vspВопросы современной педиатрииCurrent Pediatrics1682-55271682-5535Издательство «ПедиатрЪ»10.15690/vsp.v13i1.919vsp-234Research ArticleОБМЕН ОПЫТОМEXCHANGE OF EXPERIENCEВОПРОСЫ ОЦЕНКИ ПОСТНАТАЛЬНОГО РОСТА НЕДОНОШЕННЫХ ДЕТЕЙ ЧАСТЬ 2. ДОГОНЯЮЩИЙ РОСТ НЕДОНОШЕННЫХ ДЕТЕЙQUESTIONS OF EVALUATION OF POSTNATAL GROWTH IN PRETERM CHILDREN PART 2. CATCH-UP GROWTH IN PRETERM INFANTSКиосовА. Ф.KiosovA. F.

MD, Head of the Department of Special Care Nursery (2nd step) of Regional Clinical Hospital № 2

kiosow@mail.ruОбластная клиническая больница № 2, ЧелябинскРоссияRegional Clinical Hospital № 2, ChelyabinskRussian Federation201411012014131Вопросы современной педиатрии109112Copyright © Киосов А.Ф., 20142014Киосов А.Ф.Kiosov A.F.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://vsp.spr-journal.ru/jour/article/view/234

Термин «догоняющий рост» в настоящее время часто используется в неонатологии и педиатрии для описания особенностей роста недоношенных детей. Догоняющий рост — это компенсаторное усиление роста организма после периода замедленного роста. Чем меньше гестационный возраст недоношенного ребенка, тем интенсивнее в будущем догоняющий рост. Догоняющий рост считается важным критерием оценки выхаживания недоношенных детей. Формирование догоняющего роста рассматривают как благоприятный исход. Его оценку осуществляют с использованием перцентилей и стандартного отклонения (Z-балл). Догоняющий рост оказывает благоприятное воздействие на неврологический исход. Он считается достигнутым, если показатели роста находятся между 5-м и 10-м перцентилем. Значения роста считаются удовлетворительными, если они расположены на уровне 10-го перцентиля и выше. Догоняющий рост считается достигнутым при стандартном отклонении больше, чем –2 (Z-балл). Оптимальными считаются показатели, расположенные в пределах двух стандартных отклонений от медианы. Оценка показателей роста оптимально должна проводиться еженедельно. Кривые роста помогают определить, когда догоняющий рост начинается. Догоняющий рост происходит в течение всего первого года жизни. Критическим периодом для него считают первые 6 мес. В дальнейшем скорость роста снижается. Рост считается недостаточным, если значения находятся ниже 3-го перцентиля. Около 50% причин нарушения роста кроется в дефиците питания. Недоношенные могут иметь проблемы с питанием и после выписки из стационара. Очень быстрый рост может привести к развитию метаболического синдрома в дальнейшей жизни. Низкий вес при рождении связан с повышенным риском гипертонии, инсульта и сахарного диабета. Компенсаторный рост часто происходит с чрезмерным отложением жира. При оценке роста необходимо учитывать рост мышечной и жировой массы. Поддержание оптимальной скорости роста очень важно для профилактики метаболического синдрома. Чтобы определить оптимальный постнатальный рост, необходим метаанализ всех опубликованных кривых роста недоношенных детей.

 

The term catch-up growth is now widely used in neonatology and pediatrics to describe the growth of preterm infants. Catch-up growth — is a compensatory strengthening of the body's growth after a period of slow growth. The lower the gestational age of the premature baby, the more intense catch-up growth in the future.Catch-up growth is considered an important criterion for evaluating nursing preterm infants. Formation of catch-up growth is seen as a favorable outcome. Evaluation of catch-up growth is carried out with the use of percentiles and standard deviations (Z-score). Catch-up growth has a positive effect on neurological outcome. Catch-up growth achieved if the growth rates are between 5 and 10 percentile. The values of growth are satisfactory if they are located at the 10th percentile and above. Catch-up growth is achieved with a standard deviation greater than minus 2 (Z-score). The optimal parameters are considered indicators located within two standard deviations of the mean.Estimation of the growth should be carried out optimally weekly. Growth curves help to determine when the catch-up growth begins. After discharge from the hospital catch-up growth continues. Catch-up growth occurs within the first year of life. The critical period for catch-up growth are considered the first 6 months. Subsequently, the growth rate decreases. The growth is not sufficient, if the values are below the 3 percentile. About 50% of the causes impaired growth is due to the shortage of supply. Premature babies can have problems with food and after discharge from the hospital. The very rapid growth may lead to the development of metabolic syndrome in later life. Low birth weight is associated with increased risk of hypertension, stroke, and diabetes. Compensatory growth often occurs with excessive deposition of fat. In assessing the growth necessary to accommodate the growth of muscle mass and fat mass. Maintaining optimal growth rate is important for the prevention of metabolic syndrome. Requires a meta-analysis of all published growth curves for premature babies to determine the optimal postnatal growth.

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The authors declare that there are no conflicts of interest present.