影响极早产儿出院后早期追赶生长的相关因素分析
收稿日期: 2025-06-10
录用日期: 2025-09-16
网络出版日期: 2025-11-06
基金资助
（泸州-医科大）合作应用基础（2021）(ZXX-2021LZXNYD-J21);出生缺陷与相关妇儿疾病教育部重点实验室开放课题资助(SCU2023D006);重庆市妇幼疾病预防控制与公共卫生研究中心(CQFYJB01002);江油市2025年度社会科学研究规划项目(JY2025ZC020)
Risk factors of post-discharge catch-up growth in very preterm infants
Received date: 2025-06-10
Accepted date: 2025-09-16
Online published: 2025-11-06
目的 探讨影响极早产儿出院后至校正6月龄时体重追赶生长的相关因素。方法 回顾分析2019年8月至2022年6月新生儿科124例胎龄<32周极早产儿临床数据。追赶生长判定标准为校正6月龄时年龄别体重Z值较出院时上升≥0.67。根据是否达成追赶生长分组，采用logistic逐步回归分析影响追赶生长的相关危险因素。结果 124例极早产儿中，男70（56.5%）例，胎龄为30.14（28.86~31.11）周，出生体重1 330（1 170~1 607）g，出生年龄别体重Z值0.10±0.61，校正6月龄达到追赶生长的比例为62.1%（77/124）。与未追赶组比较，追赶组出生体重、生后第7天和第14天的体重及年龄别体重、出院时年龄别体重及校正胎龄40周血碱性磷酸酶均较低（P均<0.05）；而出院时胎龄、住院天数、院外日均体重增长显著高于未追赶组（P均<0.05）。多因素回归分析发现多胎（OR=0.294，95%CI：0.088~0.982）、住院天数（OR=1.082，95% CI：1.032~1.134）、出院时年龄别体重（OR=0.385，95%CI：0.167~0.890）、院外日均体重增长（OR=1.928，95% CI：1.483~2.506）、校正胎龄40周血碱性磷酸酶（OR=0.995，95%CI：0.990~0.999）为出院至校正胎龄6个月追赶生长的独立相关因素。结论 多胎、出院时年龄别体重、院外生长速率、住院天数、及校正胎龄40周血碱性磷酸酶是影响极早产儿出院后至校正6月龄追赶生长的相关因素。
宦鹏 , 王小玲 , 高强 , 罗丽娟 , 董文斌 , 雷小平 . 影响极早产儿出院后早期追赶生长的相关因素分析[J]. 临床儿科杂志, 2025 , 43(11) : 816 -822 . DOI: 10.12372/jcp.2025.25e0660
Objective To investigate the factors influencing weight catch-up growth in very preterm infants (VPIs) from discharge to corrected age 6 months. Methods A retrospective analysis was conducted on 124 VPIs (gestational age <32 weeks) admitted to the Department of Neonatology between August 2019 and June 2022. Catch-up growth was defined as Z-score of weight-for-age (WAZ) increase of ≥0.67 from discharge to corrected age 6 months. Infants were divided into catch-up and non-catch-up groups on this criterion. A forward stepwise logistic regression model was used to identify independent predictive factors. Results Among the 124 VPIS, there were 70 males (56.5%), with a median gestational age of 30.14 (28.86-31.11) weeks, birth weight of 1330.0 (1170-1607) g, birth WAZ of 0.10 ± 0.61, and a catch-up growth rate of 62.1% (77/124) at corrected 6 months. Compared to the non-catch-up infants, the catch-up group exhibited significantly lower birth weight, WAZ at day 7, day 14 and discharge, and serum alkaline phosphatase (ALP) at corrected 40 weeks (P<0.05), while showing longer hospital stay, greater postmenstrual age at discharge, and higher daily weight gain post-discharge (P<0.05). Multivariate regression analysis identified multiple pregnancy (OR=0.294, 95%CI: 0.088-0.982), hospital stay (OR=1.082, 95% CI: 1.032-1.134), WAZ at discharge (OR=0.385, 95%CI: 0.167-0.890), daily weight gain post-discharge (OR=1.928, 95% CI: 1.483-2.506), and ALP at corrected 40 weeks (OR=0.995, 95% CI: 0.990-0.999) as independent influencing factors for post-discharge catch-up growth. Conclusion Post-discharge weight catch-up growth in VPIs is synergistically modulated by multiple pregnancy, WAZ at discharge, growth rate post-discharge, hospital stay duration and ALP at corrected 40 weeks.
Key words： very preterm infants; catch-up growth; corrected age
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