PDF(Pubmed)
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。
