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

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单位： [1]Department of Neonatology, Women and Children’s Hospital, School of Medicine, Xiamen University, Xiamen 361003, Fujian, China. [2]Xiamen Key Laboratory of Perinatal-Neonatal Infection, Xiamen 361003, Fujian, China. [3]Department of Neonatology, the Third Affiliated Hospital of Guangzhou Medical University, Guangzhou 510150, Guangdong, China. [4]Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110000, China. [5]Department of Neonatology, Guiyang Maternal, and Child Health Hospital Guiyang Children’s Hospital, Guiyang, Guizhou 550002, China. [6]Department of Pediatrics, Peking University Third Hospital, Beijing 100191, China. [7]Department of Neonatology, Children’s Hospital of Fudan University, Shanghai 201102, China. [8]Department of Neonatology, Guangdong Province Maternal and Children’s Hospital, Guangzhou 510030, Guangdong, China. [9]Department of Neonatology, General Hospital of Ningxia Medical University, Yinchuan 750001, Ningxia, China. [10]Department of Neonatology, Children’s Hospital of Hebei Province, Shijiazhuang 050031, Hebei, China. [11]Department of Neonatology, Children’ Hospital of Nanjing Medical University, Nanjing 210000, Jiangsu, China. [12]Department of Neonatology, the First Hospital of Jilin University, Changchun, Jilin 130000, China. [13]Department of Neonatology, Quanzhou Maternity and Children’s Hospital, Quanzhou 362000, Fujian, China. [14]Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, Hubei, China. [15]Department of Neonatology, Liaocheng People’s Hospital, Liaocheng 252000, Shandong, China. [16]Department of Neonatology, the Affiliate Hospital of Inner Mongolia Medical University, Hohhot 010010, Inner Mongolia, China. [17]Department of Neonatology, Suzhou Municipal Hospital, Suzhou 215002, Jiangsu, China. [18]Department of Neonatology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan, China. [19]Department of Neonatology, Chengdu Women’ and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 611731, Sichuan, China. [20]Nutritional Committee of Neonatology Branch of Chinese Medical Doctor Association, National Multicenter EUGR Collaborative Group, Beijing 100191, China.

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关键词： Extrauterine growth retardation Extremely premature infants GV Nutrition Small for gestational age Zscore

摘要：

To 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.The 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.This 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 NEC stage ≥2 were the independent risk factors.SGA 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.CHICTR, ChiCTR1900023418. Registered 26/05/2019, http://www.chictr.org.cn .© 2023. BioMed Central Ltd., part of Springer Nature.

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出版当年[2022]版：

大类 | 3 区医学

小类 | 3 区儿科

最新[2025]版：

大类 | 3 区医学

小类 | 3 区儿科

JCR分区：

出版当年[2021]版：

Q3 PEDIATRICS

最新[2023]版：

Q2 PEDIATRICS

影响因子： 2 最新[2023版] 2.4 最新五年平均 2.567 出版当年[2021版] 3.002 出版当年五年平均 2.125 出版前一年[2020版] 2.4 出版后一年[2022版]

第一作者：

第一作者单位： [1]Department of Neonatology, Women and Children’s Hospital, School of Medicine, Xiamen University, Xiamen 361003, Fujian, China. [2]Xiamen Key Laboratory of Perinatal-Neonatal Infection, Xiamen 361003, Fujian, China.

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通讯作者：

通讯机构： [1]Department of Neonatology, Women and Children’s Hospital, School of Medicine, Xiamen University, Xiamen 361003, Fujian, China. [2]Xiamen Key Laboratory of Perinatal-Neonatal Infection, Xiamen 361003, Fujian, China.

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

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