某三级医院新生儿重症监护室接受早期积极氨基酸治疗的早产儿和极低出生体重新生儿的生长和神经发育结局

Ana Kristina Garcia-Sobrevega, Wilfredo R. Santos
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摘要

由于新生儿护理的改善,早产儿和极低出生体重(VLBW)婴儿的长期预后一直是已发表研究的焦点。与早产或VLBW相关的长期疾病之一是出生后生长衰竭和神经发育迟缓。因此,采取了不同的策略来解决这一问题,其中之一是在24小时内开始早期积极的氨基酸治疗,剂量为3g /kg/天,目的是改善前面提到的结果。本研究旨在确定给予3 g/kg/天氨基酸的早产儿和VLBW的生长和神经发育结果。重要的是要及早发现这种迟缓,以便采取适当的干预措施,最大限度地发挥婴儿的能力。研究共纳入34名新生儿,在校正年龄第6、9和12个月时进行基线人体测量并随访。结果显示,35.2%的受试者出院时人体测量值低于目标范围。到校正年龄的第6个月,只有2.94%低于正常,到校正年龄的第9个月,所有参与者的年龄人体测量指标正常。至于神经发育方面,34名参与者中有4人(13.8%)被归类为新兴风险,并被转介给神经发育专家。到矫正年龄的第9个月,只有2个被归类为新兴风险,到矫正年龄的第12个月,只有1个仍然有神经发育迟缓的风险。总之,早期积极的氨基酸治疗被证明对早产儿和VLBW婴儿的生长和神经发育结果有积极的影响。然而,我们建议继续监测来自这一人群的新生儿的神经发育,直到2岁,因为一些延迟在以后的生活中可能会很明显。
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Growth and Neurodevelopment Outcome Among Preterm and Very Low Birth Weight Neonates Given Early Aggressive Amino Acid Therapy Admitted in the NICU of a Tertiary Hospital
Long-term outcomes of preterm and very low birth weight (VLBW) infants have been the focus of published research due to improved neonatal care. One of the long-term morbidities associated with being born too early or VLBW is postnatal growth failure and neurodevelopment delay. Because of this, different strategies were implemented to address this, one of which is initiating early aggressive amino acid therapy at 3 g/kg/day within 24 hours of life with its goal to improve previously mentioned outcomes. This study aims to determine the growth and neurodevelopment outcome among neonates born preterm and VLBW who were given 3 g/kg/day of amino acid. It is important that such delays are detected early on so that appropriate interventions can be initiated to maximize the infant's capabilities. A total of 34 neonates were included in the study where baseline anthropometrics were taken and followed up at the 6th, 9th, and 12th month of corrected age. Results showed 35.2% of the participants were discharged with their anthropometrics below the target range. By the 6th month of corrected age, only 2.94% were below normal and by the 9th month of corrected age, all participants have normal for age anthropometrics. As for the neurodevelopment aspect, 4 of 34 participants (13.8%) were found to be classified as emerging risk and were referred to a neurodevelopment specialist. By the 9th month of corrected age, only 2 were classified as emerging risk and by the 12th month of corrected age, only 1 remained to be at risk for neurodevelopment delay. In conclusion, early aggressive amino acid therapy proves to have a positive effect in the growth and neurodevelopment outcome among preterm and VLBW infants. However, we would like to recommend continued monitoring of neurodevelopment in neonates from this population until 2 years of age, since some delays can be evident later on in life.
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