎龄儿骨转换标志物与骨声波传导速度的关系

目的：研究新生适于胎龄儿Ⅰ型前胶原羧基端前肽（PICP）、尿脱氧吡啶啉（DPD）及骨声波的传导速度（SOS）随胎龄变化的规律,探讨骨转换标志物和骨SOS的关系。方法：共选取65例新生适于胎龄儿为研究对象,根据胎龄分为早产儿组（≤34周,14例）,晚期早产儿组（>34周至<37周,13例）,足月儿组（≥37周,38例）。所有研究对象均测量出生体重、身长,采用Ponderal指数（PI）估测新生儿营养状态;生后7?d内采集静脉血测定血PICP水平;收集尿液测定尿DPD、尿肌酐（Cr）水平;生后7 d内超声定量技术测量左侧胫骨声波的传导速度（SOS）。结果：胎龄、出生体重、身长及PI值在3组间的差异均有统计学意义（分别F=140.199、47.042、46.877、11.898,均P<0.01）,且出生体重、身长和PI值随胎龄增加而增加。3组之间PICP、DPD/Cr、SOS的差异有统计学意义（分别F=30.384、21.761、20.052,均P<0.01）,且胎龄越大,PICP及DPD/Cr水平越低,骨SOS越高。PICP、DPD/Cr水平与胎龄、出生体重及骨SOS呈负相关（P<0.01）;而骨SOS与胎龄和出生体重呈正相关（P<0.01）,在校正了胎龄、出生体重后依然存在相关关系。结论：新生适于胎龄儿骨转换生化指标和胎龄、出生体重及骨SOS呈负相关;新生适于胎龄儿的高骨转换状态对骨健康不利。     

足月小于胎龄儿胃饥饿素、胰岛素样生长因子-1及瘦素关系的研究

目的探讨胃饥饿素（Ghrelin）、胰岛素样生长因子-1（IGF-1）及瘦素（Leptin）在足月小于胎龄儿（SGA）中的作用及其关系。方法本院产科出生的足月SGA和适于胎龄儿（AGA）各30例,生后测量体重、身长、头围,并计算体重指数（BMI）,生后第3天测定血Ghrelin、IGF-1及Lep-tin水平。结果 SGA组体重、身长、头围、BMI均明显低于AGA组[（2280±190）g比（3220±320）g,（46.3±1.8）cm比（50.5±2.0）cm,（31.8±1.1）cm比（33.6±1.1）cm,（10.6±0.8）cm比（12.6±0.9）cm,P均〈0.05]。SGA组血清IGF-1及Leptin水平均低于AGA组[（49.6±10.3）μg/L比（55.3±9.9）μg/L,（2.4±0.8）μg/L比（3.0±1.0）μg/L],血浆Ghrelin水平高于AGA组[（25.2±11.0）μg/L比（17.3±7.4）μg/L],P均〈0.05。两组IGF-1与体重呈正相关,Leptin与体重、身长呈正相关,Ghrelin与体重、BMI呈负相关,P均〈0.05。两组Ghrelin水平与IGF-1呈负相关,IGF-1与Leptin呈正相关;SGA组Ghrelin水平与Leptin呈负相关,P均〈0.05。结论生后早期SGA新生儿存在高Ghrelin、低IGF-1、低Leptin水平状态。Ghrelin、IGF-1及Leptin共同参与胎儿宫内营养的调节,相互起协同及拮抗作用。     

伊朗伊斯法罕新生儿重症监护中心新生儿气胸的发病因素、发生率和死亡率调查

目的：该研究旨在调查伊朗伊斯法罕新生儿重症监护中心(NICU) 住院新生儿气胸的发病因素、发生率和死亡率。方法：738 例入住NICU的新生儿中,43例发生了气胸。回顾性分析气胸患儿的临床资料,包括胎龄、出生体重、Apgar评分、出生方式、母亲年龄、产次、围产期窒息、出生时复苏、气胸发生部位、机械通气情况、肺表面活性物质治疗、肺部疾病等。结果：气胸患儿平均胎龄为31周,出生体重为1 596 g。12例（28%）患儿胎龄小于28周。28例（65%）出生体重低于1 500 g。共43 例(5.8%)新生儿发生了气胸。97%的气胸为单侧（n=63),双侧气胸仅占3%（n=2）。呼吸窘迫综合征(40/43, 93%)和机械通气(37/43, 86%)是导致气胸发生的常见原因。共28例(65%)患儿死亡。死亡患儿与幸存患儿出生体重、胎龄及胸管留置时间差异有统计学意义。需要肺表面活性物质治疗的气胸患儿死亡率显著增加,与无需表面活性物质治疗的气胸患儿比较差异有统计学意义。结论：该研究中气胸的发生率与死亡率高于其他报道,其原因可能是该研究中新生儿出生体重和胎龄都较低。呼吸窘迫综合征和机械通气是导致新生儿气胸发生的常见原因。患儿胎龄越小,体重越低,肺部疾病越严重,死亡率则越高。     

早产儿新生儿期疾病的流行病学调查

目的：探讨住院早产儿新生儿期疾病分布情况及影响其转归的因素。方法：对长沙市三家医院2008年961例住院早产儿资料进行调查。结果：呼吸系统疾病最常见,占73.8%,其次为新生儿感染（败血症）（39.4%）和神经系统疾病（38.3%）。不同胎龄、不同出生体重早产儿循环系统疾病的发生率差异无统计学意义（P>0.05）,但呼吸系统疾病、新生儿感染（败血症）、神经系统疾病等其他疾病的发生率及生后28 d治愈、好转率各组间差异均有统计学意义（P<0.05）。胎龄、出生体重增加是住院早产儿生后28 d结局的保护因素,新生儿窒息、高胆红素血症、新生儿硬肿症等是危险因素。结论：住院早产儿新生儿期常见疾病为呼吸系统疾病、新生儿感染（败血症）、神经系统疾病;随胎龄、出生体重增加,多数疾病的发生率呈下降趋势,治愈、好转率呈上升趋势。住院早产儿生后28 d转归的保护因素是胎龄和出生体重增加,危险因素有新生儿窒息、高胆红素血症、新生儿硬肿症等。     

成都市9~15岁儿童出生情况与体格指标流行病学调查

目的：宫内环境可能对儿童生长发育产生影响,通过流行病学调查研究四川省成都市9~15岁儿童出生胎龄、体重与体格发育指标的关系。方法：调查9~15岁的中小学学生共7194名,根据出生胎龄及体重对儿童进行分类（包括小于胎龄儿、适于胎龄儿、大于胎龄儿）,测量身高、体重,并对其家长进行问卷调查。结果：被调查人群小于胎龄儿发生率为6.23%（448例）,其中身高未出现“追赶生长”（低于均值两个标准差）为5.13%,且多个年龄段儿童平均身高低于适于胎龄儿（P<0.05）。大于胎龄儿发生率为18.06% (1299例),大于胎龄儿中超重发生率为13.78% (179 例),肥胖发生率为4.39%（57例）,且多个年龄段儿童平均体重大于适于胎龄儿（P<0.05）。结论：出生时为小于胎龄儿、大于胎龄儿的儿童在远期生长发育中,可以出现身高和体重异于正常儿童,应关注这类孩子在学龄期的身高体重发育情况。     

脑源性神经营养因子与新生儿出生体重的关系

目的：该文通过检测新生儿脐血脑源性神经营养因子（brain-derived neurotrophic factor,BDNF）的水平,探讨BDNF与新生儿出生体重的关系,并对相关因素进行分析。方法：根据出生体重,将51 例足月第1胎健康新生儿分为3 组:①小于胎龄组（SGA）8例;②适于胎龄组（AGA ）31例;③大于胎龄组（LGA）12例。测量新生儿身长、体重及其母亲的身高、体重,并对脐血中BDNF、瘦素（LEP）、胰岛素（INS）、总胆固醇（TC）、甘油三酯（TG）进行检测。结果：SGA组的BDNF明显高于AGA组和大于LGA组,AGA组和LGA组中BDNF没有差异;多元逐步回归分析显示BDNF值与新生儿出生体重、体重指数存在负相关关系。LEP与BDNF不呈相关趋势（P>0.05）,INS与BDNF也不呈相关趋势（P>0.05）。INS 与LEP呈现正相关（P<0.05）。LEP与新生儿体重、产妇体重及其BMI呈正相关,而TC,TG在3组新生儿中差异无显著性。结论：BDNF是新生儿体重的重要影响因素,而且不受LEP,INS的影响。     

Birth weight categorization according to gestational age does not reflect percentage body fat in term and preterm newborns

This study was performed to prove the applicability of the small-for-gestational age (SGA), appropriate-for-gestational age (AGA), and large-for-gestational age (LGA) classification depending on birth weight to predict percentage body fat (%BF) measured by dual-energy X-ray absorptiometry (DXA) in term and preterm infants. The data of 159 healthy term and preterm neonates (87 boys and 72 girls) with a gestational age at delivery of 38.4 weeks from two longitudinal studies were analyzed. Anthropometry and body composition data were assessed within the first 10 days after birth. Correlations between anthropometric parameters and fat mass measured by DXA were calculated. Prevalences of observations with low, middle, and high %BF measured by DXA were compared between SGA, AGA, and LGA groups, according to sex and gestational age. In term infants, 42.9% of the newborns with less than 10% body fat were classified to be AGA; 9.9% of all AGA newborns had less than 10% body fat. For the whole group, among the ratios investigated, the weight-length ratio (r=0.82) showed the best correlation to fat mass measured by DXA. The %BF at the time of study was higher in girls (14.75%) than in boys (11.95%). In conclusion, traditional classification based on birth weight centiles does not reflect %BF in term and preterm newborns.     

Risk factors to periventricular-intraventricular hemorrhage in newborns weighing less than 2000g

OBJECTIVE: To study the incidence and analyze risk factors to neonatal periventricular-intraventricular hemorrhage; to suggest a working protocol for diagnosis in newborns at risk.METHODS: This is a cohort prospective study including 120 out of 129 children weighing less than 2000g born from May 18 th, 1994 to May 17 th,1995 at the Hospital das Clínicas da UFMG. The study group comprised 39 newborns with the ultrasound diagnosis of periventricular-intraventricular hemorrhage; the control group comprised 81 newborns who although submitted to the same evaluation protocol did not show any echographic signs of hemorrhage. The ultrasound examinations were all done by the same researcher who was not aware of the clinical history or the neurologic and laboratory examinations. The hemorrhage was classified according to Papilés criteria: grade I (13%); grade II (7%); grade III (9%) and grade IV (3%).RESULTS: Low gestational age, low birth weight, masculine sex, vaginal delivery, and neonatal sepsis were significantly associated (p < 0.05) with periventricular-intraventricular hemorrhage in univariate analysis. Apgar score in the first or fifth minute and Battagliás and Lubchenkós classification for the weight in relation to gestational age were not predisposing factors to the hemorrhage. Low gestational age (p = 0.002), vaginal delivery (p = 0.037), and masculine sex (p = 0.016) kept statistical significance after multivariate adjustment. Birth weight may substitute for gestational age in the multivariate model because they are highly associated. The best cutoff point to screen for periventricular-intraventricular hemorrhage was 1750 g instead of the traditionally adopted point of 1500 g. CONCLUSIONS: The incidence of neonatal periventricular-intraventricular hemorrhage was similar to those reported by other studies. Low gestational age or low birth weight, vaginal delivery and masculine sex were the most important risk factors to the hemorrhage. The screening cutoff point of 1750 g seems to be more adequate than the commonly used birth weight of 1500 g.     

Retinal hemorrhages in newborn--fetal causative factors

Two hundred and eight alive newborns examined within 2 hours of birth showed 37.50% incidence of retinal hemorrhage (RH). Out of these, 38.59% were full term and 29.17% were preterm. Head circumference had a significant correlation (p less than 0.05) with retinal hemorrhage, while sex of the newborn, birth weight, gestational age and fetal distress showed no significant correlation. Birth injuries especially ocular and periocular injuries showed a significantly higher incidence of retinal hemorrhage (83.33%).     

不同胎龄新生儿身长体重指数研究

目的 制定不同胎龄新生儿身长体重指数,为胎儿宫内发育评价提供参考数据。方法 采用横断面时间段整群抽样实况调查方法,于2005~2006年在深圳宝安区妇幼保健院完成了8 357例不同胎龄新生儿体重、身长、顶臀长、头围、胸围现场测量,用以制定不同胎龄新生儿身长体重指数。结果 计算深圳不同胎龄(孕28~44周)不同性别新生儿身长体重五项指数[克托莱指数(QI)、考浦指数(KI);劳雷尔指数(RI);利比指数(LI);勃洛克指数(PI)],以均数±标准差表示。结果五项身长体重指数都随胎龄增加指数值不断递增,峰值出现在孕41~43周,显示了胎儿胎龄增大人体密度和充实度不断提高。男性QI、KI和PI值高于女性(P结论 不同胎龄新生儿随胎龄增加人体密度和充实度不断提高,男婴充实度比女婴好。     

Reference ranges for sonographic renal dimensions in preterm infants

Background

Ultrasonographic measurement of kidney dimensions is important in evaluation of renal disease in preterm infants who have multiple comorbidities that affect renal function.

Objective

The purpose of this study was to determine the reference ranges of kidney dimensions in preterm newborns and to provide a chart to use easily in daily practice.

Materials and methods

We evaluated renal dimensions in 498 preterm infants with a gestational age of <37 weeks using sonography within the first week of life. We statistically analyzed the relationships between all dimensions and gender, gestational age (based on the last menstrual period), height and weight. Minimum and maximum values of dimensions were defined.

Results

All dimensions of the kidneys were statistically different in boys and girls (P?<?0.05). Both longitudinal and anteroposterior dimensions of the right and left kidneys showed high correlation with gestational age, weight and height in girls and boys. Weight correlated best with dimensions.

Conclusion

Nomograms from these data can be used to determine an abnormality in kidneys of preterm newborns.     

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目的分析早产儿支气管肺发育不良(BPD)的发生率和危险因素,探讨防治BPD的措施。方法回顾性分析中山大学第一附属医院新生儿科1999年6月至2004年6月期间胎龄≤32周且出生体重≤2000g,存活时间>28d的早产儿72例,比较机械通气治疗中15例BPD(BPD组)和31例非BPD(对照组)患儿性别、胎龄、出生体重、生前使用糖皮质激素、生后使用肺表面活性物质、肺透明膜病、机械通气时间、呼吸支持条件、胃食管反流、动脉导管未闭、生后早期液体摄取量、反复肺部感染情况。结果早产儿BPD的总发生率为20.83%(15/72),其中<1500g早产儿BPD的发生率为38.71%(12/31);BPD组FiO2、PIP、PEEP和MAP与对照组差异无显著性意义(P>0.05);多因素Logistic回归显示,胎龄<30周、体重<1250g、机械通气≥10d和反复肺部感染是发生BPD的独立危险因素(P<0.05),而性别、生前使用糖皮质激素、生后使用肺表面活性物质、肺透明膜病、胃食管反流、动脉导管未闭、生后早期液体摄取量没有统计学意义(P>0.05)。结论避免低体重早产、长时间机械通气和有效控制肺部感染是防治BPD的关键。     

Reference ranges of kidney dimensions in term newborns: sonographic measurements

Background

Ultrasonographic measurement of kidney dimensions is important in evaluation of renal disease during the neonatal period, when renal abnormalities are common and renal size rapidly changes with age.

Objective

To determine the reference ranges of kidney dimensions in newborns and to provide a reference chart for daily practice.

Materials and methods

In this prospective study, kidney dimensions were evaluated in 385 healthy newborns with a gestational age ≥37 weeks. Each neonate seen at an obstetrics clinic and neonatal intensive care unit was examined with sonography within the first week of life. Relationships of all dimensions with gender, gestational age, height and weight were statistically analyzed.

Results

All dimensions of the kidneys were smaller in girls than in boys (P?P?P?P?Conclusion The reference values of kidney lengths and diagrams from this study may be useful in the sonographic evaluation of kidneys in newborns.     

新生儿出生后24小时内凝血功能检测的临床意义分析

目的探讨不同胎龄以及不同体重新生儿凝血功能指标的差异,为判断凝血功能指标的临床意义提供参考。方法2015年1月至2018年12月期间,在解放军总医院第五医学中心新生儿科住院治疗的新生儿中,纳入170例胎龄28~42周、出生8 h内入院的新生儿,其中男性87例,女性83例。按胎龄分为早期早产儿组、晚期早产儿组和足月儿组。按新生儿出生体重分为正常出生体重组、低出生体重组和极低出生体重组。按是否小于胎龄分为早产适于胎龄儿组、早产小于胎龄儿组、足月适于胎龄儿组、足月小于胎龄儿组。于生后24 h内抽取静脉血,检测活化部分凝血活酶时间(activatedpartial thromboplastin time,APTT)、凝血酶原时间(prothrombin time,PT)、纤维蛋白原(fibrinogen,FIB)、凝血酶时间(thrombin,TT)及D-二聚体(D-dimer)。结果早期早产儿组的APTT、PT、D-二聚体水平均高于晚期早产儿组及足月儿组(P值均<0.05),FIB水平低于晚期早产儿组及足月儿组(P值均<0.05);晚期早产儿组的APTT、PT水平均高于足月儿组(P值均<0.05),但两组间D-二聚体、FIB水平比较,差异无统计学意义(P值均>0.05)。极低出生体重组的APTT、PT、D-二聚体水平均高于低出生体重组及正常出生体重组(P值均<0.05),FIB水平低于低出生体重组及正常出生体重组(P值均<0.05);低出生体重组的APTT、PT水平均高于正常出生体重组(P值均<0.05),但两组间D-二聚体、FIB水平比较,差异无统计学意义(P值均>0.05)。早产小于胎龄儿组D-二聚体水平高于早产适于胎龄儿组(P<0.05),其余指标比较差异无统计学意义(P值均>0.05);足月适于胎龄儿与足月小于胎龄儿组的凝血指标比较,差异均无统计学意义(P值均>0.05)。早产儿出血发生率高于足月儿[26.6%(29/109)与8.2%(5/61),χ^2=9.019,P=0.003]。结论新生儿凝血指标有胎龄和体重差异,胎龄越小、体重越低的新生儿凝血功能越不完善。     

Proportionality of small-for-gestational age babies at birth: perinatal associations and postnatal sequelae

Head and chest circumference and crown-rump length measurements were obtained for 413 small-for-gestational age (SGA) infants at birth; and head-chest, head-crown-rump and chest-crown rump ratios derived. There was an inverse correlation between head-chest ratios and gestational age, and boys had higher ratios than girls. First-born infants, and those whose mothers had pre-eclampsia had higher ratios than the rest, and higher ratios were associated with instrumental delivery. Higher ratios were also found for girls (but not boys) born to women of above average weight, and those who suffered birth asphyxia or other problems in the neonatal period. When adjustment was made for confounding between variables gestational age and sex were the only factors making a significant contribution to the variance in head-chest ratios at birth. SGA babies with relatively high head-chest ratios at birth grew faster than those with lower ratios during the first 6 mth of life. Girls with above-average ratios were heavier and had larger heads at the age of 7 yr, but no differences were found for either sex in any aspect of developmental ability at 7 yr associated with head-chest ratios at birth.     

早产儿体重增长的动态评估及其意义

目的 研究早产儿宫内外生长迟缓发生率情况;显示该组人群婴儿时期生长模式.方法 回顾分析2002年1月至2009年4月,我院新生儿重症监护病房(Neonatal Intensive Care Unit,NICU)住院治疗,并坚持出院后随访的早产儿.入选标准:胎龄<37周;单胎;生后24 h内入院;住院时间≥14 d;出院后至少随访至校正年龄3个月.住院期间对早产儿宫内、外生长迟缓、生后2周及校正胎龄38～40周时仍住院患儿生长迟缓(≤生长曲线的第10百分位)情况进行描述,并对随访期早产儿生长迟缓情况及体重增长趋势进行描述.结果 符合纳入标准患儿共计239例(男135例,女104例),以体重评价,IUGR及出院时EUGR发生率分别为25.5%及40.6%,IUGR及出院时EUGR发生率均随体重减少而增加,未呈现随胎龄增加而降低的趋势.校正胎龄38～40周仍住院者生长迟缓发生率为61.8%.婴儿期校正年龄生长迟缓发生率38～40周20.5%,28 d 15%,61 d 8.8%,91 d17%,122 d 10.4%,152 d 10.1%,183 d 11.9%及274 d 7.4%,校正年龄3个月后生长迟缓发生率未再进一步降低.校正年龄6个月时女童生长迟缓发生率(19.3%)高于男童(3.8%)(x2=6.181,P=0.017).胎龄<32周、出生体重≤1500 g者中仅男童胎龄<32周者于校正年龄2个月及4个月时平均体重高于生长曲线第50百分位,余婴儿期平均体重低于生长曲线第50百分位.结论 早产/低出生体重儿是生长迟缓的高危人群,极低出生体重儿问题较为突出.生长迟缓问题随年龄增加有所减轻,远期预后有待进一步随访.