Sanchez Katherine, Spittle Alicia J, Slattery Justine M, Morgan Angela T
Clinical Sciences, Murdoch Childrens Research Institute, Parkville, Australia; Department of Audiology and Speech Pathology, University of Melbourne, Parkville, Australia.
Clinical Sciences, Murdoch Childrens Research Institute, Parkville, Australia; Department of Physiotherapy, University of Melbourne, Parkville, Australia; Newborn Research, The Royal Women's Hospital, Parkville, Australia.
J Pediatr. 2016 Nov;178:113-118.e1. doi: 10.1016/j.jpeds.2016.07.044. Epub 2016 Sep 5.
To evaluate oromotor feeding at 12 months' corrected age in children born before 30 weeks' gestational age compared with term-born peers by the use of observational assessment and to examine predictors of oromotor feeding difficulties in children born before 30 weeks.
Oromotor feeding was assessed at 12 months' corrected age with the Schedule for Oral Motor Assessment in 90 children born before 30 weeks and 137 term-born children. Feeding outcomes were compared between groups. Sex, gestational age at birth, birth weight, social risk, history of tube feeding, surgery, and respiratory support were analyzed as potential risk factors.
At 12 months' corrected age, 38% of children born before 30 weeks had oromotor feeding difficulties-with greater odds of difficulties than term-born participants (OR 2.21; 95% CI 1.55-3.16). Difficulties were observed with specific food textures (purees, solids, crackers) and areas of oromotor skill (lip and jaw movement, food loss, swallowing). Neonatal surgery (n = 4/89) appeared to be the only predictor of oromotor feeding issues (OR 11.66; 95% CI 1.56-87.23; P = .02).
Children born before 30 weeks presented with greater odds of oromotor feeding problems at 12 months' corrected age than their term-born peers. Neonatal surgery was associated with increased odds of feeding difficulties in children born before 30 weeks. Surveillance and support of oromotor feeding skills for very preterm children is indicated, particularly during their transition to solid foods.
通过观察性评估,比较孕30周前出生的儿童与足月儿在矫正年龄12个月时的口运动喂养情况,并研究孕30周前出生儿童口运动喂养困难的预测因素。
采用口腔运动评估量表,对90名孕30周前出生的儿童和137名足月儿在矫正年龄12个月时的口运动喂养情况进行评估。比较两组的喂养结果。分析性别、出生孕周、出生体重、社会风险、管饲史、手术史和呼吸支持作为潜在风险因素。
在矫正年龄12个月时,38%的孕30周前出生的儿童存在口运动喂养困难,其困难几率高于足月儿(比值比2.21;95%可信区间1.55 - 3.16)。在特定食物质地(泥状食物、固体食物、饼干)和口运动技能领域(唇和颌运动、食物掉落、吞咽)观察到困难。新生儿手术(n = 4/89)似乎是口运动喂养问题的唯一预测因素(比值比11.66;95%可信区间1.56 - 87.23;P = 0.02)。
孕30周前出生的儿童在矫正年龄12个月时出现口运动喂养问题的几率高于足月儿。新生儿手术与孕30周前出生儿童喂养困难几率增加有关。建议对极早产儿的口运动喂养技能进行监测和支持,尤其是在他们过渡到固体食物期间。