The Rate Of Weight Gain During Hospitalization Of Premature Infants And Its Influencing Factors

ObjectiveTo study the rate of weight gain during hospitalization of premature infants and the analysis of influencing factors.MethodA retrospective analysis of premature infants treated in the neonatal intensive care unit of the Fifth Affiliated Hospital of Zhengzhou University from December2019 to December 2020.Collect the general information of the child and the pregnant mother,the fetal intrauterine situation during the perinatal period and the pregnant mother’s intrauterine situation,the complications of the pregnant mother,the nutrition and supportive treatment during the hospitalization of the premature infant,and the complicated diseases of the premature infant.Analyze the weight gain rate of premature infants during hospitalization and analysis of related factors.And make multiple linear regression analysis of its related factors.Result1.In this retrospective analysis,a total of 133 preterm infants met the inclusion and exclusion criteria.Among them,81 cases were boys（60.90%）,52 cases were girls（39.10%）;89 cases were single births（66.92%）,44 cases were multiple births（33.08%）;delivery method:normal delivery 67（50.38%）,cesarean delivery 66（49.62）%);the length of hospital stay ranges from 7 to 96 days,and the median length of hospital stay is 23（13-38）days.The median weight growth rate range is 10.94（7.99-13.52）g/kg.d.The effect of gestational age on the rate of weight gain:<28 weeks of premature infants,28-30⁺⁶ weeks of premature infants,31-32⁺⁶ weeks of preterm infants,33-34⁺⁶weeks of preterm infants,35-36⁺⁶ weeks of preterm infants’weight gain during hospitalization Followed by 16.44（15.08-17.28）g/kg.d,13.80（13.04-15.50）g/kg.d,11.25（10.00-12.38）g/kg.d,10.11（7.97-12.21）g/kg.d,7.40（6.44-9.74）g/kg.d.The younger the gestational age of premature infants,the faster the weight gain during hospitalization,P<0.001.The effect of birth weight on the rate of weight gain:The rate of weight gain during hospitalization of premature infants with birth weight<1500g,1500-2500g,and>2500g is 15.39（14.97-17.17）g/kg.d,11.27（8.27-13.52）g/kg.d,7.40（6.21-8.06）g/kg.d.The lower the birth weight of premature infants,the greater the rate of weight gain during hospitalization,P<0.001.The comparison of the rate of weight gain during hospitalization between small-for-gestational age infants and non-small-for-gestational age infants[14.89（11.32-15.28）g/kg.d VS 10.66（7.92-13.15）g/kg.d,P=0.016],the difference was statistically significant.2.The rate of weight gain during hospitalization between the fetal distress group and the group without fetal distress in preterm infants was compared（Z=-3.170,P=0.002）.3.Premature rupture of membranes in pregnant mothers has a faster weight gain during the hospitalization of premature babies than in the absence of premature rupture of membranes（Z=-2.076,P=0.038）,there is a statistical difference.Premature abruption of membranes has a faster weight gain during the hospitalization period of premature infants than that of no abruption（Z=-2.165,P=0.030）,There are statistical differences.4.The hospitalized weight of premature infants in the pregnant mothers with hypertension increased faster than that in the non-hypertensive group（Z=-4.025,P<0.001）.5.During the hospitalization of preterm infants,the weight gain of using parenteral nutrition was faster than that without parenteral nutrition（Z=-3.767,P=0.013）.During the hospitalization of premature infants,the weight gain of using PS was faster than that of not using PS（Z=-2.262,P=0.024）.6.There is a strong negative correlation between weight gain and birth weight during hospitalization（r_s=-0.6892,P<0.001）,and a strong negative correlation with gestational age at birth（r_s=-0.7169,P<0.01）,There is a negative correlation with birth length（r_s=-0.3846,P<0.001）and a weak negative correlation with the percentage of physiological weight loss（r_s=-0.3846,P<0.001）.There was a positive correlation with the time of total parenteral venous nutrition support（r_s=0.2995,P<0.001）,and a moderate positive correlation with the length of hospitalization（r_s=0.4876,P<0.001）.However,no correlation was found with the age of the first feeding.7.The NRDS group has a faster weight gain during hospitalization than the NRDS group（Z=-2.366,P=0.018）.The PDA group had a slower weight gain during hospitalization than the no PDA group（Z=1.970,P=0.049）.The weight gain of the neonatal jaundice group was slower than that of the no neonatal jaundice group（Z=4.637,P<0.001）.The weight gain of the anemia group of preterm infants was faster than that of the anemia group of preterm infants（Z=-3.223,P=0.001）.8.The weight of the birth weight is lower than the birth weight is slower（Coef=-0.404,95%CI:-0.645～-0.162,t=-3.310,P=0.001）.The weight gain rate of older gestational age is slower than that of younger gestational age（Coef=-3.112,95%CI:-4.527～-1.698,t=-4.360,P<0.001）.PDA is an unfavorable factor for the weight gain rate of preterm infants after birth（Coef=-2.901,95%CI:-4.164～-1.638,t=-4.550,P<0.001）.Birth weight,gestational age,PDA,and the percentage of physiological weight loss can be predicted to affect the rate of weight gain during hospitalization.ConclusionThe gestational age and birth weight of preterm infants are negatively correlated with the rate of weight gain of preterm infants during hospitalization.The diagnosis of PDA after birth is an unfavorable factor affecting the rate of weight gain of premature infants during hospitalization.We can formulate exclusive nutritional strategies for premature infants diagnosed with PDA to optimize their growth and development during hospitalization.