极低出生体质量早产儿代谢性骨病危险因素双中心研究

A Dual-Center Study of Risk Factors for Metabolic Bone Disease in Very Low Birth Weight Preterm Infants

摘要: 目的：了解广州、东莞地区出生体质量<1500 g早产儿院内营养状况以及出生后发生代谢性骨病(MBDP)的相关影响因素。方法：采用回顾性调查方法，收集2020年9月1日至2021年11月30日广州市妇女儿童医疗中心及东莞妇幼保健院2所医院出生体质量<1500 g、胎龄小于37周的早产儿临床资料。对照组为诊断代谢性骨病45例，正常组107例，包括住院期间的出生状况、喂养情况、钙磷代谢状况、并对极低出生体重儿住院天数、体质量增长情况进行描述性分析，并分析MBDP的相关因素。结果：极低出生体重儿MBDP发生率为29.6% (45/152)，两组性别比例存在统计学差异(χ² = 155.592，P = 0.000)，单因素分析发现，出院时是否合并代谢性骨病，其住院天数、出生时胎龄的差异均有统计学意义(P < 0.05)。逻辑回归分析，显示住院天数少、出生胎龄越大是代谢性骨病保护因素(P均<0.05)。结论：低胎龄、住院天数长、男性患儿可能是极低出生体重儿发生MBDP的相关风险因素。

Abstract: Objective: To investigate the nutritional status of premature infants with a birth weight less than 1500 g in Guangzhou and Dongguan and the related influencing factors of metabolic bone disease (MBDP) after birth. Methods: A retrospective survey was used to collect preterm births with birth weight < 1500 g and gestational age less than 37 weeks from September 1, 2020 to November 30, 2021 in Guangzhou Women’s and Children’s Medical Center and 2 hospitals in Dongguan Maternal and Child Health Hospital. Clinical data of children, 45 cases of metabolic bone disease in the control group and 107 cases in the normal group, including birth status, feeding status, calcium and phosphorus metabolism status during hospitalization, hospital days and body weight growth of very low birth weight infants A descriptive analysis was performed and the associated factors of MBDP were analyzed. Results: The incidence of MBDP in very low birth weight infants was 29.6% (45/152), and there was a statistically significant difference in the gender ratio between the two groups (χ² = 155.592, P = 0.000). There were significant differences in the length of hospital stay and gestational age at birth (P < 0.05). Logistic regression analysis showed that fewer days in hospital and older gestational age were protective factors for metabolic bone disease (all P < 0.05). Conclusions: Low gestational age, long hospitalization days and male infants may be related risk factors for MBDP in very low birth weight infants.