0~6月龄小于胎龄儿能量蛋白质摄入的前瞻性队列研究

目的 了解小于胎龄儿(SGA)6月龄前的能量和蛋白质摄入情况,为SGA的早期喂养指导提供依据。方法 用前瞻性队列研究的方法,将2013年9月-2015年5月在重庆医科大学附属儿童医院儿童保健科就诊的146人构成连续随访队列,其中SGA 63人,适于胎龄儿(AGA)83人,分别在3月龄、6月龄(早产儿为矫正胎龄后的3月龄、6月龄)对其进行体重、身长和头围的测量以及膳食调查。结果 SGA组3月龄每日能量摄入量(87.70±15.82)kCal/(kg·d)]大于6月龄(80.40±14.48)kCal/(kg·d)],差异有统计学(F=11.260,P=0.001),但均低于推荐摄入量90 kCal/(kg·d);SGA组3月龄每日能量摄入量与AGA组差异无统计学意义(LSD-t=0.333,P=0.740),6月龄大于AGA组(LSD-t=3.672、P<0.001)。SGA组3月龄每日蛋白质摄入量小于6月龄(10.65±2.94)g/d vs.(12.81±3.15)g/d,F=36.770,P<0.001],均高于推荐摄入量9 g/d;SGA组每日蛋白质摄入量3月龄小于AGA组(LSP-t=-2.023,P=0.045)、6月龄与AGA组差异无统计学意义(LSD-t＝-0.072,P=0.943)。结论 SGA维持正常的体格生长需要较高的蛋白质,而不需要高于推荐值的能量。

A prospective cohort study on energy and protein intake of small-for-gestational-age infants under 6 months

Objective To investigate the energy and protein intake of small for gestational age(SGA) infants under 6 months of age, in order to provide basis for early feeding guidance of SGA. Methods Participants were prospectively enrolled from Department of Child Health Care of the Children's Hospital of Chongqing Medical University from September 2013 to May 2015. Totally 146 infants including 63 SGA and 83 appropriate-for-gestational-age(AGA) infants were selected according to the inclusion and exclusion criteria. And their weight,length,head circumference and dietary conditions were evaluated at age of 3 and 6 months(the premature were valuated at adjusted age of 3 and 6 months).Results The energy intake of SGA group in 3-month-old infants (87.70±15.82)kCal/(kg·d)] was significantly higher than that in 6-month-old infants (80.40±14.48)kCal/(kg·d)](F=11.260,P=0.001),both of which were lower than the adequate intake of 90 kCal/(kg·d). Compared with AGA group,the energy intake of SGA group was not significantly different in 3 months(LSD-t=0.333, P=0.740),and significantly higher in 6 months(LSD-t=3.672, P＜0.001). The protein intake of SGA group at the age of 3 months old was significantly lower than that of 6-month-old SGA(10.65±2.94) g/d vs.(12.81±3.15) g/d,F=36.770,P＜0.001)],both of which were higher than the adequate intake of 9 g/d. Compared with AGA group,the protein intake of SGA group was significantly lower in 3-month-old infants(LSD-t=-2.023,P=0.045),and not significantly different in 6-month-old infants(LSD-t=-0.072,P=0.943). Conclusion SGA infants need high intake of protein but no more than adequate intake of energy to keep normal physical growth.