Li Ying, Wu Fan
Department of Neonatology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou 510150, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2021 Jul;23(7):690-695. doi: 10.7499/j.issn.1008-8830.2101006.
To investigate the condition of enteral feeding and the incidence of feeding intolerance (FI) in extremely low birth weight (ELBW) infants with a gestational age (GA) of < 28 weeks versus ≥ 28 weeks.
A retrospective analysis was performed for the ELBW infants who were admitted to the Department of Neonatology, The Third Affiliated Hospital of Guangzhou Medical University, from January 2018 to January 2020. According to GA, they were divided into two groups:GA < 28 weeks (=41) and GA ≥ 28 weeks (=38). The two groups were compared in terms of enteral feeding and incidence rate of FI during hospitalization.
Among the 41 infants in the GA < 28 weeks group, 2 (5%) were small-for-gestational-age (SGA) infants, while among the 38 infants in the GA ≥ 28 weeks group, 24 (63%) were SGA infants. Compared with the GA ≥ 28 weeks group, the GA < 28 weeks group had significantly longer initial and final time to full enteral feeding ( < 0.05). The GA < 28 weeks group had a significantly higher recurrence rate of FI than the GA ≥ 28 weeks group (54% 32%, < 0.05). Compared with the GA < 28 weeks group, the GA ≥ 28 weeks group had a significantly lower incidence rate of FI within 1-2 weeks after birth (5% 29%, < 0.05) and a significantly shorter duration of FI ( < 0.05). The ELBW infants in the GA ≥ 28 weeks group had a higher velocity of weight gain, a shorter length of hospital stay, and a lower incidence rate of bronchopulmonary dysplasia, but a higher incidence rate of extrauterine growth retardation (EUGR) than the GA < 28 weeks group at discharge ( < 0.05) Conclusions: Compared with the ELBW infants with a GA of < 28 weeks, the ELBW infants with a GA of ≥ 28 weeks have a lower recurrence rate of FI and can achieve full enteral feeding earlier, but with a higher incidence rate of EUGR, suggesting that enteral feeding needs to be more active for the ELBW infants with a GA of ≥ 28 weeks.
探讨胎龄(GA)<28周与≥28周的极低出生体重(ELBW)婴儿的肠内喂养情况及喂养不耐受(FI)的发生率。
对2018年1月至2020年1月在广州医科大学附属第三医院新生儿科住院的ELBW婴儿进行回顾性分析。根据GA将其分为两组:GA<28周(=41例)和GA≥28周(=38例)。比较两组住院期间的肠内喂养情况及FI发生率。
GA<28周组的41例婴儿中,2例(5%)为小于胎龄儿(SGA),而GA≥28周组的38例婴儿中,24例(63%)为SGA婴儿。与GA≥28周组相比,GA<28周组完全肠内喂养的初始和最终时间明显更长(<0.05)。GA<28周组的FI复发率明显高于GA≥28周组(54%对32%,<0.05)。与GA<28周组相比,GA≥28周组出生后1-2周内的FI发生率明显更低(5%对29%,<0.05),FI持续时间明显更短(<0.05)。GA≥28周组的ELBW婴儿出院时体重增加速度更快、住院时间更短、支气管肺发育不良发生率更低,但宫外生长迟缓(EUGR)发生率高于GA<28周组(<0.05)。结论:与GA<28周的ELBW婴儿相比,GA≥28周的ELBW婴儿的FI复发率更低,能更早实现完全肠内喂养,但EUGR发生率更高,提示对于GA≥28周的ELBW婴儿需要更积极地进行肠内喂养。