Mezzacappa Maria Aparecida, Ferreira Bruna Gil
Faculdade de Ciências, Universidade Estadual de Campinas (Unicamp), Campinas, SP, Brasil.
Faculdade de Ciências, Universidade Estadual de Campinas (Unicamp), Campinas, SP, Brasil.
Rev Paul Pediatr. 2016 Sep;34(3):281-6. doi: 10.1016/j.rpped.2015.10.007. Epub 2016 Jan 6.
To determine the risk factors for weight loss over 8% in full-term newborns at postpartum discharge from a Baby Friendly Hospital.
The cases were selected from a cohort of infants belonging to a previous study. Healthy full-term newborns with birth weight ≥2.000g, who were exclusively breastfed, and excluding twins and those undergoing phototherapy as well as those discharged after 96 hours of life, were included. The analyzed maternal variables were maternal age, parity, ethnicity, type of delivery, maternal diabetes, gender, gestational age and appropriate weight for age. Adjusted multiple and univariate Cox regression analyses were used, considering as significant p<0.05.
We studied 414 newborns, of whom 107 (25.8%) had excessive weight loss. Through the univariate regression, risk factors associated with weight loss >8% were caesarean delivery and older maternal age. At the adjusted multiple regression analysis, the model to explain the weight loss was cesarean delivery (relative risk: 2.27 and 95% of confidence interval: 1.54 to 3.35).
The independent predictor for weight loss >8% in exclusively breastfed full-term newborns in a Baby-Friendly Hospital was the cesarean delivery. It is possible to reduce the number of cesarean sections to minimize neonatal excessive weight loss and the resulting use of infant formula during the first week of life.
确定爱婴医院足月新生儿出院时体重减轻超过8%的风险因素。
病例选自先前一项研究的婴儿队列。纳入出生体重≥2000g、纯母乳喂养的健康足月新生儿，排除双胞胎、接受光疗的新生儿以及出生后96小时后出院的新生儿。分析的母亲变量包括母亲年龄、产次、种族、分娩类型、母亲糖尿病、性别、孕周和年龄别适当体重。采用多因素和单因素Cox回归分析，以p<0.05为有统计学意义。
我们研究了414名新生儿，其中107名（25.8%）体重过度减轻。通过单因素回归分析，与体重减轻>8%相关的风险因素是剖宫产和母亲年龄较大。在多因素回归分析中，解释体重减轻的模型是剖宫产（相对风险：2.27，95%置信区间：1.54至3.35）。
爱婴医院纯母乳喂养足月新生儿体重减轻>8%的独立预测因素是剖宫产。减少剖宫产数量有可能将新生儿过度体重减轻以及出生后第一周婴儿配方奶粉的使用降至最低。
