Real-world evidence regarding the growth of very premature infants with small for gestational age after birth: a multicenter survey in China

BMC Pediatrics

Research

Rong Ju¹  Rui Cheng²  Rong Zhang³  Li Ma⁴  Yin-Ping Qiu⁵  Xiu-Zhen Ye⁶  Ling Liu⁷  Ping Xu⁸  Dong-Mei Chen⁹  San-Nan Wang^1,10  Fa-Lin Xu^1,11  Wei Shen^1,12  Xin-Zhu Lin^1,12  Zhi Zheng^1,12  Xue-Rong Huang^1,12  Hua Mei^1,13  Hui Wu^1,14  Fan Wu^1,15  Yan-Mei Chang^1,16  Xiao-Mei Tong^1,16  Jian Mao^1,17  Ling Chen^1,18 

[1] Department of Neonatology, Chengdu Women’ and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, 611731, Chengdu, Sichuan, China;Department of Neonatology, Children’ Hospital of Nanjing Medical University, 210000, Nanjing, Jiangsu, China;Department of Neonatology, Children’s Hospital of Fudan University, 201102, Shanghai, China;Department of Neonatology, Children’s Hospital of Hebei Province, 050031, Shijiazhuang, Hebei, China;Department of Neonatology, General Hospital of Ningxia Medical University, 750001, Yinchuan, Ningxia, China;Department of Neonatology, Guangdong Province Maternal and Children’s Hospital, 510030, Guangzhou, Guangdong, China;Department of Neonatology, Guiyang Maternal, and Child Health Hospital Guiyang Children’s Hospital, 550002, Guiyang, Guizhou, China;Department of Neonatology, Liaocheng People’s Hospital, 252000, Liaocheng, Shandong, China;Department of Neonatology, Quanzhou Maternity and Children’s Hospital, 362000, Quanzhou, Fujian, China;Department of Neonatology, Suzhou Municipal Hospital, 215002, Suzhou, Jiangsu, China;Department of Neonatology, The Third Affiliated Hospital of Zhengzhou University, 450052, Zhengzhou, Henan, China;Department of Neonatology, Women and Children’s Hospital, School of Medicine, Xiamen University, 361003, Xiamen, Fujian, China;Xiamen Key Laboratory of Perinatal-Neonatal Infection, 361003, Xiamen, Fujian, China;Department of Neonatology, the Affiliate Hospital of Inner Mongolia Medical University, 010010, Hohhot, Inner Mongolia, China;Department of Neonatology, the First Hospital of Jilin University, 130000, Changchun, Jilin, China;Department of Neonatology, the Third Affiliated Hospital of Guangzhou Medical University, 510150, Guangzhou, Guangdong, China;Department of Pediatrics, Peking University Third Hospital, 100191, Beijing, China;Department of Pediatrics, Shengjing Hospital of China Medical University, 110000, Shenyang, Liaoning, China;Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 430000, Wuhan, Hubei, China;

关键词: Extrauterine growth retardation;    Extremely premature infants;    GV;    Nutrition;    Small for gestational age;    Z score;   

DOI  :  10.1186/s12887-023-04245-1

 received in 2023-01-08, accepted in 2023-08-11,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundTo analyze the real-world growth pattern of very premature infants (VPI) with small for gestational age (SGA) after birth by using the ΔZ value of weight at discharge.MethodsThe clinical data were collected from 28 hospitals in China from September 2019 to December 2020. They were divided into the EUGR(Extrauterine Growth Restriction) and the non-EUGR group according to the criterion of ΔZ value of weight at discharge < –1.28.ResultsThis study included 133 eligible VPI with SGA. Following the criterion of ΔZ value, the incidence of EUGR was 36.84% (49/133). The birth weight, the 5-min Apgar score, and the proportion of male infants in the EUGR group were lower (P < 0.05). The average invasive ventilation time, cumulative duration of the administration of antibiotics, blood transfusion time, blood transfusion ratio, and total days of hospitalization were significantly higher in the EUGR group (P < 0.05). In the EUGR group, several factors exhibited higher values (P < 0.05), including the initiation of enteral feeding, the volume of milk supplemented with human milk fortifier (HMF), the duration to achieve complete fortification, the cumulative duration of fasting, the duration to achieve full enteral feeding, the length of parenteral nutrition (PN), the number of days required to attain the desired total calorie intake and oral calorie intake, as well as the age at which birth weight was regained. The average weight growth velocity (GV) was significantly lower in the EUGR group (P < 0.001). The incidences of patent ductus arteriosus with hemodynamic changes (hsPDA), neonatal necrotizing enterocolitis (NEC)stage≥ 2, late-onset sepsis (LOS), and feeding intolerance (FI) in the EUGR group were higher (P < 0.05). Multivariate logistic regression analysis showed that birth weight, male, and GV were the protective factors, while a long time to achieve full-dose fortification, slow recovery of birth weight, and NECstage ≥2 were the independent risk factors.ConclusionSGA in VPI can reflect the occurrence of EUGR more accurately by using the ΔZ value of weight at discharge. Enhancing enteral nutrition support, achieving prompt and complete fortification of breast milk, promoting greater GV, reducing the duration of birth weight recovery, and minimizing the risk of NEC can contribute to a decreased occurrence of EUGR.Trial registrationCHICTR, ChiCTR1900023418. Registered 26/05/2019, http://www.chictr.org.cn.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

【 图 表 】

Fig. 7