Miller Jennifer R, Flaherman Valerie J, Schaefer Eric W, Kuzniewicz Michael W, Li Sherian X, Walsh Eileen M, Paul Ian M
Departments of Pediatrics, and
Departments of Pediatrics, and Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, California; and.
Hosp Pediatr. 2015 May;5(5):263-8. doi: 10.1542/hpeds.2014-0143.
To develop nomograms depicting percentiles of weight loss by hour of age for both vaginal and cesarean-delivered newborns who are exclusively formula fed.
Data regarding delivery mode, race/ethnicity, feeding type, and weights were extracted from electronic medical records of the birth hospitalization at 14 Kaiser Permanente Northern California hospitals between 2009 and 2013. Newborns whose first feeding was formula from a cohort of 161 471 healthy, term, singleton neonates born at ≥36 weeks' gestation between 2009 and 2013 were identified. Quantile regression was used to create nomograms stratified according to delivery mode; percentiles of weight loss were estimated as a function of time among formula-fed neonates. Weights measured subsequent to any breast milk feeding were excluded. Percentiles were determined through 48 and 72 hours of age for those born vaginally and via cesarean delivery, respectively.
A total of 7075 formula-fed newborns had weights recorded; 4525 were delivered vaginally, and 2550 were born via cesarean delivery. The median weight loss was 2.9% at 48 hours after vaginal delivery; weight loss>7% was rare. For cesarean-delivered neonates, median weight losses at 48 and 72 hours were 3.7% and 3.5%, respectively; weight loss>8% was rare.
For newborns who are formula fed, these results provide nomograms depicting percentiles of weight loss according to mode of delivery. These plots can be used to classify early weight loss according to percentile and may enable early identification of feeding difficulties or other neonatal morbidities.
为纯配方奶喂养的经阴道分娩和剖宫产新生儿绘制按出生小时数计算的体重减轻百分位数的列线图。
从2009年至2013年期间北加利福尼亚州14家凯撒医疗机构出生住院的电子病历中提取有关分娩方式、种族/民族、喂养类型和体重的数据。在2009年至2013年期间出生的161471例健康、足月、单胎且孕周≥36周的新生儿队列中，确定首次喂养为配方奶的新生儿。采用分位数回归创建按分娩方式分层的列线图；在配方奶喂养的新生儿中，将体重减轻百分位数估计为时间的函数。排除任何母乳喂养后测量的体重。分别确定经阴道分娩和剖宫产出生的新生儿在48小时和72小时龄时的百分位数。
共有7075例配方奶喂养的新生儿记录了体重；4525例经阴道分娩，2550例剖宫产出生。经阴道分娩后48小时的体重减轻中位数为2.9%；体重减轻>7%的情况很少见。对于剖宫产出生的新生儿，48小时和72小时的体重减轻中位数分别为3.7%和3.5%；体重减轻>8%的情况很少见。
对于配方奶喂养的新生儿，这些结果提供了按分娩方式绘制的体重减轻百分位数的列线图。这些图表可用于根据百分位数对早期体重减轻进行分类，并可能有助于早期识别喂养困难或其他新生儿疾病。
