Neonatal Intensive Care Unit, IRCCS Istituto Giannina Gaslini, Genova, Italy.
Rehabilitation Department, ASL Bi Biella Hospital, Biella, Italy.
J Matern Fetal Neonatal Med. 2021 Feb;34(4):519-525. doi: 10.1080/14767058.2019.1610733. Epub 2019 May 15.
To investigate timing of oral feeding (OF) introduction and full oral feeding (FOF) achievement in preterm infants and to explore factors associated with feeding progression. Retrospective review of 100 medical records of preterms ≤32 weeks of gestation (GA) without major complications. Outcome measures were timing of OF introduction, transition time from nasogastric tube to FOF and FOF achievement. Variables such as sex, twins, GA, birthweight, respiratory supports used and duration of tube feeding, were also considered. Post menstrual age (PMA) for OF introduction was 33.6 ± 1.1 weeks. FOF was achieved at 35.1 ± 1.5 weeks. PMA at OF introduction and PMA at FOF correlated with: birthweight ( = .0001, = .001); duration of respiratory supports ( = 0.01, = .0001); PMA at which respiratory supports were stopped ( = .0001, = .0001); age of introduction of gavage ( = .0001, = .003) and time of utilization of tube feeding ( = .02, = .0001). Transition time was 1.5 ± 8.5 days. PMA at OF introduction significantly influenced PMA at FOF ( = .0001, = .61). OF introduction, transition time and FOF were correlated with duration of hospitalization ( = .004, = .0001, = .008). The achievement of feeding skills is confirmed to affect length of hospitalization, but the earlier you introduce OF, the earlier you reach FOF, so introduction should be anticipated. There is a clear trend to favor higher birthweight classes in FOF achievement. Feeding tube placement and need for respiratory supports may represent a nociceptive experience delaying feeding skills' achievement. This highlights the importance of prospective studies investigating the role of preventative interventions.
探讨早产儿经口喂养（Oral Feeding，OF）引入和完全经口喂养（Full Oral Feeding，FOF）的时间，并探讨与喂养进展相关的因素。
回顾性分析了 100 例胎龄≤32 周无重大并发症的早产儿的 100 份病历。观察指标为 OF 引入时间、从鼻胃管喂养到 FOF 的过渡时间和 FOF 实现时间。还考虑了性别、双胞胎、胎龄、出生体重、使用的呼吸支持方式和管饲时间等变量。OF 引入的校正胎龄（Postmenstrual Age，PMA）为 33.6±1.1 周。FOF 实现的 PMA 为 35.1±1.5 周。OF 引入时的 PMA 和 FOF 时的 PMA 与以下因素相关：出生体重（ = 0.0001， = 0.001）；呼吸支持的持续时间（ = 0.01， = 0.001）；停止呼吸支持时的 PMA（ = 0.0001， = 0.0001）；开始管饲的年龄（ = 0.0001， = 0.003）和管饲时间（ = 0.02， = 0.0001）。过渡时间为 1.5±8.5 天。OF 引入时的 PMA 显著影响 FOF 时的 PMA（ = 0.0001， = 0.61）。OF 引入、过渡时间和 FOF 与住院时间相关（ = 0.004， = 0.0001， = 0.008）。喂养技能的获得确实会影响住院时间的长短，但你越早引入 OF，就越早达到 FOF，所以应该提前进行。在 FOF 实现方面，较高的出生体重类别有明显的优势。放置喂养管和需要呼吸支持可能代表了延迟喂养技能获得的一种伤害性体验。这凸显了前瞻性研究调查预防干预作用的重要性。
