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目的探讨早产小于胎龄儿(small for gestational age,SGA)在生后1年内的体格生长变化趋势是否与足月SGA存在差异,为早产SGA生后体格生长随访监测提供参考依据。方法采用前瞻性队列研究,收集2013年9月至2015年6月在重庆医科大学附属儿童医院儿童保健科随访的早产SGA 54人,足月SGA 181人。分别在1、3、6、12月龄(早产SGA在纠正胎龄的1、3、6、12月龄)测量体质量、身长、头围,采用Z积分计算体格水平和生长速度。结果 1早产SGA生后快速追赶生长发生在纠正年龄1月龄后,而足月SGA在生后即开始;早产和足月SGA在前6个月追赶生长率均达63.0%。2早产SGA未纠正胎龄的体质量Z值在6、12月龄(t=-1.189、-0.911,P=0.236、0.363),身长、头围Z值在12月龄(t=-0.855、-1.078,P=0.394、0.282)与足月SGA比较差异无统计学意义。3早产SGA的体质量增长速度在1~3、>3~6月龄(t=4.685、3.787,P<0.01),身长、头围在1~3、>3~6、>6~12月龄追赶速度明显快于足月SGA(t=3.487、3.626、4.179,t=5.158、3.001、4.641,P<0.01)。但在1月龄内体质量、身长追赶速度均慢于足月SGA(t=-6.384、-4.821,P<0.01),甚至低于出生时Z值水平(ΔZ<0)。结论早产SGA追赶生长的发生晚于足月SGA,体格生长水平可在1岁时追赶上足月SGA,在1岁内生长潜力大于足月SGA,在纠正年龄1月龄内易发生宫外生长迟缓。
Objective To investigate whether the trend of physical growth of preterm small for gestational age (SGA) within one year after birth is different from full-term SGA, and provide a reference for the follow-up monitoring of the growth of premature SGA. Methods A prospective cohort study was conducted to collect 54 SGA preterm and 181 full-term SGA patients from September 2013 to June 2015 at Children’s Hospital of Chongqing Medical University. Body mass, body length and head circumference were measured at 1, 3, 6 and 12 months (premature birth SGA at 1, 3, 6, and 12 months of gestational age). Z-scores were used to calculate body weight and growth rate. Results 1 Rapid catch-up growth after prenatal SGA occurred after 1 month corrected age, whereas full-term SGA started after birth; both preterm and full-term SGA catch-up growth rates reached 63.0% in the first 6 months. The body mass Z values of gestational age without prenatal SGA were 6, 12 months old (t = -1.189, -0.911, P = 0.236,0.363), body length and head circumference Z value were 12 months old (t = -0.855, -1.078, P = 0.394, 0.282) had no significant difference with term SGA. The body mass growth rate of preterm delivery SGA ranged from 1 to 3,> 3 to 6 months old (t = 4.685, 3.787, P <0.01), body length and head circumference ranged from 1 to 3, from 3 to 6, from 6 to 12 months The catch-up rate was significantly faster than full-term SGA (t = 3.487, 3.626, 4.179, t = 5.158, 0.001, 4.641, P <0.01). However, body mass and length of catch-up in 1 month were both slower than full-term SGA (t = -6.384, -4.821, P <0.01) and even lower than Z value at birth (ΔZ <0). Conclusions The growth of premature SGA catch-up is later than full-term SGA, and the growth of body weight can catch the full-term SGA at 1 year of age. The growth potential of SGA at 1 year is greater than full-term SGA. Ectopic growth tends to occur within 1 month of correct age slow.