Etiological subgroups of term small-for-gestational-age and childhood health outcomes
Etiological subgroups of term small-for-gestational-age and childhood health outcomes
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足月小于胎龄儿和儿童健康结果的病因亚组
DOI：
10.1038/s41390-022-02412-1
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发表时间：
2022-12-30
影响因子：
3.6
通讯作者：
Zhang，Jun
中科院分区：
文献类型：
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作者：
Fang，Fang;Chen，Yan;Zhang，Jun
背景小于胎龄儿 (SGA) 的病因多种多样。我们的研究旨在检查病因学不同术语 SGA 亚组的儿童健康结果。方法使用来自围产期合作项目的数据。 SGA的病因可分为五类：母体因素、胎儿因素、胎盘因素、环境因素和生理因素。主要儿童结局包括智商低和生长受限。共有8417名足月儿符合资格。结果与AGA相比，胎儿因素导致的SGA儿童低智商的风险最高（aOR = 1.94，95% CI：1.45~2.59）。 SGA婴儿因生理因素导致生长受限的风险最高（aOR = 6.04，95% CI：3.93-9.27）。 SGA 儿童具有较高的生长受限风险，对于 SGA 婴儿具有 1 至 5 个危险因素，aOR 范围为 3.05（95% CI：2.36-3.96）至 5.77（95% CI：4.29-7.75）。具有任何危险因素的 SGA 儿童均与较高的智商较低风险相关，aOR 范围为 1.59（95% CI：4.29-7.75）。 1.31–1.94) 至 1.96 (95% CI: 1.50–2.55)。除生长受限外，无五种病因的SGA与不良儿童结局无关（aOR = 3.82，95% CI：2.62-5.55）。结论不同病因的SGA可能导致不同的儿童健康结局。影响我们的研究发现，不同病因的SGA可能导致不同的儿童健康结局。与AGA相比，胎儿因素引起的SGA儿童低智商的风险最高。 SGA婴儿由于生理因素而出现生长受限的风险最高。SGA婴儿不应受到同样的对待。在精准医疗时代，我们的研究结果可能有助于儿科医生和家长根据不同的病因和危险因素的数量更好地管理SGA婴儿。
BackgroundSmall-for-gestational-age (SGA) has a heterogeneous etiology. Our study aimed to examine the childhood health outcomes of etiology-distinct term SGA subgroups.MethodsData from the Collaborative Perinatal Project were used. The etiological factors of SGA were categorized into five groups: maternal, fetal, placental, environmental and physiological factors. Primary child outcomes included low IQ and growth restriction. A total of 8417 term infants were eligible.ResultsCompared with AGA, SGA children due to fetal factors had the highest risk of low IQ (aOR = 1.94, 95% CI: 1.45–2.59). SGA infants due to physiological factors had the highest risk of growth restriction (aOR = 6.04, 95% CI: 3.93–9.27). SGA children had a higher risk of growth restriction with the aOR ranging from 3.05 (95% CI: 2.36–3.96) to 5.77 (95% CI: 4.29–7.75) for the number of risk factors that the SGA infants had from 1 to 5. SGA children with any risk factor were associated with a higher risk of lower IQ with the aOR ranging from 1.59 (95% CI: 1.31–1.94) to 1.96 (95% CI: 1.50–2.55). SGA without the five types of etiologies was not associated with adverse child outcomes except for growth restriction (aOR = 3.82, 95% CI: 2.62–5.55).ConclusionTerm SGA of different etiologies may lead to different child health outcomes.ImpactOur study found that SGA of different etiologies may lead to different child health outcomes.Compared with AGA, SGA children due to fetal factors had the highest risk of low IQ. SGA infants due to physiological factors had the highest risk of growth restriction.SGA babies should not be treated the same. In the era of precision medicine, our findings may help pediatricians and parents better manage SGA babies according to different etiologies and the number of risk factors.