极低出生体重儿中新生儿营养不良与支气管肺发育不良的关系：倾向评分匹配分析。

Association between neonatal malnutrition and bronchopulmonary dysplasia in very low-birth-weight infants: A propensity score-matched analysis.

机构信息

Department of Pediatrics, Northern Jiangsu People's Hospital, Clinical Medical College, Yangzhou University; The Yangzhou School of Clinical Medicine of Dalian Medical University, The Yangzhou Clinical Medical College of Xuzhou Medical University; The Yangzhou School of Clinical Medicine of Nanjing Medical University; Northern Jiangsu People's Hospital, Affiliated Hospital of Nanjing University Medical School, Yangzhou 225001, China.

Laboratory of Metabolic Manipulation of Herbivorous Animal Nutrition, College of Animal Science and Technology, Yangzhou University, Yangzhou, 225009, China.

出版信息

Nutr Clin Pract. 2022 Dec;37(6):1429-1437. doi: 10.1002/ncp.10820. Epub 2022 Feb 16.

DOI:10.1002/ncp.10820

PMID:35174535

Abstract

OBJECTIVE

To investigate the relationship between the nutrition status of infants with bronchopulmonary dysplasia (BPD) at the first 4 weeks of life and the likelihood of developing neonatal malnutrition.

METHODS

A total of 1064 infants were divided into a BPD group and a non-BPD group. After propensity score matching, there were 282 infants in each group. Infants were further divided into a neonatal malnutrition （NM） group and a well-nourished （WN） group. Clinical factors, nutrition intake, and growth parameters were collected and analyzed. Multivariate logistic regression model was used to determine the factors associated with neonatal malnutrition.

RESULTS

Compared with infants in the non-BPD group, the infants in BPD group had more fluid intake and lower calorie and protein intake after the second week, longer invasive ventilation time, and longer time to total oral feeding and parenteral nutrition (PN), and the difference was more significant in NM infants than in WN infants (P < 0.05). 2. The weight/length, body mass index, triponderal mass index, and weight gain velocity in the BPD group were significantly lower than in the non-BPD group (P < 0.05) and lower in NM infants than in WN ones (P < 0.05). 3. Multivariable system regression analysis showed that invasive ventilation time, lipid intake in week 4, time to reach full feeding, and duration of PN were independent risk factors for NM.

CONCLUSION

Enhancing calorie and macronutrient intake, reducing invasive ventilation, and achieving full gastrointestinal feeding early may be effective measures to avoid malnutrition in infants with BPD.

摘要

目的

探讨支气管肺发育不良（BPD）患儿生后前 4 周营养状况与发生新生儿期营养不良的关系。

方法

将 1064 例患儿分为 BPD 组和非 BPD 组，经倾向性评分匹配后，BPD 组和非 BPD 组各 282 例，再根据患儿是否发生新生儿期营养不良分为营养不良（NM）组和营养良好（WN）组，收集并分析患儿的临床资料、营养摄入及生长参数，采用多因素 logistic 回归模型分析发生新生儿期营养不良的影响因素。

结果

与非 BPD 组比较，BPD 组患儿第 2 周后液体摄入较多、热量及蛋白质摄入较少，有创通气时间更长，达到全胃肠喂养及完全肠外营养时间更长，且 NM 组患儿上述差异更为显著（P < 0.05）。2. BPD 组患儿的体重/身长、体质量指数、三部位皮褶厚度、体重增长速度均显著低于非 BPD 组（P < 0.05），且 NM 组患儿均低于 WN 组（P < 0.05）。3. 多因素系统回归分析显示，有创通气时间、第 4 周时脂肪摄入、达到全胃肠喂养时间、肠外营养时间是 NM 的独立危险因素。