Term SGA (small for gestational age) infantlarda büyümenin izlemi ve büyümeyi etkileyen faktörler

Year 2021, Volume: 11 Issue: 4, 433 - 439, 31.07.2021

Musa Silahlı , Hasan Koç

Abstract

Amaç: SGA doğan infantlar yetişkin hayatta birçok riskle karşı karşıyadırlar. Postnatal hayatta çoğu ilk 6 ay içerisinde hızlı bir büyüme göstererek yaşıtlarının büyüme yüzdelerini yakalarlar. Bu çalışmada sağlıklı term SGA infantların büyümeyi yakalamaya etkisi olan perinatal prediktif faktörler incelendi. Gereç ve Yöntem: Çalışmaya sağlıklı 73 term SGA infant katıldı. Her hasta için prenatal, natal ve postnatal bilgi formu dolduruldu. İnfantların 0, 1, 6 ve 12. aylarda fiziki incelemeleri yapıldı ve geçmişe yönelik anamnez formu dolduruldu. Muayene sırasında kilo, boy ve baş çevresi gibi büyüme ile ilgili parametreler kaydedildi. Postnatal dönemde büyümeyi yakalama kriteri olarak referans toplumun büyüme eğrilerinde 10. persentilin üzerine çıkma olarak tanımlandı. Büyümeyi yakalama üzerine SPSS 10.0 kullanılarak perinatal, natal ve postnatal faktörlerin etkisi araştırıldı. Bulgular: Bulgular 1. ayda catch-up (CU) grubundaki infantların boyu non-catchup (NCU) grubundakilerden anlamlı derecede daha uzun idi. 6. aydaki CU grubunun APGAR skorları, 6.ayda ölçülen boy ve baş çevresi, 12. ayda boy ölçümleri NCU grubuna göre daha fazla bulundu.12. aydaki NCU grubunda diğer enfeksiyonlar ve D vitamini kullanımı CU grubuna göre daha fazla bulundu. Vakaların 12. aydaki boy ve baş çevreleri NCU grubuna göre daha fazla bulundu. Sonuç: SGA'lı doğan infantların postnatal büyüme paternlerini ve büyüme hızlarını takip etmek son derece önemlidir. Sağlıklı term SGA infantlar için postnatal büyümeyi yakalamada boy ve baş çevresi ve APGAR skorunun pozitif belirleyici, D vitamini ve diğer enfeksiyonların negatif belirleyiciler olarak kullanılabilir. Ve ilk aylarda büyümeyi yakalayan infantların büyüme hızlarını özellikle ilk 6 ay koruyabilecekleri öngörülebilir.

Keywords

SGA infant, büyümeyi yakalama, perinatal belirleyiciler, Gestasyon yaşına göre küçük

Term SGA (small for gestational age) infantlarda büyümenin izlemi ve büyümeyi etkileyen faktörler

Abstract

Aim: Infants born small for gestational age (SGA) confront many problems in adulthood. Most of them catch up with their peer as growth in the first six months. In this study, we investigated the perinatal predictive factors that influence postnatal catch-up growth in the term SGA infants.

Material and Method: The study included seventy-three term, healthy infants. Prenatal, natal, and postnatal information forms were filled for each infant. Infants were examined in 0, 1, 6, and 12th months. The information form was recorded. At the examination time parameters concerning growth like weight, length, and head circumference were recorded. Postnatal growth catch-up was defined as above the 10th centile according to the reference population growth curves. By the SPSS 10,0 version for windows prenatal, natal and postnatal factors that influence postnatal catch-up growth were investigated.

Results: Infants in the Catch up (CU) group at the first month were significantly taller than the non-catch-up (NCU) group. APGAR scores of the group CU at the sixth month were significantly more increased than group NCU. Length and head circumference of the sixth month and body length of the twelfth month were significantly more increased than the NCU group at the sixth month. Other infections and usage of vitamin D in the group NCU in the twelfth month were significantly more increased than the group CU. Length and head circumference at the twelfth month in group CU were significantly more increased than group NCU.

Conclusion: For infants with born SGA, it is very important to follow up postnatal growth patterns and growth velocity. Body length, head circumference, and APGAR scores can be a positive predictor for the postnatal growth catch up for healthy term SGA infants. The usage of vitamin D and other infections can also be negative predictors. Infants that catch up growth first few months may anticipate that will be continued growth velocity for six months.

Keywords

SGA infant, growth catch up, perinatal predictors, Small for Gestational Age

References

• 1. Karlberg JPE, Albertson - Wikland K, Kwan EYW, Lam BCC, Low LCK. The timing of early postnatal catch – up growth in normal, full – term infants born short for gestational age . Hor. Res. 1997; 48:17 – 24 2. Battaglia FC, Lubchenco LO. A practical classification of the newborn infants by weigth and gestational age. J Pediatr 1967: 7(2): 159 – 163 3. Ballard JL, Novak KK, Driver M. A simplified score for assessment of fetal maturation of newly born infants. J Pediatr. 1979;95(5 Pt 1):769-74. 4. Neyzi O, Binyıldız P, Alp H, İst.Tıp Fak. Mecm., 1978;74:41 5. J.E. Harding, L.M.E. McCowan. Perinatal predictors of growth patterns to 18 months in children born small for gestational age. Early Human Development 2003;74: 13–26. 6. Kliegmann RM. Intrauterin growth retardation. In: Fanarrof AA, Martin RJ (eds). Neonatal – perinatal medicine. Deseases of the fetus and infant (6th ed.). Mosby Year Book , St Lovis. 1997: 203 – 240 7. Ounsted M, Sleigh G. The infant’s self regulation of food intake and weight gain. Lancet 1975;1:1393 – 7. 8. Fewtrell MS, Morley R, Abbott RA, Sighal A, Stephenson T, MacFadyen Um et all. Catch – up growth in small for gestational age term infants: A randomized trial. Am J Clin Nutr. 2001;74:516-23 9. Arefeen SA, Black RE, Coulfield LE, Antelman G, Baqui AH, Nahar Q et all. Infant growth patterns in the slums of dhaka in relation to birth weight, intrauterin growth retardation and prematurity. AmJ clin Nutr 2000;72:1010 10. McCowan L, Harding J, Barker S, Ford C. Perinatal predictors of growth at six months in small for gestational age babies. Early Human Development 1999;56: 205–216 11. Albertsson-Wikland K, Wennergren G, Wennergren M, Vibergsson G, Rosberg S. Longitudinal followup of growth in children born small for gestational age. Acta Paediatr 1993;82:438–43. 12. Hack M, Weissman B, Borawski-Clarke E. Catch-up growth during childhood among very low-birthweight children. Arch Pediatr Adolesc Med. 1996;150:1122-9. 13. Geoffrey WF, Doyle LW, Noni MD, Callanan C. Very low birth weight and growth into adolescence. Arch Pediatr Adolesc Med. 2000;154:778-84. 14. Peralta-Carcelen M, Jackson DS, Goran MI, Royal SA, Mayo MS, Nelson KG. Growth of adolescents who were born at extremely low birth weight without major disability. J Pediatr. 2000;136:633-40. 15. Lucas A, Fewtrell MS, Morley R, Singhal A, Abbott RA, Isaacs E, et al. Randomized trial of nutrientenriched formula versus standard formula postdischarge preterm infants. Pediatrics. 2001;108:703-11. 16. Kuschel CA, Harding JE. Multicomponent fortified human milk for promoting growth in preterm infants. Cochrane Database Syst Rev. 2004;(1):CD000343.