目的:探讨3~6月龄早产儿铁缺乏(iron deficiency, ID)状况及影响因素。方法:利用互联网 + 早产儿智慧随访数据库,收集2018年8月~2023年11月有铁蛋白数据的1521例3~6月龄早产儿临床资料,血清铁蛋白浓度 Objective: To explore the status and risk factors of iron deficiency (ID) in preterm infants aged 3~6 months. Methods: Using the Internet + Preterm Infant Smart Follow-up Database, clinical data were collected from 1521 preterm infants aged 3~6 months with serum ferritin data from August 2018 to November 2023. Serum ferritin concentration < 12 µg/L was diagnosed as ID. The incidence of iron deficiency in preterm infants of varying gestational ages is examined. Risk factors of ID were investigated by using univariate and logistic regression analysis. Results: The incidence of ID in preterm infants aged 3~6 months was 14.40% (219/1521), The incidence of ID in early, middle and late preterm infants was 12.37% (35/283), 19.64% (54/275) and 13.50% (130/963) respectively. The proportions of males, moderately preterm infants, and exclusive breastfeeding were higher in the ID group than in the control group (all P < 0.05). The proportions of first birth, iron supplementation, and vitamin D supplementation were lower than those in the control group (all P< 0.05). Hemoglobin levels before discharge in the neonatal period in the ID group were lower than in the control group (P < 0.05). Logistics regression analysis showed that moderately preterm infants, non-1st birth, males, lower hemoglobin value before discharge, no iron supplementation, and exclusive breastfeeding at the time of testing were risk factors for ID (OR= 1.825, 1.540, 2.098, 0.974, 1.567, and 6.605, all P < 0.05). Conclusions: Targeted iron supplementation education should be performed for male, non first birth preterm infants with exclusive breastfeeding after discharge and moderately preterm infants.
目的分析早产儿校正24月龄内生长轨迹,以了解早产儿的生长趋势和规律。方法基于互联网+随访系统建立早产儿随访数据库,纳入2018年4月至2021年4月3188例早产儿,收集其出生及校正1、3、6、12、18、24月龄时的身长、体重、头围数据。按不同的围生期因素分组,绘制生长曲线,并与21世纪国际胎儿和新生儿生长联合会(International Fetal and Newborn Growth Consortium for the 21st Century,INTERGROWTH-21st)标准和世界卫生组织(World Health Organization,WHO)标准进行比较。结果按不同的围生期因素分组的各组早产儿体重、身长、头围曲线均在校正6月龄内快速上升,校正6月龄后增长速度减缓。按实际月龄比较,各出生胎龄组早产儿(<28周、28~31^(+6)周、32~33^(+6)周、34~36^(+6)周)身长曲线在实际9月龄后逐渐与WHO曲线重合(P=0.082),<32周早产儿的体重和头围则一直落后于WHO曲线(P<0.001)。校正月龄后,不同出生胎龄组早产儿(<28周、28~31+6周、32~33+6周、34~36+6周)的体格生长曲线基本重合(P>0.05)。超低出生体重儿和小于胎龄儿的身长、体重、头围曲线均低于INTERGROWTH-21st标准和WHO标准(P<0.05)。结论早产儿在校正6月龄内体格增长速度较快,校正6月龄后增长速度减缓。胎龄越小,体重和头围追赶的时间越长。应重点关注超早产儿、超低出生体重儿和小于胎龄儿的体格生长。
