Analysis Of Body Weight Growth And Its Influencing Factors In Small Gestational Age Infants During Hospitalization

ObjectiveTo explore the weight gain of small gestational age infants during hospitalization and its related factors..MethodA retrospective analysis was conducted on 508 SGA infants treated in the Department of Neonatal Pediatrics,the third affiliated Hospital of Guangzhou Medical University from January 2016 to February 2019.The general demographic data of children and pregnant mothers,perinatal complications and hospitalization complications were collected.The weight gain during hospitalization was analyzed,and the relevant factors affecting the weight gain of infants less than gestational age were discussed.Linear regression was used to analyze the influencing factors of SGA infants' weight gain during hospitalization.ResultsA total of 508 cases of EUGR were included,including 241 males(47.4%)and 267 females(52.6%),the average birth weight was 1912.03 ±443.42 g,the gestational age was 36.14 weeks,the birth age of twins was 50.4%,and cesarean section was 383 cases(79.5%).The median rate of weight growth during hospitalization was 6.02(1.78 million 9.9)g SGA,and the overall incidence of SGA at discharge was 96.8%(492ver 508).Among them,the incidence of EUGR at discharge of preterm SGA was 98.1%(314 /320).1.General condition of pregnant women: advanced age,first delivery and assisted reproductive technology had no effect on the weight gain of SGA infants during hospitalization(P > 0.05).2.The weight gain of SGA infants in the maternal placenta abruption group was faster than that in the non-placenta abruption group(Z=1.81,P=0.007),while placenta previa and placenta accreta had no effect on the body weight gain of SGA infants during hospitalization(P > 0.05).3.The weight gain of SGA infants in maternal hypertension group was faster than that in non-hypertension group(P <0.01).The body weight of SGA infants with hypothyroidism was faster than that of SGA infants with normal thyroid function in pregnant women with hypothyroidism(P < 0.01).The weight gain of SGA infants with connective tissue disease was faster than that of SGA infants without connective tissue disease(Z=3.05,P < 0.01).The body weight of SGA infants with connective tissue disease was faster than that of SGA infants without connective tissue disease.Maternal complications such as diabetes,anemia,scar uterus,pelvic surgery,uterine and ovarian diseases had no effect on the body weight gain of SGA infants during hospitalization(P > 0.05).The weight gain of SGA infants in the pregnant women with heart disease group was slower than that in the non-heart disease group(P > 0.05).Maternal complications such as diabetes,anemia,scar uterus,pelvic surgery and uterine and ovarian diseases had no effect on the body weight gain of SGA infants during hospitalization(P > 0.05).4.In terms of fetal factors,the body weight of SGA infants with fetal distress increased rapidly during hospitalization(Z=2.8 P= 0.005),while multiple births,umbilical cord around neck and congenital malformations had no effect on SGA infants' weight gain during hospitalization(P > 0.05),while multiple births,umbilical cord around neck and congenital malformations had no effect on SGA infants' weight gain during hospitalization(P > 0.05).5.Neonatal complications: the weight gain of NRDS group was faster than that of non-NRDS group(P < 0.0l),that of BPD group was faster than that of non-BPD group(P < 0.0l),that of neonatal pneumonia group was slower than that of non-neonatal pneumonia group(P < 0.0l),and that of abnormal blood coagulation group was faster than that of normal blood coagulation group(P <0.0l),and that of abnormal blood coagulation group was faster than that of normal blood coagulation group.The body weight of the transient hypothyroidism group was faster than that of the non-transient hypothyroidism group,and that of the feeding intolerance group was faster than that of the non-feeding intolerance group.The weight gain of the NEC group was faster than that of the non-NEC group(Z=-2.507,P=0.011),and the weight gain of the intracranial hemorrhage group was faster than that of the non-intracranial hemorrhage group.(Z=-1.971,P=0.05)? The weight gain of hyperbilirubinemia group was faster than that of non-hyperbilirubinemia group(Z=2.794,P=0.001),and the difference was statistically significant.However,neonatal asphyxia,intrauterine infection,hypoglycemia and gastrointestinal bleeding had no significant effect on the weight gain of SGA infants during hospitalization(P > 0.05).6.Spearman rank correlation analysis showed that the weight gain of SGA infants during hospitalization was not related to parturition,number of pregnancies,times of maternal miscarriage,maternal weight gain and so on.7.Multiple linear regression analysis showed that the factors that could predict weight gain during hospitalization were birth weight,gestational age,maternal hypertension,maternal heart disease and nutritional support time.The SGA infants whose mothers were complicated with hypertension and nutrition support for longer periods of time had faster weight gain during hospitalization(B=1.286?0.095,95%CI: 0.154~2.418?0.016~0.174).The smaller the birth weight,the lower the rate of weight growth(B=-0.008,95%CI: 0.073~1.01).The larger the gestational age is,the favorable factor for the weight growth during hospitalization(B=0.541,95%CI: 0.073~1.01).While the pregnant mother with heart disease is a disadvantageous factor that is less than the rate of weight growth after birth of the child of gestational age(B=-2.612,95%CI:-5.29~-0.067)and the higher the birth weight,the lower the rate of weight growth(2.612,95).Conclusion1.Children with small gestational age and low birth weight percentile SGA have significant weight gain during hospitalization.2.SGA children with high blood pressure,thyroid disease,and connective tissue disease during pregnancy have significant weight gain during hospitalization.3.The vast majority of infants younger than gestational age fail to meet the domestically recommended growth catch-up level.The incidence of EUGR when younger than gestational age is discharged remains high,especially premature SGA infants.