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影响印度尼西亚早产儿经口喂养能力的因素

Factors Affecting Oral Feeding Ability in Indonesian Preterm Infants.

作者信息

Wahyuni Luh Karunia, Mangunatmadja Irawan, Kaban Risma Kerina, Rachmawati Elvie Zulka Kautzia, Harini Melinda, Laksmitasari Budiati, Nugraha Boya

机构信息

Department of Physical Medicine and Rehabilitation, Faculty of Medicine Universitas Indonesia-Dr. Cipto Mangunkusumo Hospital, Jakarta 10430, Indonesia.

Department of Child Health, Faculty of Medicine Universitas Indonesia-Dr. Cipto Mangunkusumo Hospital, Jakarta 10430, Indonesia.

出版信息

Pediatr Rep. 2022 May 13;14(2):233-243. doi: 10.3390/pediatric14020031.

Abstract

Most preterm infants exhibit atypical and immature feeding skills. Even though preterm infants have fulfilled the oral feeding readiness criteria, they still do not have optimal oral feeding ability. This study aimed to determine various factors affecting oral feeding ability in Indonesian preterm infants who have fulfilled oral feeding readiness criteria but still have not been able to feed orally. A cross-sectional study included 120 preterm infants admitted to five tertiary hospitals in Jakarta, Indonesia. Participants were preterm infants born at 28-34 weeks gestational age who had fulfilled the oral feeding readiness as the inclusion criteria: (1) stable cardiorespiratory status, (2) have achieved full enteral feeding via orogastric tube (OGT) 120 mL/kg/day without vomiting or bloating, and (3) strong and rhythmic non-nutritive sucking (NNS) through objective measurement. Infants' oral feeding ability and various factors that were assumed to affect oral feeding ability, including physiological flexion postural tone, physiological stability, rooting reflex, self-regulation, behavioral state, and level of morbidity were evaluated. Chi-square and multivariate analysis with Poisson regression were performed. Results indicated that postural tone, rooting reflex, physiological stability, self-regulation, behavioral state, and level of morbidity were significantly related to oral feeding ability in preterm infants. The most influencing factors were self-regulation with a prevalence ratio (PR) of 1.96 (1.16-3.34; CI 95%) and = 0.012, followed by postural tone, high morbidity, and behavioral state (PR 1.91; 1.59; 1.56; CI 95%, respectively). In conclusion, despite meeting the oral feeding readiness criteria, most preterm infants were still not able to feed orally. There are other factors affecting oral feeding ability in Indonesian preterm infants.

摘要

大多数早产儿表现出非典型和不成熟的喂养技能。尽管早产儿已满足经口喂养准备标准,但他们仍不具备最佳的经口喂养能力。本研究旨在确定影响印度尼西亚已满足经口喂养准备标准但仍无法经口喂养的早产儿经口喂养能力的各种因素。一项横断面研究纳入了印度尼西亚雅加达五家三级医院收治的120名早产儿。参与者为孕28 - 34周出生的早产儿,他们满足经口喂养准备作为纳入标准:(1)心肺状态稳定,(2)经口胃管(OGT)实现全肠内喂养120 mL/kg/天且无呕吐或腹胀,(3)通过客观测量有强烈且有节律的非营养性吸吮(NNS)。评估了婴儿的经口喂养能力以及各种假定影响经口喂养能力的因素,包括生理屈曲姿势张力、生理稳定性、觅食反射、自我调节、行为状态和疾病严重程度。进行了卡方检验和泊松回归的多变量分析。结果表明,姿势张力、觅食反射、生理稳定性、自我调节、行为状态和疾病严重程度与早产儿的经口喂养能力显著相关。最具影响的因素是自我调节,患病率比(PR)为1.96(1.16 - 3.34;95%置信区间),P = 且0.012,其次是姿势张力、高疾病严重程度和行为状态(PR分别为1.91、1.59、1.56;95%置信区间)。总之,尽管满足经口喂养准备标准,但大多数早产儿仍无法经口喂养。还有其他因素影响印度尼西亚早产儿的经口喂养能力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad7a/9149927/86bdd5cf2748/pediatrrep-14-00031-g001.jpg

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