Neonatology Department, São João Hospital and Porto Medical School - Porto/Portugal.
Clinics (Sao Paulo). 2010 Feb;65(2):139-42. doi: 10.1590/S1807-59322010000200004.
The main objective of this study was to evaluate the association between prematurity and the time to achieve full enteral feeding in newborns with gastroschisis. The second objective was to analyze the associations between length of hospital stay and time to achieve full enteral feeding with mode of delivery, birth weight and surgical procedure.
The medical records of newborns with gastroschisis treated between 1997 and 2007 were reviewed. Two groups were considered: those delivered before 37 weeks (group A) and those delivered after 37 weeks (group B). The variables of gestational age, mode of delivery, birth weight, time to achieve full enteral feeding, length of hospital stay and surgical approach were analyzed and compared between groups.
Forty-one patients were studied. In Group A, there were 14 patients with a mean birth weight (BW) of 2300 g (range=1680-3000) and a mean gestational age (GA) of 36 weeks (range=34-36). In group B, there were 24 patients with a mean BW of 2700 g (range=1500-3550) and a mean GA of 38 weeks (range=37-39). The mean time to achieve full enteral feeding was 30.1+/-6.7 days in group A and 17.0+/-2.5 days in group B (p=0.09) with an OR of 0.82 and a 95% CI of 0.20-3.23 after adjustment for sepsis and BW. No statistical difference was found between low BW (<2500 g), mode of delivery and number of days to achieve full enteral feeding (p=0.34 and p=0.13, respectively). Patients with BW over 2500 g had fewer days in the hospital (22.9+/-3.1 vs. 35.7+/-5.7 days; p=0.06).
The results of this study do not support the idea of anticipating the delivery of fetuses with gastroschisis in order to achieve full enteral feeding earlier.
本研究的主要目的是评估胃膨出新生儿的早产与完全肠内喂养时间之间的关系。第二个目的是分析分娩方式、出生体重和手术方式与住院时间和完全肠内喂养时间之间的关系。
回顾了 1997 年至 2007 年间接受治疗的胃膨出新生儿的病历。将这些患儿分为两组：37 周前分娩的患儿（A 组）和 37 周后分娩的患儿（B 组）。分析并比较两组患儿的胎龄、分娩方式、出生体重、达到完全肠内喂养时间、住院时间和手术方式等变量。
共研究了 41 例患儿。A 组 14 例患儿的平均出生体重（BW）为 2300g（范围 1680-3000），平均胎龄（GA）为 36 周（范围 34-36）。B 组 24 例患儿的平均 BW 为 2700g（范围 1500-3550），GA 为 38 周（范围 37-39）。A 组患儿达到完全肠内喂养的平均时间为 30.1+/-6.7 天，B 组患儿为 17.0+/-2.5 天（p=0.09）。经调整脓毒症和 BW 后，OR 为 0.82，95%CI 为 0.20-3.23。低 BW（<2500g）、分娩方式和达到完全肠内喂养时间之间无统计学差异（p=0.34 和 p=0.13）。BW 超过 2500g 的患儿住院时间更短（22.9+/-3.1 天 vs. 35.7+/-5.7 天；p=0.06）。
本研究结果不支持为实现更早的完全肠内喂养而提前分娩胃膨出胎儿的观点。
