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中国住院晚期早产儿肠内喂养实践的多中心研究。

Multi-center Study of Enteral Feeding Practices in Hospitalized Late Preterm Infants in China.

机构信息

Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China.

Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229, USA.

出版信息

Biomed Environ Sci. 2018 Jul;31(7):489-498. doi: 10.3967/bes2018.066.

Abstract

OBJECTIVE

To investigate the current enteral feeding practices in hospitalized late preterm infants in the Beijing area of China.

METHODS

A multi-center, cross-sectional study was conducted. Infants born after 34 weeks and before 37 weeks of gestation were enrolled from 25 hospitals in the Beijing area of China from October 2015 to October 2017. Data on enteral feeding practices were collected and analyzed.

RESULTS

A total of 1,463 late preterm infants were enrolled, with a mean gestational age (GA) of 35.6 (34.9, 36.1) weeks. The percentage of exclusive breastfeeding was 4.5% at the initiation of enteral feeding but increased to 14.4% at discharge. When human milk was not available, most infants (46.1%) were fed with preterm infant formula. The rate of exclusive human milk feeding in infants born at 34 weeks gestation was higher than at discharge (21.1% of infants born at 34 weeks' GA versus 12.1% of infants born at 35 weeks' GA versus 12.3% of infants born at 36 weeks' GA, P < 0.001). Only 28.4% of late preterm infants achieved full enteral feeding at discharge, and only 19.2% achieved 120 kcal/(kg•d) by enteral feeding at discharge. Importantly, 40.5% of infants did not regain the birth weight at discharge.

CONCLUSION

Enteral feeding support of late preterm infants has not been standardized to achieve optimal growth. Moreover, the human milk feeding rate was low, and many late preterm infants did not achieve the goal of enteral feeding and failed to regain birth weight at the time of discharge. More aggressive enteral feedings protocols are needed to promote human milk feeding and optimize growth for late preterm infants.

摘要

目的

调查中国北京地区住院晚期早产儿的肠内喂养现状。

方法

采用多中心、横断面研究方法,于 2015 年 10 月至 2017 年 10 月选取北京地区 25 家医院胎龄 34~36+6 周的早产儿,收集其肠内喂养相关数据并进行分析。

结果

共纳入 1463 例晚期早产儿,平均胎龄(GA)为 35.6(34.9,36.1)周,肠内喂养起始时纯母乳喂养率为 4.5%,出院时增至 14.4%。当无法提供人乳时,大部分患儿(46.1%)接受早产儿配方奶喂养。34 周 GA 早产儿出生时纯母乳喂养率高于出院时(21.1%比 35 周 GA 早产儿的 12.1%和 36 周 GA 早产儿的 12.3%,P<0.001)。仅 28.4%的晚期早产儿出院时达到全肠内喂养,仅 19.2%的患儿出院时通过肠内喂养达到 120 kcal/(kg·d)。重要的是,40.5%的患儿出院时未恢复出生体重。

结论

晚期早产儿的肠内喂养支持尚未标准化,以实现最佳生长。此外,母乳喂养率较低,许多晚期早产儿未能达到肠内喂养目标,也未能在出院时恢复出生体重。需要更积极的肠内喂养方案来促进母乳喂养,优化晚期早产儿的生长。

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