Incidence And Risk Factors Of Extrauterine Growth Retardation In Premature Infants

Objective To investigate the incidence of extrauterine growth retardation（EUGR）and nutritional support in premature infants,and to explore the risk factors for EUGR,so as to formulate relevant measures to reduce the incidence of EUGR in premature infants.Methods The clinical data of 407 premature infants hospitalized in our hospital from January 2019 to December 2020 were retrospectively analyzed,according to the presence or absence of EUGR based on the evaluation of body weight at discharge or at the corrected gestational age（GA）of 36 weeks,they were divided into EUGR group（n=136）and non-EUGR group（n=271）.The general clinical data,disease occurrence,treatment,nutritional support and related serum biochemical indexes of the two groups were analyzed by univariate analysis.The meaningful indicators of univariate analysis were incorporated into multivariate Logistic regression analysis to determine the independent risk factors of EUGR in premature infants in our hospital.Results 1.The incidence of EUGR was 33.42%（136/407）evaluated by weight.According to different birth weight（BW）,the incidence of EUGR in premature infants<2500g was 46.53%,and that of EUGR in premature infants≥2500g was 1.68%,the difference was statistically significant（P<0.05）.According to different GA,the incidence of EUGR in preterm infants at 28～33⁺⁶weeks was 50.65%,and that of premature infants at 34～36⁺⁶weeks was 22.92%,the difference was statistically significant（P<0.05）.2.Premature infants of EUGR group had lower BW and GA,the incidences of multiple births,intrauterine growth retardation（IUGR）and hypertensive disorder complicating pregnancy in EUGR group were significantly higher than those in non-EUGR group,the differences were statistically significant（P<0.05）.3.The incidence of neonatal respiratory distress syndrome（NRDS）,necrotizing enterocolitis（NEC）,neonatal asphyxia and anemia,invasive mechanical ventilation and pulmonary surfactant（PS）utilization rate in EUGR group were higher than those in non-EUGR group,the differences were statistically significant（P<0.05）.Compared with non-EUGR group,the time of starting enteral nutrition was later,fasting time was longer,maximum calorie during total enteral nutrition was lower,cumulative calorie deficiency during the first week of hospitalization was higher,age of total enteral nutrition was older and serum prealbumin level before discharge was lower in EUGR group,the differences were statistically significant（P<0.05）.4.The multivariate logistic regression analysis showed that the lower BW,multiple births,higher cumulative calorie deficit during the first week of hospitalization and older age of total gastrointestinal nutrition were the risk factors of EUGR in premature infants.Conclusion 1.The incidence of EUGR in premature infants was higher,BW and GA were the influencing factors of EUGR in premature infants.2.The incidence of multiple births and IUGR was higher in EUGR premature infants,and mothers were often complicated with hypertensive disorder complicating pregnancy.3.The incidence of NRDS,NEC,neonatal asphyxia and anemia was higher in EUGR premature infants during hospitalization,invasive mechanical ventilation and PS were often used in treatment,and there were often insufficient nutritional support and low serum prealbumin level before discharge.4.The lower BW,multiple births,higher cumulative calorie deficiency during the first week of hospitalization and later age of total gastrointestinal nutrition were independent risk factors for EUGR in premature infants.