早产儿/低出生体重儿和足月儿配方粉对住院早产儿生长发育影响的多中心对照研究

目的研究不同组成成分的配方粉对胎龄<34周和（或）出生体重＜2 000 g的住院早产儿早期生长发育的影响，并对早产儿的喂养提出建议 。方法受试对象为上海市3家医院住院的胎龄＜34周或出生体重＜2 000 g的早产儿。分为两组，分别应用Ⅰ号（早产Ⅰ组）和Ⅱ号（早产Ⅱ组 ）配方粉进行喂养。研究采用严格的盲法，试验设计者不参与试验实施，数据整理者为独立的第3方人员，参与试验的医生和患儿家长对两种配 方粉的具体组成成分均不知情。Ⅰ号为适于早产儿的优博早产儿/低出生体重儿配方粉，Ⅱ号为足月儿或胎龄>34周早产儿的优博标准婴儿配方 粉。结果2007年7月至2008年6月，早产Ⅰ组117例，早产Ⅱ组106例进入分析。早产Ⅰ组体重、身长和头围的生长速度均显著快于早产Ⅱ组。试 验期间早产Ⅰ组和早产Ⅱ组的平均体重增加速度分别为12.6 g·kg-1·d-1 和10.6 g·kg-1·d-1（P＜0.001），头围每周增长分别为0.86 cm 和0.80 cm（P＜0.05），身长每周增长分别为0.73 cm和0.67 cm（P＜0.05）；按生理性体重下降恢复后计算，早产Ⅰ组和早产Ⅱ组的平均体重 增加速度分别为16.2 g·kg-1·d-1和14.1 g·kg-1·d-1（P＜0.001），头围每周增长分别为0.96 cm和0.87 cm（P＜0.05），身长增长分别为 1.08 cm和0.99 cm（P＜0.05）。早产Ⅰ组的宫外发育迟缓（EUGR）发生率（57.3％）低于早产Ⅱ组（72.5％）（P＜0.05）。结论在胎龄＜34 周或出生体重＜2 000 g的早产儿中，应用优博早产儿/低出生体重儿配方粉喂养对早产儿生长发育的影响明显优于优博标准婴儿配方粉，其体 重、身长和头围的生长速度都能够达到理想的宫内生长速度，也可明显降低EUGR的发生率。

Growth of preterm infants fed with preterm or term formula: A multicenter control trial

cnAbstractObjectiveTo evaluate the growth of preterm (gestational age <34 weeks)or low birth weight(birth weight < 2 000 g) infants fed with preterm or term formula during early postnatal stage and give the recommendation of preterm infant formula selection.MethodsThree neonatal intensive care units participated in this study in Shanghai. Neonates were involved if they were born less than 34 weeks of gestational age or birth weight less than 2 000 g. All neonates were randomly divided into preterm (group Ⅰ) or term formula (group Ⅱ) group. Independent investigators collected the data. Independent analysis accomplished all the statistical analysis using SPSS 10.0. The formula was supplied by Synutra International Inc. and all investigators were blinded except trial designer. ResultsThe rates of weight gain, linear growth and head growth were all higher in group Ⅰ as compared to group Ⅱ neonates. During the whole trial, the average weight gain was 12.6 g·kg-1·d-1 and 10.6 g·kg-1·d-1 in group Ⅰ and group Ⅱ respectively（P＜ 0.001）.The increase of head circumference was 0.86 cm per week and 0.80 cm per week（P＜0.05）and linear growth was 0.73 cm per week and 0.67 cm per week（P＜0.05）in group Ⅰ and Ⅱ respectively. If all these data were recalculated after regaining their birth weight, there was still statistical significance between two groups. The average weight gain was 16.2 g·kg-1·d -1 in group Ⅰ and 14.1 g·kg-1·d-1 in group Ⅱ（P＜0.001）.The increase of linear growth was 1.08 cm per week in group Ⅰ and 0.99 cm per week in group Ⅱ（P＜0.05）.The rate of head growth was 0.96 cm per week in group Ⅰ and 0.89 cm per week in group Ⅱ（P＜0.05）.Group Ⅰ also had lower incidence of EUGR（57.3％） than group Ⅱ (72.5％） (P＜0.05).ConclusionsPreterm infants fed with preterm formula had better growth than fed with term formula. The rates of weight gain, linear growth and head growth in infants fed with preterm formula could reach intrauterine growth rates. The incidence of EUGR was also significantly decreased in infants fed with preterm formula.