A Multicenter Study On The Influencing Factors Of Extrauterine Growth Retardation In Very Low Birth Weight Infants And Follow-up Of Prognosis

Objective:1.To investigate the incidence and risk factors of extrauterine growth retardation(EUGR)in very low birth weight infant(VLBWI)discharged from hospital in Shandong Province.2.To explore the catch-up growth and risk factors of very low birth weight infants with EUGR within 1-6 months after discharge.Methods:1.A total of 607 very low birth weight infants were selected from neonatal intensive care units of 32 hospitals in Shandong Province from january 1 to june 30,2019,the basic information at birth,maternal diseases during pregnancy,complications during hospitalization and feeding status were collected.The patients were divided into EUGR group and non EUGR group according to the growth and development indicators at discharge(weight,length and head circumference at discharge as evaluation criteria).2.The 62 cases of very low birth weight infants with EUGR in Linyi people’s Hospital from January to December 2019 were followed up regularly within 1-6months.The adjusted gestational age was 40 weeks,and the follow-up time was 1 month,3 months and 6 months,according to the weight at the time of follow-up,they were divided into growth retardation group and non growth retardation group.To analyze the situation and influencing factors of EUGR very low birth weight infants with growth retardation after discharge.Results:1.In january-june 2019,607 cases of very low birth weight infants under 32 weeks were included in the multi-center cooperation group of Shandong Province,the incidence of EUGR was 53.2% when the anygrowth index was lower than the 10 th percentile level of the mean growth index of the same gestational age at discharge,the incidence of EUGR was 52.7%,25.4% and 24.2% respectively according to the weight,head circumference and body length.The incidence of EUGR was 66.4% in very low birth weight infants.Compare EUGR group and non-EUGR group of very low birth weight infants,small for gestational age,severe asphyxia,BPD,NEC,RDS,neonatal sepsis,maternal hypertension,abnormal amniotic fluid,birth weight,small for gestational age,average daily weight gain,duration of invasive ventilator,days of fasting,start feeding time,duration of intravenous nutrition Total enteral feeding time and hospital stay,the differences were statistically significant(P<0.05);multiple logistic regression analysis showed that the incidence of EUGR was significantly correlated with SGA(OR=390.125,95%CI: 53.431-2848.491),birth weight(OR=1.007,95%CI: 1.004-1.011),days of fasting(OR=0.709,95%CI: 0.586-0.856),average daily weight gain(OR=2.483,95%CI:2.030-3.037),time of recovery of birth weight(OR=0.497,95%CI: 0.423-0.585)and hospital stay(OR=1.122,95%CI: 1.069-1.178),P<0.05.2.Follow-up study included 62 cases of very low birth weight infants with EUGR in Linyi People’s Hospital.When the follow-up adjusted age was 1 month,3 months,and 6months,the incidence of growth retardation using weight as the evaluation standard was54.8%,35.4%,and 27.1%.Univariate analysis of EUGR very low birth weight infants after discharge from the hospital with correction age of 1 month growth retardation group and non-growth retardation group,there are statistically significant differences between BPD,small for gestational age,diarrhea,and intensive breastfeeding(P<0.05).Univariate analysis of EUGR very low birth weight infants after discharge from the hospital with correction age of 3 month growth retardation group and non-growth retardation group,there are statistically significant differences between BPD,gestational age at birth,small for gestational age,anemia,intensive breastfeeding and exclusive breastfeeding(P <0.05).Univariate analysis of EUGR very low birth weight infants after discharge from the hospital with correction age of 6 month growth retardation group and non-growth retardation group,there are statistically significant differences between BPD,small for gestational age(P<0.05).Multivariate logistic regression analysis found that at adjusted age of 1,3 and 6 months,small for gestational age and BPD is a risk factor for growth retardation,and intensive breastfeeding is a protective factor(P<0.05).Conclusion:1.At present,the incidence of EUGR in very low birth weight infants in Shandong Province is 53.2%,which is still at a high level,small for gestational age,low birth weight,nutritional support and length of hospital stay were independent risk factors for EUGR.2.The incidence of growth retardation in EUGR very low birth weight infants after discharge is gradually decreasing with age,smaller than gestational age and BPD is a persistent risk factor for growth retardation within 6 months of corrected age,and intensive breastfeeding is its protective factor.