Clinical Research On Extrauterine Growth Retardation Of Premature Infants

Objective: To study the high risk element of extrauterine growth retardation of premature infants and the correlation between EUGR and biochemical metabolism index, and to provide theoretical basis for improving development of premature infants, through measuring the physical development index and biochemical metabolism of 60 premature infants with birth weight lower than 2000 g,having postpartum followup visit till the 6th month after deliver.Methods: 60 premature infants hospitalized in neonatal department of Affiliate Hospital of Guiyang Medical college from April 2014 to January 2015 were selected as researching objects. These infants are categorized into extrauterine growth retardation(EUGR) group and non extrauterine growth retardation(NON EUGR)group,meanwhile 30 full term infants were selected as comparison group. Metabolic diseases that may affect insulin,C peptide and IGF-1 were excluded. 4ml of peripheral venous blood on empty stomach were taken from the infants in the morning on their7 th day, 14 th day after new born. albumin(ALB),prealbumin(PA),cholesterol(TC),triglyceride(TG),hyperdensity lipoprotein-cholesterol(HDL-C),low density lipoprotein-cholestrol( LDL-C),fasting blood glucose(FBG),insulin,C peptide(CP),insulin-like growth factor(IGF-I) were checked and insulin resistance index was calculated; physical development index( weight,height,head circumference) were checked;first feeding date,sufficient feeding time,starting time of intravenous nutrition,intravenous nutrition duration were recorded after being hospitalized,and the complication situation was recorded during hospitalization. Results: 1.birth weight of EUGR group premature infant was lower than the one of NON-EUGR group,the difference was statistically significant(P<0.05).2.Intrauterine Growth Retardation(IUGR),infection, small gestational age and low birth weight are high risk elements of EUGR(OR=35.867,73.941, 2.991,3.258,P<0.05).3.first feeding date,starting time of intravenous nutrition of EUGR group premature infant was later than the one of NON-EUGR group,sufficient feeding time and intravenous nutrition duration was longer than the one of NON-EUGR group, the difference is statistically significant(P<0.05).4.weight,head circumference and height of EUGR group and NON-EUGRgroup premature infants was lower than full term infants on their 7th, 14 th day after birth, the difference was statistically significant(P<0.05);EUGR group infants is lower than NON-EUGR on weight,head circumference,height,increasing speed of weight,increasing of head circumference,increasing of height when they are 3 month and 6 month old, the difference is statistically significant(P<0.05);the growth retardation rate of weight,head circumference and height of EUGR group infants was higher than the one of NON-EUGR group when they are 3 month old, the growth retardation rate of weight and head circumference of EUGR group infants was higher than the one of NON-EUGR group when they are 6 month old, the difference is statistically significant(P<0.05).5.the IGF-I, INS,PA,ALB,TP,TC,TG level of EUGR group and NON-EUGR group premature infants are lower than full term infants on their 7th and 14 th day after birth,the PA level of EUGR group infants is lower than NON-EUGR group on their 7thand 14 thday after birth,the difference was statistically significant(P<0.05),PA,IGF-I level of all groups tends to increase along with age increasing.6.IGF-1,PA level of EUGR group infants is lower than NON-EUGR group when they are 3 month and 6 month old;INS level of EUGR group infants is lower than NON-EUGR group when they are 3 month old;incidence rate of IRI on EUGR group infants was higher than NON-EUGR group on when they are 3 month old,the difference was statistically significant(P<0.05).7.IGF-I level was positively correlated with weight increasing speed, height increasing and head circumference increasing(r=0.610,0.544,0.515,P<0.05) in the postpartum followup visit of the 3rd month after new born;PA level was positively correlated with weight increasing speed,height increasing and head circumference increasing(r=0.426,0.494,0.327,P<0.05);TC level was negatively correlated with weight increasing speed, head circumference increasing(r=-0.289,-0.388,P<0.05);lg IRI level was negatively correlated with height increasing and head circumference increasing(r=-0.442,-0.243,P<0.05).Conclusion:1.the younger the gestational age is and the smaller the birth weight is,the more likely EUGR will occur, premature infants with complication IUGR or infection is more likely to have EUGR than those without IUGR or infection.2. the late the first feeding date and starting time of intravenous nutrition and sufficient feeding time is, and the longer the intravenous nutrition duration is, and the more frequently respirator is used and digestive tract bleeding occur, the more likelyEUGR will occur.3. physical development of EUGR group is later than NON EUGR group when they are 3 month and 6 month old.4.PA,IGF-1,INS level and IR are closely related to physical development of infants.