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目的探讨低出生体重儿(low birth weight,LBW)生长发育规律和围生期保健管理。方法将出生至24个月内定期随访13次的235例婴儿分为足月低出生体重儿(mature low birth weight infant,MLBW)组、早产低体重儿(premature low birth weight infant,PLBW)组、正常出生体重儿(normal birth weight infant,NBW)组,比较分析24月内体重、身高、头围的平均值和Z值。结果体重和身长从出生至3月龄、头围从1月龄至5月龄均表现为NBW﹥MLBW﹥PLBW,差异有统计学意义(P﹤0.01);但MLBW和PLBW体重分别从1月龄和2月龄开始、身长分别从1月龄和4月龄开始、头围分别从1月龄和2月龄开始,各月龄均有50%以上达到追赶生长;PLBW追赶生长更明显,体重、身长、头围分别从4月龄、6月龄开始,两组各月龄已无统计学差异(P﹥0.05);体重、身长、头围分别从5月龄、12月龄、8月龄开始,各月龄均有1/3左右基本达到正常生长水平,但仍明显小于NBW(P﹤0.01);至24月龄,MLBW和PLBW体重、身长仍分别有约10%和4%、4%和2%未达追赶生长,头围均达追赶生长,但仍明显小于NBW(P﹤0.01)。结论 LBW在出生后前3个月追赶生长最快,PLBW追赶生长更明显;身长追赶生长晚发于体重。至24月龄,LBW尚不能达到NBW体格发育水平,甚至还有部分不能达到追赶生长,可能出现终生生长发育落后。加强围生期保健管理,在孕期和新生儿期系统监测和及时干预与强化营养支持是降低LBW发生率、保障LBW完成追赶生长的关键措施。
Objective To investigate the growth and development of low birth weight (LBW) and management of perinatal health care. Methods Thirty-five infants who were born at least 12 times within 24 months after birth were divided into two groups: mature low birth weight infant (MLBW), premature low birth weight infant (PLBW) Normal birth weight infant (NBW) group, the average body weight, height, head circumference and Z value in 24 months were compared and analyzed. Results Body weight and body length ranged from birth to 3 months of age. Head circumference ranged from 1 month to 5 months with NBW> MLBW> PLBW, with significant difference (P <0.01). However, the body weights of MLBW and PLBW increased from January Beginning at age of 2 months and starting at 1 month and 4 months of age, head circumference started from 1 month and 2 months respectively, and over 50% of all age groups were catch-up. PLBW catch-up growth was more obvious, Body weight, length and head circumference ranged from 4 months and 6 months respectively. There was no significant difference between the two groups (P> 0.05). The body weight, length and head circumference ranged from 5 months, 12 months, 8 From the beginning of the month, about one-third of each age reached the normal level of growth, but still significantly less than NBW (P <0.01). At 24 months, the body weight and length of MLBW and PLBW were still about 10% and 4% , 4% and 2%, respectively, did not catch up with the growth, head circumference reached catch up growth, but still significantly less than NBW (P <0.01). Conclusion LBW catch up in the first 3 months after birth, the fastest growing, PLBW catching more obvious growth; length catch up late in weight loss. To 24 months of age, LBW still can not reach the level of physical development of NBW, and even some can not achieve the catch-up growth, growth and development may appear lifelong backwardness. Strengthening perinatal healthcare management, systematic monitoring during pregnancy and neonatal period, timely intervention and intensive nutrition support are the key measures to reduce the incidence of LBW and ensure that LBW can catch up with growth.