Risk Factors And Outcomes Of Extrauterine Growth Restriction In Extremely Low Birth Weight Infants

Objective To explore risk factors and outcomes of extrauterine growth restriction(EUGR)in extremely low birth weight infants(ELBWIs).Methods: A retrospective analysis was performed on the clinical data of ELBWIs born from NICU of Shengjing Hospital between Jan.1st 2012 and Jun.31 st 2017.These subjects were classified into EUGR(Z-score?-2)and non-EUGR groups(Z-score>-2)based on the body weight at discharge.The risk factors for the occurrence of EUGR and outcomes were studied by multivariate logistic regression analysis.Results: A total of 154 cases were enrolled.110 cases with gestational age of 28.9±1.7 weeks met the criteria of EUGR(Z-score:-2.64±0.73)as case group,which include 62 males and 48 females.Other 44 cases with gestational age of 27.8 ± 1.3 weeks were no-EUGR(Z-score:-1.53±0.34)as control group,which include 26 males and 18 females.The abnormality of umbilical blood flow(27.3% vs 9.1%,P=0.017,OR=3.0)and IUGR ratio(14.5%vs 0%,P=0.006,OR=9.4)in case group are higher than control group.Birth weight in case group are much lower[904(816,960)g]vs[947(912,971)g],P=0.008.The the total days of feeding interruptions are longer in case group[3(0,7)d vs 1(0,4)d;p=0.046].Weight gain velocity(216±62 vs 253±41,P<0.001)[g/(kg*w)]after4 weeks of life are lesser in case group.The late onset sepsis(58.2% vs 38.6%,P=0.033)and cholestasis(40.9% vs 18.2%,P=0.008)ratio are higher in case group.Logistic regression analysis indicated that the total time of feeding interruption(OR 3.174,P=0.034),weight gain velocity after 4 weeks(OR 1.034,P =0.047)and cholestasis(OR8.062,P =0.043)are the independent risk factors for EUGR.Conclusion: The causes of EUGR are multi-factorial.The ratio of abnormality of umbilical blood flow?IUGR are higher and the birthweight are much lower in in case group.Mechanical ventilation prolongs the time of total enteral feeding.Feeding intolerance?lower weight gain velocity after 4 week and cholestasis are the independent risk factors for EUGR.