分析宫外生长发育迟缓（EUGR）早产儿出院后校正年龄1岁内生长发育迟缓发生情况及其影响因素。

选取2014年7月至2017年12月在泰安市中心医院新生儿重症监护治疗病房（NICU）住院治疗且正常出院的90例EUGR早产儿。对90例EUGR早产儿在校正年龄1岁内进行定期随访，测量体质量、身长、头围等，并收集相关临床资料，如喂养情况、疾病情况、前白蛋白量、元素锌含量等，分析出院后EUGR早产儿校正年龄1岁内生长发育迟缓发生情况及其影响因素。采用t检验比较生长发育迟缓患儿和非生长发育迟缓患儿母亲年龄、出生体质量、出院体质量、胎龄、住院时间、达完全肠内营养时间、血前白蛋白、血锌等指标的差异。采用χ²检验比较生长发育迟缓患儿和非生长发育迟缓患儿双胎、妊娠高血压综合征、糖尿病、胎膜早破、宫内生长发育迟缓（IUGR）、窒息、剖宫产、新生儿呼吸窘迫综合征（NRDS）、支气管肺发育不良（BPD）、新生儿坏死性小肠结肠炎（NEC）、应用有创呼吸机、贫血、感染等的发生情况以及不同喂养方式的差异。对生长发育迟缓的高危因素进行logistic回归分析。

对EUGR早产儿随访时间点为校正年龄1个月、6个月、12个月，分别为90例、86例、70例，生长发育迟缓发生率分别为48.9%（44/90）、30.2%（26/86）、17.1%（12/70）。在校正年龄1个月时，与非生长发育迟缓患儿相比较，生长发育迟缓患儿IUGR、NRDS、BPD、应用有创呼吸机的发生率明显增高，差异有统计学意义（χ²=10.146，P=0.001；χ²=7.479，P=0.006；χ²=14.407，P<0.001；χ²=10.500，P=0.001）；出生体质量、出院体质量、胎龄、血前白蛋白明显降低，差异有统计学意义（t=-4.945，P<0.001；t=-3.522，P=0.001；t=-2.047，P=0.044；t=-2.312，P=0.023）；住院时间、达完全肠内营养时间明显延长，差异有统计学意义（t=3.797，P<0.001；t=2.840，P=0.006）；在喂养方式方面明显不同，差异有统计学意义（χ²=7.060，P=0.029）。logistic回归分析表明，生长发育迟缓与达完全肠内营养时间（P=0.040）、IUGR（P<0.001）及BPD（P=0.011）有显著相关性。在校正年龄6个月时，与非生长发育迟缓患儿相比较，生长发育迟缓患儿IUGR、NRDS、BPD、应用有创呼吸机的发生率明显增高，差异有统计学意义（χ²=8.474，P=0.004；χ²=12.613，P<0.001；χ²=24.398，P<0.001；χ²=12.662，P<0.001）；出生体质量、出院体质量、胎龄、血前白蛋白明显降低，差异有统计学意义（t=-5.849，P<0.001；t=-3.211，P=0.002；t=-3.405，P=0.001；t=-2.636，P=0.010）；住院时间、达完全肠内营养时间明显延长，差异有统计学意义（t=5.351，P<0.001；t=3.095，P=0.003）。logistic回归分析表明，生长发育迟缓与出生体质量（P=0.013）、IUGR（P=0.001）及BPD（P=0.022）有显著相关性。在校正年龄12个月时，与非生长发育迟缓患儿相比较，生长发育迟缓患儿IUGR、NRDS、BPD的发生率明显增高，差异有统计学意义（χ²=4.050，P=0.044；χ²=5.737，P=0.017；χ²=8.393，P=0.004）；出生体质量、胎龄、前白蛋白明显降低，差异有统计学意义（t=-3.192，P=0.002；t=-2.271，P=0.026；t=-3.509，P=0.001）；住院时间明显延长，差异有统计学意义（t=3.133，P=0.003）。logistic回归分析表明，生长发育迟缓与IUGR（P=0.040）及BPD（P=0.003）有显著相关性。

NICU出院的EUGR早产儿是一组特殊的高危人群，IUGR、BPD是出院后发生生长迟缓的持续危险因素。

To investigate the incidence and influencing factors of growth retardation in premature infants with extrauterine growth restriction (EUGR) under one year of corrected age.

Ninety premature infants with EUGR who were discharged from July 2014 to December 2017 from the Neonatal Intensive Care Unit of Tai'an Central Hospital were selected. The infants were followed within one year of corrected age. Weight, height, and head circumference were measured, and data such as feeding, diseases, prealbumin, and zinc were collected. The incidence and influencing factors of growth retardation were analyzed. The t-test was used to compare the differences in maternal age, birth weight, weight at discharge, gestational age, hospitalization time, total enteral nutrition time, prealbumin, and zinc between children with and without growth retardation. The Chi-square test was used to compare the occurrence of twins, pregnancy induced hypertension syndrome, diabetes mellitus, premature rupture of membranes, intrauterine growth restriction (IUGR), asphyxia, cesarean section, neonatal respiratory distress syndrome (NRDS), bronchopulmonary dysplasia (BPD), necrotizing enterocolitis (NEC), invasive ventilator use, anemia, and infection, as well as the difference in feeding methods between children with and without growth retardation. Logistic regression analysis was used for identifying high risk factors for growth retardation.

The follow-up time points were 1, 6, and 12 months of corrected age, at which 90, 86, and 70 cases were present. The incidence of growth retardation in preterm infants was 48.9% (44/90), 30.2% (26/86), and 17.1% (12/70) at 1, 6, and 12 months, respectively. The rates of IUGR, NRDS, BPD, and invasive ventilator use at 1 month were significantly higher in children with growth retardation than in those without (χ²=10.146, P=0.001; χ²=7.479, P=0.006; χ²=14.407, P<0.001; χ²=10.500, P=0.001). Birth weight, discharge weight, gestational age, and prealbumin decreased significantly (t=-4.945, P<0.001; t=-3.522, P=0.001; t=-2.047, P=0.044; t=-2.312, P=0.023), hospitalization time and total enteral nutrition time were significantly prolonged in children with growth retardation (t=3.797, P<0.001; t=2.840, P=0.006), and the feeding methods were significantly different between the two groups (χ²=7.060, P=0.029). Logistic regression analysis showed that growth retardation was significantly correlated with total enteral nutrition time (P=0.040), IUGR (P<0.001), and BPD (P=0.011). The rates of IUGR, NRDS, BPD, and invasive ventilator use at 6 months were significantly higher in children with growth retardation compared with those without (χ²=8.474, P=0.004; χ²=12.613, P<0.001; χ²=24.398, P<0.001; χ²=12.662, P<0.001). Birth weight, discharge weight, gestational age, and prealbumin decreased significantly (t=-5.849, P<0.001; t=-3.211, P=0.002; t=-3.405, P=0.001; t=-2.636, P=0.010), and hospitalization time and total enteral nutrition time were significantly prolonged in children with growth retardation (t=5.351, P<0.001; t=3.095, P=0.003). Logistic regression analysis showed that growth retardation was significantly correlated with birth weight (P=0.013), IUGR (P=0.001), and BPD (P=0.022). The rates of IUGR, NRDS, and BPD at 12 months were significantly higher in children with growth retardation compared with those without (χ²=4.050, P=0.044; χ²=5.737, P=0.017; χ²=8.393, P=0.004). Birth weight, gestational age, and prealbumin decreased significantly (t=-3.192, P=0.002; t=-2.271, P=0.026; t=-3.509, P=0.001), and hospitalization time was significantly prolonged in children with growth retardation (t=3.133, P=0.003). Logistic regression analysis showed that growth retardation was significantly correlated with IUGR (P=0.040) and BPD (P=0.003).

Premature infants with EUGR discharged from the neonatal intensive care unit are at high risk for growth retardation. IUGR and BPD are the persistent risk factors for growth retardation in preterm infants with EUGR.