6岁以下极早产儿身材矮小的纵向生长轨迹和预测危险因素
Longitudinal growth trajectories and predictive risk factors for short stature in extremely preterm infants up to six years of age.
摘要(中文译文)
这项回顾性队列研究评估了极早产儿至6岁时的纵向身高轨迹，重点关注小于胎龄儿（SGA）与非小于胎龄儿之间的差异，并识别了日后矮身材的新生儿危险因素。纳入2007年至2011年间在东京都大塚医院出生、胎龄小于28周的婴儿。SGA定义为出生体重低于第10百分位。在矫正年龄3~4个月和9~10个月，以及实际年龄2岁、3岁和6岁时评估身高Z评分和追赶生长。追赶生长定义为身高Z评分≥-2 SD。在158名婴儿中，129名（82%）为非SGA，29名（18%）为SGA。SGA组在所有时间点的身高Z评分均显著低于非SGA组（p<0.001）。尽管两组均表现出追赶生长，但SGA婴儿早期生长较慢，至6岁时仅80%实现追赶生长，而非SGA婴儿约为90%（p<0.05）。胎龄、出生体重和身长Z评分以及SGA状态是6岁时矮身材的显著预测因素。多因素分析证实，较低胎龄（比值比[OR] 0.60，95%置信区间[CI] 0.37-0.97，p=0.036）和SGA（OR 5.16，95%CI 1.13-23.4，p=0.034）为独立危险因素，胎龄阈值为25周。超过20%的SGA婴儿和7%的非SGA婴儿存在持续性矮身材，凸显了在这一高危人群中持续进行生长监测的重要性。
Abstract
This retrospective cohort study evaluated longitudinal height trajectories up to 6 years of age in extremely preterm infants, focusing on differences between those born small for gestational age (SGA) and non-SGA, and identified neonatal risk factors for later short stature. Infants born before 28 weeks' gestation at Tokyo Metropolitan Ohtsuka Hospital between 2007 and 2011 were included. SGA was defined as birth weight below the 10th percentile. Height Z-scores and catch-up growth were assessed at corrected ages of 3-4 and 9-10 months, and at chronological ages of 2, 3, and 6 years. Catch-up growth was defined as a height Z-score ≥ -2 SD. Among 158 infants, 129 (82%) were non-SGA and 29 (18%) were SGA. The SGA group had significantly lower height Z-scores than the non-SGA group at all time points (p < 0.001). Although both groups showed catch-up growth, SGA infants had slower early growth, with only 80% reaching catch-up by age 6 years, compared to approximately 90% of non-SGA infants (p < 0.05). Gestational age, birth weight and length Z-scores, and SGA status emerged as significant predictors of short stature at age 6 years. Multivariate analysis confirmed lower gestational age (odds ratio [OR] 0.60, 95% confidence interval [CI] 0.37-0.97, p = 0.036) and SGA (OR 5.16, 95%CI 1.13-23.4, p = 0.034) as independent risk factors, with a gestational age threshold of 25 weeks. More than 20% of SGA and 7% of non-SGA infants had persistent short stature, highlighting the importance of ongoing growth monitoring in this high-risk population.
如何引用
AMA
Megumi Seya, Nobuhiko Nagano, Aya Okahashi, Mio Ohshima, Shoko Ohashi, Ken Masunaga, et al. Longitudinal growth trajectories and predictive risk factors for short stature in extremely preterm infants up to six years of age.. Early human development. 2026; doi:10.1016/j.earlhumdev.2026.106516.
APA
Megumi Seya, Nobuhiko Nagano, Aya Okahashi, Mio Ohshima, Shoko Ohashi, Ken Masunaga, et al (2026). Longitudinal growth trajectories and predictive risk factors for short stature in extremely preterm infants up to six years of age.. Early human development. https://doi.org/10.1016/j.earlhumdev.2026.106516
GB/T 7714
Megumi Seya, Nobuhiko Nagano, Aya Okahashi, Mio Ohshima, Shoko Ohashi, Ken Masunaga, et al. Longitudinal growth trajectories and predictive risk factors for short stature in extremely preterm infants up to six years of age.[J]. Early human development, 2026 doi:10.1016/j.earlhumdev.2026.106516.
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