渭南市187例早产儿纵向生长发育模式研究

摘要

Objectve To longitudinally monitor the indexes of preterm physical growth, analyze the monitoring results of each time point and dynamic trend, and to explore key points of preterm management.Methods According to gestational age 187 cases of premature infants were divided into three groups:36 cases in early preterm group (gestational week<34), 83 cases in late preterm group 1 (34≤gestational week<36) and 68 cases in late preterm group 2 (36≤gestational week<37).The differences among three groups in physical growth indexes of each time point were compared and trend analysis was conducted on complete data of each index.Results Birth weight, length and head circumference among groups were significantly different (F value was 27.291, 18.616 and 16.610, respectively, all P<0.05). The factors such as mother's profession, maternal weight before pregnancy and weight before delivery were closely related to gestational age of preterm (χ2 or F value was 10.390, 3.971 and 2.412, respectively, all P<0.05).At time points of 6 and 12 month old, the weight was significantly different between early preterm group and late preterm group (t value was 4.159 and 12.563, respectively, both P<0.05).Large catch up changes were detected in each group with time going, and the differences were significant (Fweight =7077.954, Flength =5643.301, Fhead circumference =407.858, all P<0.05).Conclusion The growth and development patterns of preterm infants and full term in infancy are different.Preterm infants'growth pattern is closely related to birth weight and gestational age.Body weight is a very sensitive index, while length and head circumference show statistical significance later.%目的 纵向监测早产儿体格生长发育指标,对各时点监测结果及动态趋势进行分析,探讨本地区早产儿随访管理要点.方法 将187例早产儿按胎龄分为3组:早期早产儿组(胎龄<34周)36例,晚期早产儿1组(36周>胎龄≥34周)83例,晚期早产儿2组(37周>胎龄≥36周)68例,比较各组体格生长发育指标在各个时点的差异,并对103例完整资料的各项指标进行趋势分析.结果 各组间的出生体重、出生身长及出生头围,经比较均有显著性差异(F值分别为27.291、18.616、16.610,均P<0.05);母亲职业、孕前体重、分娩前体重等因素和早产儿的胎龄呈密切关联(χ2/F值分别为10.390、3.971、2.412,均P<0.05);在6个月和12个月时间点,早期早产儿组和晚期早产儿组的体重差别较大(为早期的追赶速度更快),t值分别为4.159、12.563,均P<0.05;各组内依时间推移,均有较大的追赶变化,时点间比较差异均有显著性(F体重=7077.954、F身长=5643.301、F头围=407.858,均P<0.05).结论 早产儿与足月儿在婴儿期的生长发育模式不同,早产儿的生长发育模式与其出生体重和胎龄有密切的关系,体重是一个非常敏感的指标,而身长和头围相对滞后才表现出统计学差异.