Pires Priscilla Larissa Silva, Romão Rejane Sousa, Souza Rayany Cristina de, Pereira Leandro Alves, Rinaldi Ana Elisa Madalena, Azevedo Vivian Mara Gonçalves de Oliveira
Universidade Federal de Uberlândia, Uberlândia, Brasil.
Cad Saude Publica. 2024 Sep 9;40(8):e00194923. doi: 10.1590/0102-311XPT194923. eCollection 2024.
This study aimed to analyze the association between sociodemographic factors, maternal and neonatal characteristics and the time taken to introduce complementary feeding in low birthweight and preterm newborns. This is a prospective cohort study of 79 preterm newborns weighing less than or equal to 1,800g. Data were collected at the time of hospital discharge and at the 6th, 9th ,and 12th months of corrected gestational age (CGA), using a structured questionnaire to analyze the time taken to introduce complementary feeding and the texture of the foods introduced. Furthermore, the Survey of Well-being of Young Children (SWYC-BR) was used to assess the risk of developmental delay. Cox proportional hazards regression was used to analyze the variables. The introduction of complementary feeding was assessed in preterm newborns based on the median age of introduction of liquid foods (3.50; IQR: 2.50-5.00), followed by solid (4.70; IQR: 3.20-5.20) and soft foods (5.00; IQR: 4.50-5.50). There was also an association with gestational age (RR = 1.25; 95%CI: 1.02-1.52) throughout the process of food introduction. For solid and soft foods, those with the longest length of stay (RR = 1.03; 95%CI: 1.10-1.05) and on mixed breastfeeding (RR = 2.97; 95%CI: 1.24-7.09) delayed the introduction of complementary feeding the longest. For liquid foods, less severe preterm newborns (Score for Neonatal Acute Physiology and Perinatal Extension - SNAPPE II [RR = 0.96; 95%CI: 0.94-0.98]) and mothers who were breastfeeding at hospital discharge (RR = 11.49; 95%CI: 1.57-84.10) delayed the introduction of complementary feeding. Guidelines are needed to better advise professionals and parents and/or guardians on the ideal time to introduce feeding.
本研究旨在分析社会人口学因素、母亲和新生儿特征与低出生体重和早产新生儿引入辅食时间之间的关联。这是一项对79名体重小于或等于1800克的早产新生儿进行的前瞻性队列研究。在出院时以及矫正胎龄（CGA）的第6、9和12个月收集数据，使用结构化问卷分析引入辅食的时间以及所引入食物的质地。此外，采用幼儿幸福感调查（SWYC-BR）评估发育迟缓风险。使用Cox比例风险回归分析变量。根据引入流质食物的中位年龄（3.50；四分位间距：2.50 - 5.00）、其次是固体食物（4.70；四分位间距：3.20 - 5.20）和软质食物（5.00；四分位间距：4.50 - 5.50）来评估早产新生儿引入辅食的情况。在整个食物引入过程中，与胎龄也存在关联（风险比 = 1.25；95%置信区间：1.02 - 1.52）。对于固体和软质食物，住院时间最长者（风险比 = 1.03；95%置信区间：1.10 - 1.05）以及纯母乳喂养者（风险比 = 2.97；95%置信区间：1.24 - 7.09）引入辅食的延迟时间最长。对于流质食物，病情较轻的早产新生儿（新生儿急性生理学及围生期扩展评分 - SNAPPE II [风险比 = 0.96；95%置信区间：0.94 - 0.98]）以及出院时进行母乳喂养的母亲（风险比 = 11.49；95%置信区间：1.57 - 84.10）引入辅食的时间延迟。需要制定指南，以便更好地就引入喂养的理想时间向专业人员以及父母和/或监护人提供建议。
