Davis Jessica A, Baumgartel Kelley, Baust Tracy, Conley Yvette P, Morowitz Michael J, Ren Dianxu, Demirci Jill R
Division of General Academic Pediatrics, Department of Pediatrics, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania (Dr Davis); UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania (Drs Davis and Morowitz); School of Nursing, University of South Florida, Tampa (Dr Baumgartel); Departments of Critical Care Medicine (Ms Baust) and Surgery (Dr Morowitz), School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania; and Departments of Health Promotion and Development (Dr Conley and Demirci) and Health and Community Systems (Dr Ren), School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania.
J Perinat Neonatal Nurs. 2024;38(1):54-64. doi: 10.1097/JPN.0000000000000790. Epub 2024 Jan 12.
Neonates with critical congenital heart defects (CCHD neonates) experience high rates of feeding intolerance, necrotizing enterocolitis (NEC), and malnutrition. The benefits of human milk and direct chest/breastfeeding are well known, but research is limited in CCHD neonates. Therefore, the purpose of this study is to examine the impact of neonatal diet and feeding modality on the incidence of feeding intolerance, NEC, and malnutrition among a cohort of CCHD neonates.
A single-center retrospective study was conducted using electronic health record data of CCHD neonates admitted to a cardiac intensive care unit between April 2016 and April 2020. Regression models were fit to analyze associations between neonatal diet, feed modality, and adverse feeding outcomes.
Seventy-four CCHD neonates were included. Increased days of direct chest/breastfeeding were associated with fewer signs of gastrointestinal distress ( P = .047) and bloody stools ( P = .021). Enteral feeding days of "all human milk" were associated with higher growth trajectory ( P < .001).
Human milk and direct chest/breastfeeding may be protective against some adverse feeding outcomes for CCHD neonates. Larger, multicenter cohort studies are needed to continue investigating the effects of neonatal diet type and feeding modality on the development of adverse feeding outcomes in this unique population.
患有严重先天性心脏病的新生儿（CCHD 新生儿）出现喂养不耐受、坏死性小肠结肠炎（NEC）和营养不良的发生率很高。母乳和直接胸/母乳喂养的益处是众所周知的，但在 CCHD 新生儿中的研究有限。因此，本研究的目的是探讨新生儿饮食和喂养方式对一组 CCHD 新生儿喂养不耐受、NEC 和营养不良发生率的影响。
利用 2016 年 4 月至 2020 年 4 月期间入住心脏重症监护病房的 CCHD 新生儿的电子健康记录数据进行了一项单中心回顾性研究。采用回归模型分析新生儿饮食、喂养方式与不良喂养结局之间的关联。
纳入了 74 例 CCHD 新生儿。直接胸/母乳喂养天数增加与胃肠道不适体征较少（P = .047）和血便较少（P = .021）相关。“全母乳喂养”的肠内喂养天数与较高的生长轨迹相关（P < .001）。
母乳和直接胸/母乳喂养可能对 CCHD 新生儿的一些不良喂养结局具有保护作用。需要开展更大规模的多中心队列研究，以继续调查新生儿饮食类型和喂养方式对这一特殊人群不良喂养结局发生发展的影响。
