2019冠状病毒病大流行期间英国急诊科婴儿喂养就诊情况的频率：一项全国性电子健康记录研究

The Frequency of Infant-Feeding Presentations at English Emergency Departments During the SARS-CoV-2 Pandemic: A Nation-Wide Electronic Health Records Study.

作者信息

Wyatt Steven, Aldridge Patrick, Ross Samantha, Narayanan Sankara, Zuccolo Luisa

机构信息

Health Policy, Strategy Unit, NHS Midlands and Lancashire Commissioning Support Unit, Birmingham, GBR.

Health Policy, Institute of Applied Health Research, University of Birmingham, Birmingham, GBR.

出版信息

Cureus. 2022 Aug 3;14(8):e27645. doi: 10.7759/cureus.27645. eCollection 2022 Aug.

OBJECTIVES

To examine the frequency and distribution of infant feeding-related presentations at emergency departments (EDs) before and during the SARS-CoV-2 pandemic.

SETTING

Attendances at 48 major EDs in England in two 50-week periods before and during the COVID-19 pandemic: period 1, April 2, 2019 to March 10, 2020 and period 2, April 1, 2020 to March 10, 2021.

METHODS

We estimated the change in frequency of ED presentations by age group and diagnosis before and after the start of the SARS-CoV-2 pandemic in England. We compared changes in the frequency of attendances of infant-feeding related presentations by infant age, sex, ethnicity, deprivation, rurality, arrival mode, arrival time, acuity, mother's age, gravidity and mental health, birth length of stay, attendance duration, and disposal (i.e., admission or discharge).

RESULTS

While total ED attendances fell by 16.7% (95% CI -16.8% to -16.6%), infant attendances increased for feeding problems (+7.5% 95% CI 2.3% to 13.0%), neonatal jaundice (+12.8%, 95% CI 3.3% to 23.3%) and gastro-esophageal reflux (+9.7%, 95% CI 4.4% to 15.2%). These increases were more pronounced amongst first babies (+22.4%, 95% CI 13.1% to 32.5%), and where the stay in hospital after birth was brief (0-1 days, +20.1%, 95% CI 14.8% to 25.7%). Our analysis suggests that many of these attendances were of low acuity.

CONCLUSIONS

While ED attendances reduced dramatically and systematically with the COVID-19 pandemic, presentations for infant feeding issues increased, implying growth in the unmet needs of new mothers and infants.

目的

研究在严重急性呼吸综合征冠状病毒2（SARS-CoV-2）大流行之前及期间，急诊科（ED）与婴儿喂养相关就诊情况的频率和分布。

背景

在2019冠状病毒病（COVID-19）大流行之前及期间的两个50周时间段内，对英格兰48家主要急诊科的就诊情况进行研究：第1阶段，2019年4月2日至2020年3月10日；第2阶段，2020年4月1日至2021年3月10日。

方法

我们估计了在英格兰SARS-CoV-2大流行开始前后，按年龄组和诊断分类的急诊科就诊频率的变化。我们比较了按婴儿年龄、性别、种族、贫困程度、农村地区、到达方式、到达时间、 acuity、母亲年龄、妊娠次数和心理健康状况、出生后住院时长、就诊时长以及处置方式（即入院或出院）分类的与婴儿喂养相关就诊情况的频率变化。

结果

虽然急诊科总就诊人数下降了16.7%（95%置信区间为-16.8%至-16.6%），但因喂养问题就诊的婴儿人数增加了（+7.5%，95%置信区间为2.3%至13.0%），新生儿黄疸（+12.8%，95%置信区间为3.3%至23.3%）以及胃食管反流（+9.7%，95%置信区间为4.4%至15.2%）。这些增加在头胎婴儿中更为明显（+22.4%，95%置信区间为13.1%至32.5%），以及出生后住院时间较短的婴儿中（0 - 1天，+20.1%，95%置信区间为14.8%至25.7%）。我们的分析表明，这些就诊情况中许多 acuity较低。