Study On Extrauterine Growth Retardation And Short-term Outcome Of Neurodevelopment In Preterm Infants

Part 1:Study on extrauterine growth retardation in preterm infantsObjectiveTo investigate the physical growth of premature infants from birth to corrected age?CA?of 12 months,and analyze the effect of intrauterine growth retardation?IUGR?,birth weight?BW?and gestational age?GA?on extrauterine growth retardation?EUGR?,which can provide helpful information for prevention and treatment of EUGR.MethodData of preterm infants who had been hospitalized in the neonatalogy department and followed up in outpatient clinic for high-risk children in the Third Affiliated Hospital of Guangzhou Medical University from July 1^st,2015 to December 31^st,2019,were prospectively collected.The growth parameter and relative incidence of EUGR were calculated and made comparisons between groups according to the BW,GA,small for gestational age?SGA?,and mean growth rate?MGR?from birth to CA 40 weeks.The statistical software SPSS 25.0 was used to analyze the data,and P<0.05 was served as statistically significant.Results1.For weight,the incidence of IUGR at birth was 9.8%?18/184?,and the incidences of EUGR at CA 40 weeks,CA 3 months,CA 6 months,and CA 12months were 57.4%?97/169?,22.3%?39/175?,18.2%?29/159?,and 34.3%?47/137?,respectively.For length,the incidence of IUGR at birth was 8.7%?16/184?,and the incidences of EUGR at the above CAs were 39.1%?66/169?,25.1%?44/175?,12.6%?20/159?,and 27.7%?38/137?,respectively.And for head circumference,the incidence of IUGR at birth was 13.6%?25/184?,and the incidences of EUGR at the above CAs were 18.9%?32/169?,23.4%?41/175?,19.5%?31/159?,and 29.2%?40/137?,respectively.2.At CA 40 weeks,all of the weight,length and head circumference in group BW?1500g were higher than in group BW<1500g?t=-2.717?-3.441?-3.141,P=0.007?0.001?0.002?,and the relative incidences of EUGR were lower in group BW?1500g??²=6.408?5.444?5.335,P=0.011?0.020?0.021?.At CA 3 months,both of the length and head circumference in group BW?1500g were higher than in group BW<1500g?t=-2.819?-2.025,P=0.005?0.043?,and the relative incidences of EUGR were lower in group BW?1500g??²=4.013?5.018,P=0.045?0.025?.At CA 6 months,both of the length and head circumference in group BW?1500g were higher than in group BW<1500g?t=-3.738?-2.242,P=0.000?0.025?,but only the incidence of EUGR for head circumference was lower in group BW?1500g??²=5.763,P=0.016?.At CA 12 months,the length in group BW?1500g was higher than in group BW<1500g?t=-2.245,P=0.026?.3.At CA 40 weeks,all of the weight,length and head circumference in non-SGA group were higher than in SGA group?t=-3.830?-3.734?-2.505,P=0.000?0.000?0.012?,and the incidences of EUGR for weight and length were lower in non-SGA group??²=9.552?6.548,P=0.002?0.010?.At CA 3 months,all of the weight,length and head circumference in non-SGA group were higher than in SGA group?t=-2.776?-2.559?-2.507,P=0.006?0.011?0.012?,and the incidences of EUGR for weight and head circumference were lower in non-SGA group??²=4.351?9.634,P=0.037?0.002?.At CA 6 months,all of the weight,length and head circumference in non-SGA group were higher than in SGA group?t=-3.256?-3.020?-2.344,P=0.001?0.003?0.019?,and the incidences of EUGR for weight and head circumference were lower in non-SGA group??²=6.994?5.996,P=0.008?0.014?.At CA 12 months,all of the weight,length and head circumference in non-SGA group were higher than in SGA group?t=-2.386?-4.043?-2.521,P=0.018?0.000?0.013?.4.There was no significant difference in weight,length or head circumference,or the relative incidence of EUGR between the group GA<30 weeks and GA?30weeks at CA 40 weeks,CA 3 months,CA 6 months or CA 12 months,respectively?all P>0.05?.Conclusion1.The incidence of EUGR in premature infants at CA 40 weeks was higher than the incidence of IUGR at birth,and it decreased at CA 3 months and 6 months,but increased again at CA 12 months.2.Preterm infants with BW<1500g or SGA were in high risk of EUGR.Part 2: Study on short-term outcome of neurodevelopment in preterm infantsObjective To investigate the neurodevelopment of premature infants from birth to corrected age?CA?of 12 months,and analyze the correlation between various factors?such as intrauterine growth retardation?IUGR?,birth weight?BW?,gestational age?GA?,extrauterine growth retardation?EUGR??and neurodevelopmental disorders,which can provide available information for prevention and treatment of neurodevelopmental disorders in preterm infants.Method Data of preterm infants who had been hospitalized in the neonatalogy department and followed up in outpatient clinic for high-risk children in the Third Affiliated Hospital of Guangzhou Medical University from July 1st,2015 to December 31 st,2019,were prospectively collected.The neurodevelopmental indicators were calculated and made comparisons between groups according to the BW,GA,small for gestational age?SGA?,mean growth rate?MGR?from birth to CA 40 weeks,and EUGR for weight,length and head circumference,respectively.The statistical software SPSS 25.0 was used to analyze the data,and P <0.05 was served as statistically significant.Results 1.At CA 3 months,the score of mental index?MI?in group BW ?1500g were higher than in group BW <1500g?z=-2.057,P=0.040?,and the abnormal rate of language was lower in group BW ?1500g??2=4.744,P=0.029?.At CA 6 months,the scores of Alberta infant motor scale?AMIS?,adaptability and social skill in group BW ?1500g were higher than in group BW <1500g?z=-2.585?-2.086?-3.216,P=0.010?0.037?0.001?,and abnormal rate of AMIS and social skill were lower in group BW ?1500g??2=5.343?4.483,P=0.021?0.034?.At CA 12 months,the scores of developmental quotient?DQ?,adaptability and social skill in group BW ?1500g were higher than in group BW <1500g?z=-2.216?-2.797?-2.965,P=0.027?0.005?0.003?.2.At CA 3 months,the score of mental development index?MDI?in group GA ?30 weeks were higher than in group GA <30 weeks?z=-2.787,P=0.006?.At CA 6 months,the abnormal rate of MDI in group GA ?30 weeks was lower than in group GA <30 weeks,??2=6.085,P=0.014?.At CA 12 months,the scores of DQ?MDI?adaptability and social skill in group GA ?30 weeks were all higher than in group GA <30 weeks?z=-2.233?-2.619?-2.834?-3.590,P=0.026?0.009?0.005?0.000?,and the abnormal rate of MDI was lower in group GA ?30 weeks??2=6.640,P=0.010?.3.At CA 6 months,the score of social skill in non-SGA group were higher than in SGA group?z=-2.294,P=0.022?.At CA 12 months,the scores of MI and language in non-SGA group were higher than in SGA group?z=-2.084?-2.154,P=0.037?0.031?,and the abnormal rate of MI and language were lower in non-SGA group??2=7.285,P=0.009?.4.For weight,the score of AMIS in non-EUGR group were higher than in EUGR group?z=-2.137,P=0.033?at CA 40 weeks.The score of AMIS in non-EUGR group were higher than in EUGR group?z=-2.002,P=0.045?,and the abnormal rate of fine motor was lower in non-EUGR group??2=4.065,P=0.044?atCA 3 months.The score of MI in non-EUGR group was higher than in EUGR group?z=-2.373,P=0.018?,and the abnormal rate of AMIS was lower in non-EUGR group??2=5.931,P=0.015?at CA 6 months.5.For head circumference,the scores of AMIS?MI?DQ?psychomotor development index?PDI??gross motor?adaptability and social skill in non-EUGR group were all higher than in EUGR group?z=-3.198?-3.425?-2.272?-2.568?-2.065?-2.508?-2.418,P=0.001?0.001?0.023?0.010?0.039?0.012?0.016?,and the abnormal rate of PDI and any evaluation indicator were lower in non-EUGR group??2=4.147?7.730,P=0.042?0.005?at CA 6 months.6.At CA 12 months,the score of fine motor in group MGR ?10g/kg/d were higher than in group MGR <10g/kg/d?z=-2.374,P=0.018?,and the abnormal rate of MI was lower in group MGR ?10g/kg/d??2=5.694,P=0.017?.Conclusion 1.Differences in incidence of neurodevelopmental disorders varied in preterm infants at different follow-up months.2.Association could be found between GA ? BW ? SGA ? EUGR and neurodevelopmental disorders in preterm infants.