早产小于胎龄儿校正0~24月龄追赶生长的纵向研究

doi:10.7499/j.issn.1008-8830.2307059

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摘要目的了解早产小于胎龄儿（small for gestational age, SGA）和适于胎龄儿（appropriate for gestational age, AGA）校正0~24月龄期间生长发育状况和差异，为早产儿早期健康干预提供依据。方法回顾性选取2019年7月—2022年7月在广州市妇女儿童医疗中心定期保健的824例早产儿作为研究对象，其中SGA 144例，AGA 680例。分析和比较SGA组和AGA组出生及校正0~24月龄的体格发育数据。结果 SGA组在校正0~18月龄期间的体重和身长均落后于同月龄AGA组（P<0.05），而校正24月龄时，两组的体重和身长比较差异无统计学意义（P>0.05）。校正24月龄时，85%（34/40）SGA早产儿和79%（74/94）AGA早产儿完成追赶生长。按胎龄分层分析的结果显示：胎龄<34周SGA亚组体重、身长在校正0~9月龄与胎龄<34周和≥34周AGA亚组比较差异有统计学意义（P<0.05）；胎龄≥34周SGA亚组体重、身长分别在校正0~18月龄和校正0~12月龄与胎龄<34周和≥34周AGA亚组比较差异有统计学意义（P<0.05）。胎龄<34周和≥34周SGA早产儿追赶生长分别主要发生在校正0~12月龄、校正0~18月龄。结论 SGA早产儿生命早期体格发育落后于AGA早产儿，但在校正24月龄时实现追赶生长的比例高于AGA早产儿。胎龄<34周SGA早产儿实现追赶生长的时间早于胎龄≥34周SGA早产儿。

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关键词 ：小于胎龄儿, 适于胎龄儿, 体格发育, 追赶生长, 早产儿

Abstract：Objective To understand the growth and development status and differences between small for gestational age (SGA) and appropriate for gestational age (AGA) preterm infants during corrected ages 0-24 months, and to provide a basis for early health interventions for preterm infants. Methods A retrospective study was conducted, selecting 824 preterm infants who received regular health care at the Guangzhou Women and Children's Medical Center from July 2019 to July 2022, including 144 SGA and 680 AGA infants. The growth data of SGA and AGA groups at birth and corrected ages 0-24 months were analyzed and compared. Results The SGA group had significantly lower weight and length than the AGA group at corrected ages 0-18 months (P<0.05), while there were no significant differences between the two groups at corrected age 24 months (P>0.05). At corrected age 24 months, 85% (34/40) of SGA and 79% (74/94) of AGA preterm infants achieved catch-up growth. Stratified analysis by gestational age showed that there were significant differences in weight and length at corrected ages 0-9 months between the SGA subgroup with gestational age <34 weeks and the AGA subgroups with gestational age <34 weeks and ≥34 weeks (P<0.05). In addition, the weight and length of the SGA subgroup with gestational age ≥34 weeks showed significant differences compared to the AGA subgroups with gestational age <34 weeks and ≥34 weeks at corrected ages 0-18 months and corrected ages 0-12 months, respectively (P<0.05). Catch-up growth for SGA infants with gestational age <34 weeks and ≥34 weeks mainly occurred at corrected ages 0-12 months and corrected ages 0-18 months, respectively. Conclusions SGA infants exhibit delayed early-life physical growth compared to AGA infants, but can achieve a higher proportion of catch-up growth by corrected age 24 months than AGA infants. Catch-up growth can be achieved earlier in SGA infants with a gestational age of <34 weeks compared to those with ≥34 weeks.

Key words： Small for gestational age Appropriate for gestational age Physical growth Catch-up growth Preterm infant

收稿日期: 2023-07-08

基金资助:广州市卫生健康科技项目（2021A031002）；母婴营养与护理研究基金（2019BINCMCF22）。

通讯作者: 胡艳，女，副主任医师。Email：yayayan1979@163.com。 E-mail: yayayan1979@163.com

作者简介: 李佳美，女，硕士研究生；

引用本文:

李佳美,谢群英,文羽祺等. 早产小于胎龄儿校正0~24月龄追赶生长的纵向研究[J]. 中国当代儿科杂志, 2024, 26(1): 72-80.

LI Jia-Mei,XIE Qun-Ying,WEN Yu-Qi et al. Longitudinal study on catch-up growth in preterm infants with small for gestational age at corrected ages 0-24 months[J]. CJCP, 2024, 26(1): 72-80.

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