| Background High risk infants have more potential growth problems and a higher risk of poor prognosis than normal newborns.According to the "first 1,000 days of life" concept,the period from the beginning of a mother’s pregnancy to the age of 2 is a critical period that determines children’s health throughout her life.Follow-up of high-risk infants after hospital discharge is of great significance for early detection of developmental delay,early intervention,catch-up growth,improvement of long-term prognosis and quality of life of high-risk infants.Preterm birth is the most common risk factor,while late preterm babies accounting for about 75 percent of premature births.At present,there are two kinds of follow-up modes in Beijing,namely,specialized follow-up in general hospitals and follow-up in community health service centers.This study was conducted to understand the follow-up situation and follow-up effect of the two modes.Objective Understand and compare the two follow-up modes of late preterm follow-up situation,including the follow-up process and content,high risk factors of the late preterm,baseline,infants’ growth and development situation,explore the factors affecting the physical growth and development of late premature infants,in order to provide a reference for the establishment of a reasonable follow-up model.Method Purpose of this study is a retrospective cohort study,late preterm infants born on January 1,2013 solstice and December 31,2017(gestational age:34 to 36+6 weeks)were selected as subjects,and the observation nodes were taken at birth,adjusted age:6 months,12 months,18 months and 24 months,and postnatal age:30 months and 36 months.Collect the data of the growth and development follow-up information system,and the collected data were collated and statistically analyzed.Results1、Data of 576 late preterm infants were collected,including 278 in the community follow-up group and 298 in the hospital follow-up group.2、In the hospital follow-up group,there were more cases of pregnancy-induced hypertension and gestational diabetes mellitus,more cases of multiple births,cesarean delivery and fetal distress,more cases of low birth weight(66.1%),less gestational age(35.20±0.90)weeks,and more associated risk factors.The gestational age and physical index at birth in the hospital follow-up group were lower than those in the community follow-up group,and the baseline level was lower.As the age increased,the number of people lost to follow-up gradually increased,but there was no significant difference between the two groups.3、At 6 months of age,the physical measurements of the two groups were no different from those of normal children of the same age.The community follow-up group completed catch-up growth in weight and the hospital follow-up group completed catch-up growth in body length,and the increase of body weight and body length in 6 months was greater than that of the community follow-up group.4、At 24 months and 36 months of age,there was no significant difference in the physical development between the two groups and the normal children.The increase of physical growth measured in the hospital follow-up group was greater than that of the community follow-up group.5、The results of multivariate analysis showed that the hospital follow-up pattern was significantly positively correlated with the Z score of body length at 6 months,and positively correlated with the evaluation indexes of body length at 24 months.Conclusion Regular follow-up can promote the growth and development of late premature infants,so we must reinforce the follow-up work in 6 months after birth.It is suggested that community health institutions should improve the follow-up model,formulate follow-up plans according to corrected gestational age,and refine follow-up contents,especially the management of postnatal environmental factors.It is conducive to the homogenized development of the medical level to strengthen the community support provided by general hospitals,and do a good job in technical support,training and learning of new knowledge,new technology and new progress. |
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