Department of Pediatrics, National Hospital Organization Nagasaki Medical Center, Kubara 2-1001-1, Omura, Nagasaki, 856-8562, Japan.
Int Breastfeed J. 2020 Mar 24;15(1):19. doi: 10.1186/s13006-020-00263-2.
Excessive weight loss in newborns is associated with neonatal complications such as jaundice and dehydration, which cause renal failure, thrombosis, hypovolemic shock, and seizures. The identification of the risk factors for excessive weight loss will help to discover preventive measures. The aim of this study was to determine the factors associated with excessive weight loss, defined as weight loss of ≥10%, in breastfed full-term newborns in Japan.
The present retrospective study, which was performed in a tertiary perinatal center accredited as a Baby-Friendly Hospital, included neonates who were born alive with a gestational age of ≥37 weeks. Cases of multiple births, admission to the neonatal intensive care unit (NICU), referral to another facility, or exclusive formula feeding were excluded. Multivariate logistic regression analyses were performed to assess the association between maternal or neonatal characteristics and excessive weight loss.
We studied 399 newborns, of whom 164 (41%) had excessive weight loss. According to the adjusted multiple regression analysis, the factors associated with excessive weight loss were an older maternal age, primiparity, and antepartum Caesarean section, with adjusted odds ratios (95% Confidence Intervals [CIs]) of 1.07 (1.02, 1.11), 2.72 (1.69, 4.38), and 2.00 (1.09, 3.65), respectively.
Close monitoring of infants born to older mothers, primiparous mothers, or infants delivered by antepartum Cesarean section is recommended, and earlier supplementation with artificial milk may be considered.
新生儿体重过度减轻与黄疸和脱水等新生儿并发症有关，这些并发症会导致肾衰竭、血栓形成、低血容量性休克和癫痫发作。确定体重过度减轻的危险因素有助于发现预防措施。本研究的目的是确定与日本母乳喂养足月新生儿体重过度减轻（定义为体重减轻≥10%）相关的因素。
本回顾性研究在一家被认证为婴儿友好医院的三级围产期中心进行，纳入了胎龄≥37 周的活产新生儿。排除多胎分娩、入住新生儿重症监护病房（NICU）、转院或完全配方奶喂养的病例。采用多变量逻辑回归分析评估母亲或新生儿特征与体重过度减轻之间的关联。
我们研究了 399 名新生儿，其中 164 名（41%）体重过度减轻。根据调整后的多回归分析，与体重过度减轻相关的因素是母亲年龄较大、初产妇和产前剖宫产，调整后的优势比（95%置信区间[CI]）分别为 1.07（1.02，1.11）、2.72（1.69，4.38）和 2.00（1.09，3.65）。
建议密切监测大龄母亲、初产妇或经产前剖宫产分娩的婴儿，并考虑早期补充人工奶。
