294例宫内发育迟缓儿出生2年内的身长追长观察

Observation of catch-up growth in height within two years of birth in 294 infants with intrauterine growth retardation

摘要:

目的：对294例宫内发育迟缓（IUGR）儿童出生2年内的身长追长观察，了解不同性别、不同胎龄、不同出生体重IUGR儿身长追长情况。方法：294例IUGR儿童与300例足月正常儿在出生后4、6、9、12、15、18、21、24月龄随访，测量其身长，计算身长增长值，比较身长增长情况。结果：IUGR儿童身长追长成功率男女分别为72.2%和71.5%（P=0.90）；早产小样儿与足月小样儿追长成功率分别为77.4%、68.6%（P=0.11）；出生体重1500~2499 g者的身长追长成功率较出生体重<1500 g和≥2500 g者高（P<0.01）。IUGR男童在4、6月龄及18、21、24月龄测得的身长增长值明显高于正常儿（P<0.05）；女童在4、6、9、12及21月龄测得的身长增长值明显高于正常儿。男童早产小样儿在6月龄及9月龄身长增长值明显大于足月小样儿，女童早产小样儿在4月龄及18月龄身长增长值明显大于足月小样儿。不论男女，出生体重<1500 g者在4月龄身长增长值均明显大于≥2500 g者；男童1500～2499 g者在4、6、18、21及24月龄身长增长值明显大于≥2500 g者，女童1500～2499 g者在4、6、9、12及21月龄身长增长明显大于≥2500 g者。结论：IUGR女童的追长以出生后第一年为主，而男童除出生半年内追长外，在出生第二年仍追长明显。早产小样儿的追长比足月小样儿好。出生体重<1500 g者及1500～2499 g者的追长比≥2500 g者好。

Abstract:

OBJECTIVE: To observe catch-up growth in height within two years of birth in infants of different sexes, gestational ages, and birth weights with intrauterine growth retardation (IUGR). METHODS: Follow-up was performed on 294 IUGR infants and 300 healthy full-term infants at 4, 6, 9, 12, 15, 18, 21 and 24 months after birth to measure the height, calculate the height increase and compare the two groups with respect to height increase. RESULTS: The success rates of catch-up growth in height were 72.2% in male infants and 71.5% in female infants (P=0.90), and were 77.4% in preterm small-for-gestational age (SGA) infants and 68.6% in full-term SGA infants (P=0.11). Success rates of catch-up growth in height in infants with birth weights between 1500-2499 g was higher than in those with birth weights of <1500 g and ≥2500 g (P<0.01). The male infants showed significant catch-up growth at 4, 6, 18, 21 and 24 months after birth, while significant catch-up growth was found in female infants at 4, 6, 9, 12 and 21 months after birth. Of the male infants, preterm SGA infants showed significantly greater height increase than the full-term SGA infants at 6 and 9 months after birth. Of the female infants, preterm SGA infants showed significantly greater height increase than the full-term SGA infants at 4 and 18 months after birth. For both male and female infants, height increase at 4 months after birth was significantly greater in those with birth weights of<1500 g than in those with birth weights of ≥2500 g. For male infants, height increases at 4, 6, 18, 21 and 24 months after birth were significantly greater in those with birth weights of 1500-2499 g than in those with birth weights of ≥2500 g. For female infants, height increases at 4, 6, 9, 12 and 21 months after birth were significantly greater in those with birth weights of 1500-2499 g than in those with birth weights of ≥2500 g. CONCLUSIONS: The catch-up growth in height within two years of birth in infants with IUGR occurs mainly in the first year after birth in female infants, but can be seen in the first six months and the second year after birth in male infants. Preterm SGA infants better catch-up growth than full-term SGA infants, and infants with birth weights of below 1500 g and between 1500-2499 g show better catch-up growth than those with birth weights of ≥2500 g.