Fonseca Maria João, Severo Milton, Barros Henrique, Santos Ana Cristina
Institute of Public Health, University of Porto, Porto, Portugal.
Birth. 2014 Jun;41(2):160-8. doi: 10.1111/birt.12087. Epub 2014 Mar 17.
Newborn weight loss (NWL) in the first 3 days of life is around 6 percent of birthweight (BW). We aim to describe the determinants of an excessive and insufficient NWL in the first 96 hours of life.
A sample of 1,288 full-term singletons without congenital abnormality belonging to Generation XXI birth cohort was selected. Newborns were recruited in 2005-2006 at all public units providing obstetrical and neonatal care in Porto, Portugal. Information was collected by face-to-face interview and additionally abstracted from clinical records. Anthropometrics were obtained by trained examiners and newborn weight change (NWC) was estimated as (weight-BW)/BW × 100. We categorized NWL as excessive (below 10th percentile of the sample distribution of NWC: ≤-9.4% of BW), normal (between 10th and 90th percentiles: -9.3 to -4.2%) and insufficient (above 90th percentile: ≥ -4.1%). Adjusted odds ratios (OR) and 95 percent confidence intervals (CI) were calculated using multinomial regression models.
Excessive NWL was positively associated with maternal age ≥40 years (OR = 3.32, 95%CI 1.19-9.25), maternal education (OR = 1.04, 95% CI 1.00-1.09), cesarean delivery (OR = 2.42, 95% CI 1.12-5.23), and phototherapy-treated jaundice (OR = 1.69, 95% CI 1.00-2.87). Insufficient NWL was positively associated with low BW (OR = 2.68, 95% CI 1.13-6.33), and formula/mixed feeding (OR = 1.74, 95% CI 1.13-2.66).
Excessive NWL was positively associated with maternal age and education, cesarean delivery, and phototherapy-treated jaundice. Insufficient NWL reflected child's feeding. As breastfed newborns did not lose weight excessively, but newborns with formula/mixed feeding had insufficient NWL, our study supports that breastfeeding provides excellent nutrition during this period.
出生后前3天的新生儿体重减轻（NWL）约为出生体重（BW）的6%。我们旨在描述出生后96小时内NWL过多和不足的决定因素。
选取了1288例属于二十一世纪出生队列的无先天性异常的足月单胎新生儿作为样本。2005 - 20o6年在葡萄牙波尔图所有提供产科和新生儿护理的公共单位招募新生儿。通过面对面访谈收集信息，并从临床记录中额外提取信息。人体测量数据由经过培训的检查人员获取，新生儿体重变化（NWC）估计为（体重 - BW）/BW×100。我们将NWL分为过多（低于NWC样本分布的第10百分位数：≤BW的 - 9.4%）、正常（在第10和第90百分位数之间： - 9.3%至 - 4.2%）和不足（高于第90百分位数：≥ - 4.1%）。使用多项回归模型计算调整后的比值比（OR）和95%置信区间（CI）。
NWL过多与母亲年龄≥40岁（OR = 3.32，95%CI 1.19 - 9.25）、母亲受教育程度（OR = 1.04，95%CI 1.00 - 1.09）、剖宫产（OR = 2.42，95%CI 1.12 - 5.23）以及接受光疗的黄疸（OR = 1.69，95%CI 1.00 - 2.87）呈正相关。NWL不足与低出生体重（OR = 2.68，95%CI 1.13 - 6.33）以及配方奶/混合喂养（OR = 1.74，95%CI 1.13 - 2.66）呈正相关。
NWL过多与母亲年龄和受教育程度、剖宫产以及接受光疗的黄疸呈正相关。NWL不足反映了婴儿的喂养情况。由于母乳喂养的新生儿体重没有过度减轻，而配方奶/混合喂养的新生儿NWL不足，我们的研究支持母乳喂养在此期间能提供优质营养。
