Clinical Analysis Of Physical Growth In Neonates With Pneumonia During Hospitalization

Objective: To understand the physical growth of newborn infants hospitalized for pneumonia,and to provide reference for early and timely nutritional support.Methods: 228 cases of neonatal pneumonia admitted to the Department of Neonatology,Children's Hospital Affiliated to Chongqing Medical University from March 2018 to March 2019 were collected.They were divided into premature infant(PI)and full-term infant(FTI)according to their gestational age.According to the relationship between birth weight and gestational age,they were divided into small for gestational age(SGA)and appropriate.Groups were divided into appropriate for gestational age(AGA)and larger for gestational age(LGA).Weight-for-age Z-score(WAZ),Length-for-age Z-score(LAZ),Head circumference-for-age Z-score(HCZ),hospital stay,albumin(ALB),hemoglobin(Hb)and hemoglobin levels during hospitalization were compared among different groups.The birth weight of newborns at different gestational ages in 15 cities of China in 1986 and the physical development of children under seven years old in nine cities of China in2015 were taken as reference values.Results: A total of 228 cases were collected,including PI90,FTI 138,SGA 25,AGA 159 and LGA 44.1)Basic data: Compared with SGA,AGA and LGA groups,it can be seen that the majority of cases collected in this subject are AGA infants,LGA mostly occurs in full-term infants;2)Admission time(PI ? FTI):WAZ,LAZ,HCZ and ALB in PI group were lower than those in FTI group,and there was significant difference between the two groups(P<0.05);Hb in PI group was higher than that in FTI group,and the difference between the two groups was significant(P<0.05);3)Discharge time(PI?FTI):Hb and WAZ in PI group were significantly lower than those in FTI group,with significant difference between the two groups(P<0.05);hospitalization days in PI group were longer than those in FTI group,with significant difference between the two groups(P<0.05);?Hb and ?WAZ in PI group were smaller than those in FTI group,with significant difference between the two groups(P<0.05);4)Pregnancy condition(PI ? FTI):The proportions of cesarean section,hypertension,diabetes,cholestasis and premature rupture of membranes in PI group were higher than those in FTI group(P<0.05).The proportions of anemia in PI group were lower than those in FTI group(P<0.05).There was no significant difference in the proportions of infection in pregnancy between the two groups(P>0.05);5)Complications during hospitalization(PI ?FTI):The proportions of NRDS,neonatal asphyxia,respiratory failure and hypoproteinemia in PI group were higher than those in FTI group(P< 0.05);there was no significant difference in the proportions of suppurative meningitis,neonatal anemia,neonatal sepsis and neonatal jaundice between the two groups(P>0.05);6)Admission time(PI):Compared with WAZ,LAZ and HCZ,SGA group was lower than AGA and LGA group,the difference was statistically significant(P<0.05);compared with Hb,SGA group was higher than AGA and LGA group,the difference was statistically significant(P<0.05);compared with ALB,the difference was not statistically significant(P>0.05);7)Discharge time(PI):Compared with WAZ,SGA group was lower than AGA and LGA group,the difference was statistically significant(P<0.05);compared with ?Hb,SGA group was smaller than AGA and LGA group,the difference was statistically significant(P<0.05);compared with Hb,?WAZ,hospitalization days,the difference was not statistically significant(P>0.05);8)Admission time(FTI):Compared with WAZ,LAZ,HCZ,SGA group were lower than AGA and LGA group,the difference was statistically significant(P<0.05);compared with Hb,SGA group was higher than AGA and LGA group,the difference was statistically significant(P<0.05);compared with ALB,the difference was not statistically significant(P>0.05);9)Discharge time(FTI):Compared with WAZ,SGA group was lower than AGA and LGA group,the difference was statistically significant(P<0.05);compared with ?Hb,SGA group was smaller than AGA and LGA group,the difference was statistically significant(P<0.05);compared with ?WAZ,LGA group was smaller than SGA and AGA group,the difference was statistically significant(P<0.05);Hb,hospitalization days had no significant difference(P>0.05).Conclusion: 1)Compared with full-term infants,premature infants had poor nutritional status at admission and discharge;2)After corrected gestational age,the WAZ of premature infants and full-term infants discharged from hospital in SGA group was <-2,suggesting that they were in a low weight state at discharge.The WAZ of full-term infants discharged from hospital in SGA group was improved,suggesting that more attention should be paid to the nutritional status of premature infants in SGA;3)The corrected gestational age,premature infants,full-term infants,WAZ discharged from hospital and admission showed a downward trend,suggesting that we should also pay attention to the nutritional status of AGA and LGA in clinical practice;4)Neonatal pneumonia is a common disease in neonatal period,which results in strong catabolism,high energy consumption and weight loss.Compared with full-term infants,premature infants have less nutrient and energy reserves at birth,weak nutrient intake ability,more and more serious complications,and their malnutrition and disease status can affect their growth and development.