Clinical Study On Growth Retardation And Related Influencing Factors In EUGR Premature Infants At 1 Year Old

Objective: 1.To investigate the incidences and related influencing factors of extrauterine growth restriction(EUGR) in preterm infants at discharge; 2.To observe longitudinally the incidences and related influencing factors of the growth retardation of EUGR in preterm infants between 0-1 year after discharge.Methods: 152 preterm infants who were discharged from July 2014 to December 2014 from the neonatal intensive care unit were selected for study and divided into EUGR group and non- EUGR group assessed by weight. The maternal condition, delivery condition and circumstances in hospital were registered. The incidences and related influencing factors of EUGR in preterm infants at discharge were analyzed. Regular longitudinal follow up was conducted within one year corrected age.The follow-up times were 40 weeks,1, 3, 6, 12 months at corrected age. Related clinical data, such as, weight,feeding pattern, diseases, prealbumin, serum zinc were collected. The incidences and related influencing factors of the growth retardation were analyzed. Univariate analysis(chi square test, t test) and Logistic regression analysis were used for statistical analysis.Results: 1.The subjects included 152 preterm infants. The EUGR was 90 cases and the incidence of EUGR was 59.2%(90/152), the non-EUGR was 62 cases and the incidence of EUGR was 40.8%(62/152). The single factor analysis showed that pregnancy-induced hypertension syndrome, IUGR, neonatal respiratory distress syndrome,bronchopulmonary dysplasia, necrotizing enterocolitis, severe anemia complicated with blood transfusion, utilization of mechanical ventilation, birth weight, maternal age, the weight at discharge, hospitalization time, total enteral nutrition time and prealbumin at birth had significant differences between EUGR group and non- EUGR group(P<0.05).Analyzed with Logistic regression model,the lower weight at discharge、longer total enteral nutrition time and utilization of mechanical ventilation were related to EUGR. 2.The incidences of the growth retardation of EUGR in preterm infants were 64.4%(58/90)、48.9%(44/90)、36.7%(33/90)、30.2%(26/86)、17.1%(12/70)at corrected age of forty weeks 、 one month 、 three months 、 six months 、 twelve months.The single factor analysis showed that IUGR, NRDS, BPD, utilization of mechanical ventilation, anemia, birth weight, the weight at discharge, maternal age, hospitalization time, total enteral nutrition time, prealbumin and feeding patterns had significant differences between growth retardation group and non- growth retardation group at corrected age of forty weeks( P<0.05). IUGR,NRDS,BPD, birth weight,maternal age, hospitalization time and prealbumin had significant differences between growth retardation group and non- growth retardation group at corrected age of twelve month( P<0.05). Logistic regression analysis showed that the growth retardation of EUGR in preterm infants at corrected age of forty weeks had significant correlation with intrauterine growth restriction(IUGR) 、 albumin and feeding method; the growth retardation at corrected age of one month had significant correlation with IUGR 、bronchopulmonary dysplasia(BPD)and total enteral nutrition time; the growth retardation at corrected age of three month had significant correlation with IUGR、BPD、birth weight and albumin; the growth retardation at corrected age of six month had significant correlation with IUGR、BPD、birth weight; the growth retardation at corrected age of twelve month had significant correlation with IUGR、BPD(P<0.05).Conclusions:1. The incidence of EUGR in preterm infants is 59.2%, the low weight at discharge、IUGR、total enteral nutrition time and utilization of mechanical ventilation are the risk factors of EUGR. 2. The incidences of the growth retardation of EUGR in preterm infants within one year corrected age show decreased trend with age, but the growth retardation is extremely serious; the growth retardation at different ages has slightly different and IUGR is the persistent risk factors of the growth retardation of EUGR in preterm infants within one year-old.