Weight Growth Velocity and Postnatal Growth Failure in Infants 501 to 1500 Grams: 2000-2013
Weight Growth Velocity and Postnatal Growth Failure in Infants 501 to 1500 Grams: 2000-2013
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DOI：
10.1542/peds.2015-0129
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发表时间：
2015-07-01
期刊：
影响因子：
8
通讯作者：
Bellu, Roberto
中科院分区：
文献类型：
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作者：
Horbar, Jeffrey D.;Ehrenkranz, Richard A.;Bellu, Roberto
背景：极低出生体重儿在最初住院期间体重增加不佳并表现出生长障碍。虽然这些婴儿在最初的NICU住院期间经历的许多主要发病率近年来有所下降，但尚不清楚生长是否有所改善。我们研究了2000年至2013年出生的362833名体重501至1500 g的婴儿，他们在佛蒙特州的736家北美医院住院15至175天，BBC.平均生长速度（GV; g/kg/天）的基础上，出生体重和出院体重的基础上，使用2点指数模型计算。出生后生长障碍和严重出生后生长障碍分别定义为出生后体重小于第10和第3个月经后年龄的体重。结果：从2000年到2013年，平均GV从11.8 g/kg/d增加到12.9 g/kg/d。出生后生长障碍从64.5%下降到50.3%，严重出生后生长障碍从39.8%下降到27.5%。2013年参与医院的四分位数范围如下：GV，12.3至13.4 g/kg/天;产后生长障碍，41.1%至61.7%;严重产后生长障碍，19.4%至36.0%。调整后和未调整的估计值几乎是相同的。结论：对于出生时体重为501至1500克的婴儿，平均GV增加，出生后生长失败的百分比下降。然而，在2013年，这些婴儿中有一半仍然表现出产后生长障碍，四分之一表现出严重的产后生长障碍。
BACKGROUND: Very low birth weight infants often gain weight poorly and demonstrate growth failure during the initial hospitalization. Although many of the major morbidities experienced by these infants during their initial NICU stays have decreased in recent years, it is unclear whether growth has improved.METHODS: We studied 362 833 infants weighing 501 to 1500 g without major birth defects born from 2000 to 2013 and who were hospitalized for 15 to 175 days at 736 North American hospitals in the Vermont Oxford Network. Average growth velocity (GV; g/kg per day) was computed by using a 2-point exponential model on the basis of birth weight and discharge weight. Postnatal growth failure and severe postnatal growth failure were defined as a discharge weight less than the 10th and third percentiles for postmenstrual age, respectively.RESULTS: From 2000 to 2013, average GV increased from 11.8 to 12.9 g/kg per day. Postnatal growth failure decreased from 64.5% to 50.3% and severe postnatal growth failure from 39.8% to 27.5%. The interquartile ranges for the hospitals participating in 2013 were as follows: GV, 12.3 to 13.4 g/kg per day; postnatal growth failure, 41.1% to 61.7%; and severe postnatal growth failure, 19.4% to 36.0%. Adjusted and unadjusted estimates were nearly identical.CONCLUSIONS: For infants weighing 501 to 1500 g at birth, average GV increased and the percentage with postnatal growth failure decreased. However, in 2013, half of these infants still demonstrated postnatal growth failure and one-quarter demonstrated severe postnatal growth failure.