Abstract:
Background/Objectives: Extrauterine growth restriction (EUGR) is associated with high mortality and an increased incidence of poor neurodevelopmental outcomes in preterm infants. In this study, we aimed to compare the Intergrowth-21ST (IG-21ST) and Fenton charts in predicting long-term neurodevelopmental and anthropometric outcomes of very low birth weight (VLBW) infants. Methods: Data were collected from 2649 VLBW infants registered in the Korean Neonatal Network born between 240/7 and 316/7 weeks of gestational age from January 2013 to December 2017. Follow-up assessments were conducted at 18-24 months of age, corrected for prematurity. Multiple logistic regression analysis was performed to evaluate the association between EUGR and long-term outcomes. Results: Among the 2649 VLBW infants, 60.0% (1606/2649) and 36.9% (977/2649) were diagnosed as having EUGR defined by the Fenton chart (EUGRF) and by the IG-21ST chart (EUGRIG), respectively. The EUGRIG group exhibited a higher proportion of infants with cerebral palsy, neurodevelopmental impairment (NDI), and growth failure. In multiple logistic regression analysis, adjusted for risk factors for long-term outcome, the EUGRIG group showed higher risk of cerebral palsy (adjusted odds ratio [aOR], 1.66; 95% confidence interval [CI], 1.04-2.65), NDI (aOR, 2.09; 95% CI, 1.71-2.55), and growth failure (aOR, 1.57; 95% CI, 1.16-2.13). Infants with EUGRF tended to develop NDI (aOR, 1.29; 95%CI, 1.03-1.63) and experience growth failure (aOR, 2.44; 95% CI, 1.77-3.40). Conclusions: The IG-21ST chart demonstrated a more effective prediction of long-term neurodevelopmental outcomes, whereas the Fenton chart may be more suitable for predicting growth failure at 18-24 months.
摘要:
背景/目标:宫外生长受限(EUGR)与早产儿高死亡率和不良神经发育结局的发生率增加有关。在这项研究中,我们旨在比较Intergrowth-21ST(IG-21ST)和Fenton图预测极低出生体重(VLBW)婴儿的长期神经发育和人体测量结局.方法:收集了2013年1月至2017年12月在韩国新生儿网络中登记的2649名VLBW婴儿的数据,这些婴儿出生在胎龄240/7至316/7周之间。随访评估在18-24月龄进行,因早产而更正。采用多因素logistic回归分析评估EUGR与长期结局之间的关系。结果:在2649名VLBW婴儿中,60.0%(1606/2649)和36.9%(977/2649)被诊断为具有由Fenton图(EUGRF)和IG-21ST图(EUGRIG)定义的EUGR,分别。EUGRIG组表现出更高比例的婴儿脑瘫,神经发育障碍(NDI),增长失败。在多元逻辑回归分析中,根据长期结果的风险因素进行调整,EUGRIG组出现脑瘫的风险较高(调整后比值比[aOR],1.66;95%置信区间[CI],1.04-2.65),NDI(AOR,2.09;95%CI,1.71-2.55),和生长失败(AOR,1.57;95%CI,1.16-2.13)。患有EUGRF的婴儿倾向于发展NDI(aOR,1.29;95CI,1.03-1.63)和经历增长失败(AOR,2.44;95%CI,1.77-3.40)。结论:IG-21ST图显示了对长期神经发育结果的更有效预测,而芬顿图可能更适合预测18-24个月的生长失败。