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Abstract：
Introduction The aim of our study was to assess the impact of intrauterine growth restriction (IUGR) and placental insufficiency (PI) on the nutritional outcomes of extremely low birth weight (ELBW) infants. Methods We conducted a six-year retrospective case-control study that included 117 ELBW infants. Of these, 58 infants had IUGR and 59 were born appropriate-for-gestational age (AGA). Infants with IUGR were further divided based on the presence or absence of PI, as determined by umbilical arterial doppler velocimetry on serial ultrasounds. Results IUGR infants with PI had the lowest enteral calorie intake at 28 days of life (DOL) (median intake- IUGR+PI: 32 vs IUGR-PI: 93 vs AGA: 110 kcal/kg/day; p-value 0.011) and at 36 weeks corrected gestational age (CGA) (median intake- IUGR+PI: 102 vs IUGR-PI: 125 vs AGA: 119 kcal/kg/day; p-value 0.012). These infants also trended towards requiring a longer duration of total parenteral nutrition (TPN) (median duration - IUGR+PI: 35 vs IUGR-PI: 25 vs AGA: 21 days; p-value 0.054) and higher incidence of conjugated hyperbilirubinemia (IUGR+PI: 43% IUGR-PI: 29% vs AGA: 16%; p-value 0.058), but these results did not reach statistical significance. Despite challenges with enteral nutrition, IUGR infants with PI showed good catch-up growth and had higher growth velocities over the first month of life, compared to AGA controls. Conclusion IUGR in the presence of PI is associated with significantly poorer enteral nutritional outcomes in ELBW infants. However, with the support of optimal parenteral nutrition these infants showed good catch-up growth.
摘要：
引言我们研究的目的是评估宫内生长受限（IUGR）和胎盘功能不全（PI）对极低出生体重（ELBW）婴儿营养结局的影响。方法我们进行了一项为期6年的回顾性病例对照研究，包括117名ELBW婴儿。其中,58名婴儿有IUGR，59名婴儿出生时适合胎龄（AGA）。根据是否存在PI进一步划分IUGR的婴儿，通过连续超声脐动脉多普勒测速测定。结果患有PI的IUGR婴儿在28天生命（DOL）时的肠内卡路里摄入量最低（中位摄入量-IUGRPI：32vsIUGR-PI：93vsAGA：110kcal/kg/天；p值0.011）和36周校正胎龄（CGA）（中位摄入量-IUGRPI：102vsIUGR-PI：125vsAGA：119kcal/kg。这些婴儿还倾向于需要更长的总肠外营养（TPN）持续时间（中位持续时间-IUGRPI：35vsIUGR-PI：25vsAGA：21天；p值0.054）和更高的共轭高胆红素血症发生率（IUGRPI：43％IUGR-PI：29％vsAGA：16％；p值0.058），但这些结果没有达到统计学意义。尽管肠内营养面临挑战，患有PI的IUGR婴儿在出生后的第一个月表现出良好的追赶生长，并且生长速度较高。与AGA对照相比。结论存在PI的IUGR与ELBW婴儿肠内营养结局明显较差相关。然而,在最佳肠外营养的支持下，这些婴儿表现出良好的追赶生长。
