| Objective:1. To study the outcome of ELBW/VLBW infants discharged from NICU at discharge and the incidence of EUGR in ELBW/VLBW infants in NICU, and to analyze the risk factors correlating with EUGR.2. To evaluate the long-term outcome of ELBW/VLBW infants discharged from NICU at18-24months corrected age and to analyze its impact factors.Methods:The ELBW and VLBW infants who were discharged from January2006to May2007from the neonatal department of our hospital were selected for study. Clinical datas including basic characteristics, diagnosis and feeding related informations were collected. Regular follow up was performed after discharge from hospital. Before1year corrected age, growth measurements (weight, height and head circumference) and neurological assessment (Amiel-Tison method) were performed during follow up. At18-24months corrected age, growth measurements and neurodevelopmental assessment were done again(using Bayley Infant Development Scale-II). Investigate the outcomes of ELBW/VLBW infants discharged from NICU at discharge and the incidence of EUGR in ELBW/VLBW infants, and to analyze the risk factors correlating with EUGR. The long-term outcome of ELBW/VLBW survivors at18-24months corrected age was evaluated. The risk factors of mental delay were analyzed. SPSS11.5was useed to analyse. The t-test, chi-square and logistic regression analysis were use to analyse.Results:1. There are total94ELBW/VLBW infants discharged from NICU enrolled in the study. EUGR occurred in78cases (82.9%) at discharge. Sixteen cases (17.1%) grew normaly. The incidences of RDS, BPD, apnea, sepsis, gastroesophageal reflux, extrauterine growth retardation in infants of GA≤30weeks group were significantly higher than those of GA>30weeks group, P<0.05. The occurrences of sepsis, anemia of prematurity and SGA in the infants of EUGR group were significantly higher than those of the normal growth group. TPN duration and the ages of achieving full enteral feeding were significantly longer in infants of EUGR group than those of the normal growth group, P<0.05. Risk factors in logistic regression analysis showed the OR and95%confidence interval of sepsis, anemia of prematurity, SGA and TPN duration were8.674(1.420-52.652),4.865(1.059-22.348),11.591(1.458-92.143) and1.201(1.016-1.419), respectively.2. Fifty-four cases completed the follow-up at18-24months corrected age. The mean gestational age of54follow-up cases is29.97±2.05weeks, mean birth weight is1227.63±199.99grams. Nine cases (16.7%) are ELBW infants, and45cases (83.3%) are VLBW infants. The mean MDI was86.31±18.26, and mean PDI was80.61±15.78. Four cases (7.4%)had cerebral palsy. No case had hearing impairment needing a hearing aid or blindness. Neurodevelopmental impairment occurred in15cases (27.7%). Mental delay (MDI <85) occurred in22cases (40.7%). Growth retardation occurred in19cases (35.2%). The occurrences of cesarean section, IVH, sepsis, ROP and anemia of prematurity in the mental delay group were significantly higher than those of normal group, P<0.05. Psychomotor developmental index (PDI) of mental delay group was also significantly lower than that of than normal group(69.72±14.22vs88.09±12.13, P<0.001). Logistic regression analysis showed odds ratio and95%confidence interval of sepsis, cesarean section and anemia of prematurity were6.001(1.003-35.908),10.047(1.082-93.335),14.507(1.063-197.935), respectively.Conclusions:1. ELBW/VLBW infants in NICU are prone to have many neonatal diseases and premature complications. ELBW/VLBW infants in NICU are also easy to develop extrauterine growth retardation. Sepsis, anemia of prematurity, SGA and long TPN duration are the risk factors of EUGR.2. The ELBW/VLBW infants in NICU are at high-risk to have adverse long term outcomes. Sepsis, cesarean section and anemia of prematurity are the risk factors of mental delay.3. A good follow-up system and early interventions are very important for ELBW/VLBW infants discharged from NICU. |
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