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极低出生体重早产儿的初乳方案评估

[Colostrum protocol evaluation for very low birth weight preterm infants].

作者信息

Maraboli Aguilera Marcia, Lavanderos Bustamante Graciela, León Martínez Camila, Zúñiga Ulloa Mabel, Mena Nannig Patricia

机构信息

Complejo Aslsteoclal Dr. Sótero del Río, Santiago, Chile.

出版信息

Andes Pediatr. 2022 Jun;93(3):343-350. doi: 10.32641/andespediatr.v93l3.3870.

Abstract

INTRODUCTION

Early administration of oral colostrum has been recommended in very-low-birth-weight (VLBW) preterm infant care.

OBJECTIVE

To evaluate the clinical effect of early colostrum administration on in-hospital outcome and lactation of VLBW preterm infants compared with historical control in an Intensive Care Unit.

SUBJECTS AND METHOD

descriptive cohort study with historical control of VLBW preterm infants who did or did not receive early oral colostrum, born 1.6 years before and 1.4 years after this protocol, with information collected from the database of infants under 1500 grams at birth and in the colostrum protocol registry. Children born to HIV+ mothers, with hepatitis, chemothe rapy, and those born with malformations incompatible with life were excluded. The main perinatal, morbidity, nutritional, and breastfeeding data at discharge were compared.

RESULTS

94 patients were born pre-colostrum and 64 in the protocol period (post-colostrum). The groups were comparable in perinatal history. No difference was observed in infectious, respiratory, or gastrointestinal morbidity, progress in enteral feeding, days of parenteral nutrition, and length of hospital stay. There were signi ficant differences in the percentage breastfeeding at discharge (52 vs. 69%, p < 0.037) and in average breast milk volume at discharge (70 vs. 102 ml/k/day, p < 0.012) in the post-colostrum group. Con clusions: Early colostrum administration to preterm infants was associated with a higher volume of maternal milk at discharge, being a good benefit in VLBW preterm infant care.

摘要

引言

在极低出生体重(VLBW)早产儿护理中,建议尽早给予口服初乳。

目的

在重症监护病房,将早期给予初乳的极低出生体重早产儿的院内结局和泌乳情况与历史对照组进行比较,以评估早期给予初乳的临床效果。

研究对象与方法

采用描述性队列研究,对在本方案实施前1.6年和实施后1.4年出生的、接受或未接受早期口服初乳的极低出生体重早产儿进行历史对照,从出生体重低于1500克的婴儿数据库和初乳方案登记处收集信息。排除感染艾滋病毒母亲所生、患有肝炎、接受化疗以及出生时伴有与生命不相容畸形的儿童。比较出院时的主要围产期、发病率、营养和母乳喂养数据。

结果

初乳方案实施前有94例患者出生,方案实施期间(初乳方案实施后)有64例。两组围产期病史具有可比性。在感染性、呼吸性或胃肠道发病率、肠内喂养进展、肠外营养天数和住院时间方面未观察到差异。初乳方案实施后组在出院时母乳喂养百分比(52%对69%,p<0.037)和出院时平均母乳量(70对102毫升/千克/天,p<0.012)方面存在显著差异。

结论

对早产儿尽早给予初乳与出院时更高的母乳量相关,这对极低出生体重早产儿护理有益。

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