目的 分析早发型败血症（early⁃onset sepsis, EOS）足月适于胎龄儿（appropriate for gestational age infant, AGA）住院期间不良结局与生后早期体重变化的相关性。 方法 回顾性分析重庆医科大学附属儿童医院2023年1月—2024年9月间收治的EOS足月AGA的临床资料，根据生后第7天体重与出生体重的变化情况分为体重增加组（体重差值>0 kg，229例）和体重未增组（体重差值≤0 kg，131例），比较分析两组住院期间不良结局的发生率。 结果 体重增加组的总住院时间、抗生素使用时间、机械通气时间长于体重未增组（P<0.05），急性肾损伤、电解质紊乱、颅内出血、动脉导管未闭、中-重度肺动脉高压及肺出血的发生率高于体重未增组（P<0.05）。体重增加组生后第5天、第6天每日液体净平衡及第5天、第6天、第7天每日累积液体净平衡高于体重未增组（P<0.05）。 结论 EOS足月AGA生后早期体重增加可能增加住院期间不良结局发生率，体重变化可作为评估新生儿液体平衡的指标之一。

Objective To study the association between adverse outcomes during hospitalization and early postnatal weight changes in term appropriate-for-gestational-age (AGA) infants with early-onset sepsis (EOS). Methods A retrospective study was conducted on clinical data of term AGA infants with EOS admitted to the Children's Hospital of Chongqing Medical University from January 2023 to September 2024. The infants were divided into a weight-gain group (weight difference > 0 kg; n=229) and a no-weight-gain group (weight difference ≤ 0 kg; n=131) based on the change in weight from birth to postnatal day 7, and the incidence of adverse outcomes during hospitalization was compared between groups. Results Length of hospital stay, duration of antibiotic use, and duration of mechanical ventilation in the weight-gain group were longer than those in the no-weight-gain group (P<0.05). The incidence of acute kidney injury, electrolyte imbalance, intracranial hemorrhage, patent ductus arteriosus, moderate-to-severe pulmonary arterial hypertension, and pulmonary hemorrhage was higher in the weight-gain group than in the no-weight-gain group (P<0.05). Daily net fluid balance on postnatal days 5 and 6, and cumulative net fluid balance on postnatal days 5-7, were higher in the weight-gain group than in the no-weight-gain group (P<0.05). Conclusions Early postnatal weight gain in term AGA infants with EOS is associated with an increased incidence of adverse outcomes during hospitalization, and weight change can serve as one of the indicators to assess neonatal fluid balance.