Preterm Infant Growth Velocity Calculations: A Systematic Review
Preterm Infant Growth Velocity Calculations: A Systematic Review
复制标题
DOI：
10.1542/peds.2016-2045
复制
发表时间：
2017-03-01
期刊：
影响因子：
8
通讯作者：
Ehrenkranz, Richard A.
中科院分区：
文献类型：
--
作者：
Fenton, Tanis R.;Chan, Hilton T.;Ehrenkranz, Richard A.
背景：临床医生评估早产儿的生长和比较生长速度使用抽象的各种methods.Objective：我们确定了用于描述早产儿体重，身长和头围生长速度的数值方法;这些方法包括克/公斤/天（g/kg/d），克/天（g/d），厘米/周（cm/week），和z分数的变化。2015年4月，使用PubMed对Medline数据库进行了一次检索，以查找将出生至出院和/或经后40周早产儿的生长作为主要结局的研究。包括英语、法语、德语和西班牙语文章。采用系统评价首选报告项目和Meta分析方法进行系统评价。资料选择：在1543篇定位研究中，373篇（24%）计算了生长速度。资料提取：我们对151篇报道g/kg/d体重增加速度的研究进行了详细提取。在1543项研究中报告的最常用的计算体重增加速度的方法是g/kg/d（40%），其次是g/d（32%）; 29%报告了z评分相对于宫内或生长图表的变化。在g/kg/d研究中，39%在出生/入院时开始计算g/kg/d，20%在研究开始时，10%在完全喂养时，7%在出生体重恢复后。62%未报告千克分母。在确实报告了增重因子的研究中，大多数使用起始和结束体重的平均值作为分母（36%），其次是指数方法（23%）;不太常用的增重因子包括出生体重（10%）和早期体重，而不是出生体重（16%）。19%（355项研究中的67项）得出了关于子宫外生长受限或产后生长失败的结论。在头围增长和长度增加的时间趋势变化，主要是厘米/周，主要是z scores. LIMITED和结论缺乏标准化的方法来计算早产儿的生长速度，使研究之间的比较困难，并提出了一个障碍，使用研究结果来指导临床实践。
CONTEXT: Clinicians assess the growth of preterm infants and compare growth velocity using a abstract variety of methods.OBJECTIVE: We determined the numerical methods used to describe weight, length, and head circumference growth velocity in preterm infants; these methods include grams/kilogram/day (g/kg/d), grams/day (g/d), centimeters/week (cm/week), and change in z scores.DATA SOURCES: A search was conducted in April 2015 of the Medline database by using PubMed for studies that measured growth as a main outcome in preterm neonates between birth and hospital discharge and/or 40 weeks' postmenstrual age. English, French, German, and Spanish articles were included. The systematic review was conducted by using Preferred Reporting Items for Systematic Reviews and Meta-analyses methods.STUDY SELECTION: Of 1543 located studies, 373 (24%) calculated growth velocity.DATA EXTRACTION: We conducted detailed extraction of the 151 studies that reported g/kg/d weight gain velocity.RESULTS: A variety of methods were used. The most frequently used method to calculate weight gain velocity reported in the 1543 studies was g/kg/d (40%), followed by g/d (32%); 29% reported change in z score relative to an intrauterine or growth chart. In the g/kg/d studies, 39% began g/kg/d calculations at birth/admission, 20% at the start of the study, 10% at full feedings, and 7% after birth weight regained. The kilogram denominator was not reported for 62%. Of the studies that did report the denominators, the majority used an average of the start and end weights as the denominator (36%) followed by exponential methods (23%); less frequently used denominators included birth weight (10%) and an early weight that was not birth weight (16%). Nineteen percent (67 of 355 studies) made conclusions regarding extrauterine growth restriction or postnatal growth failure. Temporal trends in head circumference growth and length gain changed from predominantly cm/wk to predominantly z scores.LIMITATIONS AND CONCLUSIONS The lack of standardization of methods used to calculate preterm infant growth velocity makes comparisons between studies difficult and presents an obstacle to using research results to guide clinical practice.