Unit of Pediatrics and Neonatology, "F. Del Ponte" Hospital, Dipartimento di Medicina e Chirurgia University of Insubria, Varese, Italy.
Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy.
J Pediatr. 2019 Sep;212:44-51. doi: 10.1016/j.jpeds.2019.04.061. Epub 2019 Jun 11.
To assess the prevalence of functional gastrointestinal disorders (FGIDs) in the first year of life and the influence of different neonatal factors on development of FGIDs.
A prospective cohort multicenter study including neonates, consecutively enrolled at birth, and followed up until 1 year. Gestational age, neonatal antibiotic administration, duration of hospitalization, mode of delivery, birth weight, and feeding pattern were recorded. FGIDs were classified according to Rome III criteria and assessed at 1, 3, 6, and 12 months of life.
Among 1152 newborns enrolled, 934 (81.1%) completed the study, 302 (32%) were newborns born preterm, 320 (34%) had neonatal antibiotics, and 718 (76.9%) had at least 1 FGID according to Rome III criteria (443 [47.4%] infantile colic, 374 [40.0%] regurgitation, 297 [31.8%] infant dyschezia, 248 [26.6%] functional constipation, and 34 [3.6%] functional diarrhea) throughout the first year of life. The proportion of infants born preterm presenting with FGIDs (86%) was significantly greater compared with infants born full term (72.5%) (χ = 21.3, P = .0001). On multivariate analysis, prematurity and neonatal use of antibiotics was significantly associated with at least 1 FGID.
We found a high rate FGIDs in infants, likely related to the population recruited, the long observation period, the diagnosis based on Rome III criteria, and parental reports. Preterm delivery and neonatal use of antibiotics in the first months of life are associated with an increased incidence of FGIDs, particularly infantile colic and regurgitation. In our population, cesarean delivery and feeding pattern at 1 month of life emerged as additional risk factors for infant dyschezia and functional diarrhea. Other neonatal factors associated with FGIDs need to be further explored.
评估婴儿期功能性胃肠疾病（FGIDs）的患病率，并研究不同新生儿因素对 FGIDs 发生的影响。
这是一项前瞻性队列多中心研究，纳入了连续于出生时入组的新生儿，并随访至 1 岁。记录了胎龄、新生儿抗生素使用、住院时间、分娩方式、出生体重和喂养方式。FGIDs 根据 Rome III 标准进行分类，并在婴儿 1、3、6 和 12 个月时进行评估。
在纳入的 1152 名新生儿中，934 名（81.1%）完成了研究，302 名（32%）为早产儿，320 名（34%）新生儿使用了抗生素，718 名（76.9%）根据 Rome III 标准至少出现 1 种 FGID（443 名[47.4%]为婴儿绞痛，374 名[40.0%]为胃食管反流，297 名[31.8%]为婴儿便秘，248 名[26.6%]为功能性便秘，34 名[3.6%]为功能性腹泻）。与足月产婴儿（72.5%）相比，早产儿 FGIDs （86%）的比例显著更高（χ²=21.3，P=.0001）。多变量分析显示，早产和新生儿使用抗生素与至少 1 种 FGID 显著相关。
我们发现婴儿 FGIDs 的发生率较高，这可能与所招募的人群、长时间观察期、基于 Rome III 标准的诊断以及父母报告有关。婴儿早期的早产和使用抗生素与 FGIDs 的发生率增加相关，尤其是婴儿绞痛和胃食管反流。在我们的人群中，剖宫产分娩和 1 个月时的喂养方式是婴儿便秘和功能性腹泻的其他危险因素。需要进一步探讨与 FGIDs 相关的其他新生儿因素。
