Abstract：
BACKGROUND: Preterm infants often have poor short- and long-term growth. Kangaroo mother care supports short-term growth, but longer-term outcomes are unclear.
METHODS: This study analysed longitudinally collected routine clinical data from a South African cohort of preterm infants (born <37 weeks gestation) attending the outpatient follow-up clinic of a tertiary-level hospital (Tshwane District, South Africa) for 1 year between 2012 and 2019. At 1 year, small-for-gestational age (SGA) and appropriate-for-gestational age (AGA) infants were compared with regard to age-corrected anthropometric z-scores (weight-for-age [WAZ], length-for-age [LAZ], weight-for-length [WLZ] and BMI-for-age [BMIZ]) and rates of underweight (WAZ < -2), stunting (LAZ < -2), wasting (WLZ < -2) and overweight (BMIZ> + 2). Multiple regression analysis was used to investigate associations between maternal/infant characteristics and rates of underweight, stunting, wasting and overweight.
RESULTS: At 1 year, compared with AGA infants (n = 210), SGA infants (n = 111) had lower WAZ (-1.26 ± 1.32 vs. -0.22 ± 1.24, p < 0.001), LAZ (-1.50 ± 1.11 vs. -0.60 ± 1.06, p < 0.001), WLZ (-0.66 ± 1.31 vs. 0.11 ± 1.24, p < 0.001) and BMIZ (-0.55 ± 1.31 vs. 1.06 ± 1.23, p < 0.001), despite larger WAZ gains from birth (+0.70 ± 1.30 vs. +0.05 ± 1.30, p < 0.001). SGA infants had significantly more stunting (34.2% vs. 9.1%; p < 0.001), underweight (31.2% vs. 7.2%; p < 0.001) and wasting (12.6% vs. 4.3%, p = 0.012), with no difference in overweight (4.5% vs. 7.7%, p = 0.397). In multiple regression analysis, birth weight-for-GA z-score more consistently predicted 1-year malnutrition than SGA.
CONCLUSIONS: Preterm-born SGA infants remain more underweight, stunted and wasted than their preterm-born AGA peers at 1 year, despite greater WAZ gains. Interventions for appropriate catch-up growth especially for SGA preterm infants are needed.
METHODS: This study analysed longitudinally collected routine clinical data from a South African cohort of preterm infants (born <37 weeks gestation) attending the outpatient follow-up clinic of a tertiary-level hospital (Tshwane District, South Africa) for 1 year between 2012 and 2019. At 1 year, small-for-gestational age (SGA) and appropriate-for-gestational age (AGA) infants were compared with regard to age-corrected anthropometric z-scores (weight-for-age [WAZ], length-for-age [LAZ], weight-for-length [WLZ] and BMI-for-age [BMIZ]) and rates of underweight (WAZ < -2), stunting (LAZ < -2), wasting (WLZ < -2) and overweight (BMIZ> + 2). Multiple regression analysis was used to investigate associations between maternal/infant characteristics and rates of underweight, stunting, wasting and overweight.
RESULTS: At 1 year, compared with AGA infants (n = 210), SGA infants (n = 111) had lower WAZ (-1.26 ± 1.32 vs. -0.22 ± 1.24, p < 0.001), LAZ (-1.50 ± 1.11 vs. -0.60 ± 1.06, p < 0.001), WLZ (-0.66 ± 1.31 vs. 0.11 ± 1.24, p < 0.001) and BMIZ (-0.55 ± 1.31 vs. 1.06 ± 1.23, p < 0.001), despite larger WAZ gains from birth (+0.70 ± 1.30 vs. +0.05 ± 1.30, p < 0.001). SGA infants had significantly more stunting (34.2% vs. 9.1%; p < 0.001), underweight (31.2% vs. 7.2%; p < 0.001) and wasting (12.6% vs. 4.3%, p = 0.012), with no difference in overweight (4.5% vs. 7.7%, p = 0.397). In multiple regression analysis, birth weight-for-GA z-score more consistently predicted 1-year malnutrition than SGA.
CONCLUSIONS: Preterm-born SGA infants remain more underweight, stunted and wasted than their preterm-born AGA peers at 1 year, despite greater WAZ gains. Interventions for appropriate catch-up growth especially for SGA preterm infants are needed.
摘要：
背景：早产儿的短期和长期生长通常较差。袋鼠母亲护理支持短期成长，但长期结果尚不清楚.
方法：本研究分析了在三级医院（Tshwane区，南非）在2012年至2019年之间为期1年。在1年,比较小于胎龄（SGA）和适合胎龄（AGA）婴儿的年龄校正人体测量z评分（年龄体重[WAZ]，年龄长度[LAZ]，长度体重[WLZ]和年龄BMI[BMIZ]）和体重不足率（WAZ<-2），发育迟缓（LAZ<-2），消瘦(WLZ<-2)和超重(BMIZ>+2)。多元回归分析用于调查母婴特征与体重不足率之间的关系。发育迟缓,浪费和超重。
结果：在1年，与AGA婴儿（n=210）相比，SGA婴儿（n=111）的WAZ较低（-1.26±1.32vs.-0.22±1.24，p<0.001)，LAZ（-1.50±1.11vs.-0.60±1.06，p<0.001)，WLZ(-0.66±1.31vs.0.11±1.24，p<0.001）和BMIZ（-0.55±1.31vs.1.06±1.23，p<0.001），尽管WAZ从出生时获得了更大的收益（+0.70±1.30vs.+0.05±1.30，p<0.001）。SGA婴儿发育迟缓明显增多（34.2%vs.9.1%；p<0.001)，体重不足（31.2%与7.2%；p<0.001）和消瘦（12.6%与4.3%,p=0.012),超重没有差异(4.5%与7.7%,p=0.397)。在多元回归分析中，与SGA相比,出生体重-GAz-评分更一致地预测1年营养不良.
结论：早产SGA婴儿体重仍然较低，发育迟缓和浪费比他们的早产AGA同龄人在1年，尽管WAZ收益更大。需要进行适当的追赶生长干预，特别是对于SGA早产儿。
方法：本研究分析了在三级医院（Tshwane区，南非）在2012年至2019年之间为期1年。在1年,比较小于胎龄（SGA）和适合胎龄（AGA）婴儿的年龄校正人体测量z评分（年龄体重[WAZ]，年龄长度[LAZ]，长度体重[WLZ]和年龄BMI[BMIZ]）和体重不足率（WAZ<-2），发育迟缓（LAZ<-2），消瘦(WLZ<-2)和超重(BMIZ>+2)。多元回归分析用于调查母婴特征与体重不足率之间的关系。发育迟缓,浪费和超重。
结果：在1年，与AGA婴儿（n=210）相比，SGA婴儿（n=111）的WAZ较低（-1.26±1.32vs.-0.22±1.24，p<0.001)，LAZ（-1.50±1.11vs.-0.60±1.06，p<0.001)，WLZ(-0.66±1.31vs.0.11±1.24，p<0.001）和BMIZ（-0.55±1.31vs.1.06±1.23，p<0.001），尽管WAZ从出生时获得了更大的收益（+0.70±1.30vs.+0.05±1.30，p<0.001）。SGA婴儿发育迟缓明显增多（34.2%vs.9.1%；p<0.001)，体重不足（31.2%与7.2%；p<0.001）和消瘦（12.6%与4.3%,p=0.012),超重没有差异(4.5%与7.7%,p=0.397)。在多元回归分析中，与SGA相比,出生体重-GAz-评分更一致地预测1年营养不良.
结论：早产SGA婴儿体重仍然较低，发育迟缓和浪费比他们的早产AGA同龄人在1年，尽管WAZ收益更大。需要进行适当的追赶生长干预，特别是对于SGA早产儿。
