极低/超低出生体重早产儿代谢性骨病危险因素的全国多中心调查

doi:10.7499/j.issn.1008-8830.2012055

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Abstract Objective To investigate the incidence rate and risk factors for metabolic bone disease of prematurity (MBDP) in very low birth weight/extremely low birth weight (VLBW/ELBW) infants. Methods The medical data of 61 786 neonates from multiple centers of China between September 1, 2013 and August 31, 2016 were retrospectively investigated, including 504 VLBW/ELBW preterm infants who met the inclusion criteria. Among the 504 infants, 108 infants diagnosed with MBDP were enrolled as the MBDP group and the remaining 396 infants were enrolled as the non-MBDP group. The two groups were compared in terms of general information of mothers and preterm infants, major diseases during hospitalization, nutritional support strategies, and other treatment conditions. The multivariate logistic regression analysis was used to investigate the risk factors for MBDP. Results The incidence rate of MBDP was 19.4% (88/452) in VLBW preterm infants and 38.5% (20/52) in ELBW preterm infants. The incidence rate of MBDP was 21.7% in preterm infants with a gestational age of < 32 weeks and 45.5% in those with a gestational age of < 28 weeks. The univariate analysis showed that compared with the non-MBDP group, the MBDP group had significantly lower gestational age and birth weight, a significantly longer length of hospital stay, and a significantly higher incidence rate of extrauterine growth retardation (P < 0.05). Compared with the non-MBDP group, the MBDP group had significantly higher incidence rates of neonatal sepsis, anemia, hypocalcemia, and retinopathy of prematurity (P < 0.05). The MBDP group had a significantly lower mean feeding speed, a significantly higher age when reaching total enteral feeding, and a significantly longer duration of parenteral nutrition (P < 0.05). The use rate of caffeine citrate in the MBDP group was significantly higher, but the use rate of erythropoietin was significantly lower than that in the non-MBDP group (P < 0.05). The multivariate logistic regression analysis showed that gestational age < 32 weeks, hypocalcemia, extrauterine growth retardation at discharge, and neonatal sepsis were risk factors for MBDP (P < 0.05). Conclusions A lower gestational age, hypocalcemia, extrauterine growth retardation at discharge, and neonatal sepsis may be associated an increased risk of MBDP in VLBW/ELBW preterm infants. It is necessary to strengthen perinatal healthcare, avoid premature delivery, improve the awareness of the prevention and treatment of MBDP among neonatal pediatricians, and adopt positive and reasonable nutrition strategies and comprehensive management measures for preterm infants.

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	Articles by authors
	ZHONG Xiao-Yun
	HE Xiao-Ri
	LUO Kai-Ju
	LIANG Can
	YU Yuan-Qiang
	WU Pei-Jia
	CHEN Xiang-Hong
	CHEN Yu-Jun
	YANG Yong-Hui
	LIU Cui-Qing
	OU-YANG Xiang-Dong
	SHAN Ruo-Bing
	DONG Qing-Yi
	PAN Wei-Wei
	CHANG Yan-Mei
	WANG Dan
	HU Jin-Tao
	ZHONG Xiao-Yun
	LUO Kai-Ju
	YANG Yong-Hui
	DONG Qing-Yi
	HU Jin-Tao
	HE Ming-Feng
	HE Ming-Feng
	TONG Xiao-Mei
	TONG Xiao-Mei
	CHEN Ping-Yang
	CHEN Ping-Yang

Key words： Metabolic bone disease of prematurity Risk factor Very low birth weight/extremely low birth weight preterm infant

Received: 11 December 2020

Cite this article:

ZHONG Xiao-Yun,HE Xiao-Ri,LUO Kai-Ju et al. Risk factors for metabolic bone disease of prematurity in very/extremely low birth weight infants: a multicenter investigation in China[J]. CJCP, 2021, 23(6): 555-562.

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http://www.zgddek.com/EN/10.7499/j.issn.1008-8830.2012055 OR http://www.zgddek.com/EN/Y2021/V23/I6/555

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