Physical,Intellectual Development And Nutritional Status Of 415 Premature Infants In Binhai New Area,Tianjin

With the continuous rise in the proportion of premature infants living in the international community,as a special and high-risk group,the survival status of premature infants have been widely concerned by the society and medical profession.Developed countries not only attach importance to the rescue of premature infants,but also the post-discharge management.The early growth state of premature infants is critical to their catch-up growth and it directly affects children’s long-term growth、intelligence and health.According to the requirements of the health care standards for premature infants,conducting regular follow-up after discharge,finding and solving the problems in time,personalized guidance and intervention,improving the quality of life of premature infants are the urgent tasks for child health workers.Therefore,this study conducted a follow-up study on 415 premature infants borning in Binhai new area and regularly followed in Binhai new area Women and Children Center between 2016.01-2018.08.The study is to understand the development and nutritional status of premature infants in our region at that time.ObjectivesThrough the study we can understand the characteristics of physical development and intellectual development from birth to 12 months of corrected age of premature infants and analyze the growth development,intelligence development,hemoglobin,bone alkaline phosphatase,ultrasound bone density of preterm infants at different levels and their differences.Meanwhile,the study can provide data support and basis for clinical practice.It can further standardize premature infants health care and more scientific and reasonable guidance for the management of premature infants.MethodsThis study collects basic information on preterm infants born in 2016.01-2018.08 in our center according to the uniform questionnaire.Doing physical examinations,tests and guiding the development regularly.Obtaining the basic data such as body length,weight,head circumference,intelligent development results and hemoglobin then recorded in excel and analyzed by SPSS22.Results 1、 The mean of WAZ and LAZ in 415 premature infants at all corrected age were> 0,and the peaks of both occurred at 2 months of corrected age,while the peak of the HCZ appeared at 40 weeks gestational age.2、 Premature infants of different birth weights had significantly different WAZ,LAZ,and HCZ(except for 10 months of corrected age).WAZ and LAZ in the NBW were greater than those in the LBW and the LBW was greater than the VLBW(P < 0.05).The peak of WAZ and LAZ in the LBW and NBW appeared at 2 months of corrected age,while the peak of WAZ in the VLBW appeared at 4 and 6 months of corrected age.3、 The HCZ of preterm infants with different gestational weeks within 4 months of corrected age was statistically significant.The group of ≥ 34 W weeks was significantly higher than the group of <32 weeks(P <0.05).The peaks of the three groups all appeared at 40 weeks gestational age.4、 Premature infants with different levels of nutritional risk had different WAZ(except 4 months of corrected age)and LAZ at different corrected months and HCZ were different within 4 months of corrected age(P <0.05).5、 Among the 415 premature infants enrolled in this study,there were more late premature infants.The incidence of IUGR was 14.21%.The incidence of weight EUGR was 12.95%.The incidence of length EUGR was 7.51% and the head circumference EUGR was 4.14%.Lower than reported in other papers.6、 VLBW,EPI,and middle-high risk premature infants,which the abnormal rate of NBNA examination at the due date,the abnormal rate of children’ psychological examination at 6 and 12 months of corrected age were higher than LBW,LPI and Low-risk group.The results were statistically significant(P <0.05).7、 The prevalence of anemia in VLBW、EPI and middle-high risk preterm infants was higher than that in LBW、LPI and low-risk preterm infants at 3 months of corrected age.The positive rates of BALP in preterm infants EPI and middle-high risk groups were significantly higher than that in the LPI and the low-risk group(P <0.05).There were statistically significant differences in bone Z among preterm infants stratified by different birth weights,gestational weeks,and nutritional risk levels at 3 and 6 months of corrected age(P <0.05).Conclusion 1、 Catch-up growth occurred after birth of premature infants and the peak of catch-up growth in length and weight is 2 months of corrected age.Catch-up growth of head circumference is advanced and obvious in 40 weeks gestational age.Attention should be paid to the nutritional and developmental conditions before 2 months of corrected age to reduce the occurrence of adverse consequences.2、 The Catch-up growth of VLBW are not as ideal as those in LBW,NBW and high-risk preterm infants are not as ideal as those in the middle and low-risk groups.There are no significant differences between different genders and gestational weeks.The postnatal system management of high-risk preterm infants and VLBW preterm infants should be paid attention to.As a new classification method of premature infants,nutritional risk level is of great significance to guide the application of different premature infant intervention models and improve the quality of life of preterm infants.3、 The abnormal rate of intelligent development increase obviously in VLBW,EPI,and middle-high-risk preterm infants within 1 year of age.The vertical comparison shows a trend of rising first and then decreasing.Therefore,the intelligent training of 6 months of corrected age and before needs to be improved and enhanced.4、 Premature infants are prone to anemia in VLBW,EPI and middle-high-risk premature infants when they are 3 months of corrected age.Appropriate prophylactic medication,monitoring closely and checking regularly are indispensable.5、Ultrasound bone density Z values of preterm infants are all lower.There are significant differences in ultrasound bone density Z values and BALP between different gestational weeks and different nutritional risk stratification within 6 months of corrected age.Therefore,though ultrasound bone density and BALP cannot diagnose bone nutrition but they can be used as one of the screening and monitoring index of bone nutrition status in preterm infants.