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影响新生儿重症监护病房中监测的早产儿母乳喂养状况的可能因素。

Possible Factors Affecting Breast Milk Feeding Status Of Preterm Infants Monitored in the Neonatal Intensive Care Unit.

作者信息

Yakar Funda Emren, Korğalı Elif Ünver

机构信息

Department of Pediatrics, Private Medicana Sivas Hospital, Sivas, Türkiye.

Department of Pediatrics, Department of Social Pediatrics, Sivas Cumhuriyet University Faculty of Medicine, Sivas, Türkiye.

出版信息

Turk Arch Pediatr. 2025 May 2;60(2):280-288. doi: 10.5152/TurkArchPediatr.2025.24265.

Abstract

Objective: The aim was to investigate the rates, duration, and possible influencing factors of breast milk feeding (BMF) in preterm infants in the neonatal intensive care unit (NICU) at discharge and in the first year of life. Materials and Methods: In a retrospective cohort study, 173 preterm infants <37 weeks who were hospitalized in the NICU were evaluated. Information was obtained from hospital records and mothers via telephone. Results: The BMF rate was 90.7% with 62.4% exclusively breastfeeding (EBF) and 28.3% partially breastfeeding at discharge. The exclusive, partial, and formula feeding rates were 53.7%, 27.7%, 18.5% and 43.9%, 37%, 19.1% at 4 and 6 months, respectively. The median EBF and total BMF durations were 4 (1-6) and 12 (4.5-24) months, respectively. Very preterms were weaned at a higher rate in the first 6 months compared to moderate and late preterms (50%, 26.3%, 33.3%, P=.046, respectively). EBF at discharge was significantly associated with EBF at 4 and 6 months by chronological and corrected age. The BMF rate for >12 months was higher for multiparous mothers (56.40%, 36.10%, P=.02). Total BMF duration was shorter in preterms with sepsis compared to those without sepsis (median 5 (1-12) and 12.5 (5-24) months, P=.02). It was positively correlated with gestational age (P=.046, r = 0.13), birthweight (P=.012, r=0.17), APGAR (Appearance, Pulse, Grimace, Activity, Respiration) scores 1-minute (P=.002, r = 0.22) and 5-minutes (P=.016, r = 0.16), and maternal age (P < .001, r = 0.25) and negatively correlated with the length of stay in the NICU (P=.031, r=-0.14) and the intubation time (P=.006,r= -0.41). Conclusion: To improve breastfeeding, EBF should be aimed at discharge in all preterms. After discharge, breastfeeding support and close follow-up should be continued for all preterms, especially very preterms.

摘要

目的

旨在调查新生儿重症监护病房(NICU)中早产儿出院时及出生后第一年的母乳喂养率、持续时间及可能的影响因素。材料与方法:在一项回顾性队列研究中,对173名孕周<37周且在NICU住院的早产儿进行了评估。通过医院记录和电话联系母亲获取信息。结果:出院时母乳喂养率为90.7%,其中纯母乳喂养(EBF)率为62.4%,部分母乳喂养率为28.3%。4个月和6个月时,纯母乳喂养、部分母乳喂养及配方奶喂养率分别为53.7%、27.7%、18.5%和43.9%、37%、19.1%。纯母乳喂养和总母乳喂养持续时间的中位数分别为4(1 - 6)个月和12(4.5 - 24)个月。与中度和晚期早产儿相比,极早早产儿在出生后头6个月断奶率更高(分别为50%、26.3%、33.3%,P = 0.046)。按实际年龄和矫正年龄计算,出院时的纯母乳喂养与4个月和6个月时的纯母乳喂养显著相关。经产妇>12个月的母乳喂养率更高(56.40%,36.10%,P = 0.02)。与无败血症的早产儿相比,有败血症的早产儿总母乳喂养持续时间更短(中位数分别为5(1 - 12)个月和12.5(5 - 24)个月,P = 0.02)。其与胎龄(P = 0.046,r = 0.13)、出生体重(P = 0.012,r = 0.17)、1分钟(P = 0.002,r = 0.22)和5分钟(P = 0.016,r = 0.16)的阿氏评分(外观、脉搏、 grimace、活动、呼吸)以及母亲年龄(P < 0.001,r = 0.25)呈正相关,与在NICU的住院时间(P = 0.031,r = -0.14)和插管时间(P = 0.006,r = -0.41)呈负相关。结论:为提高母乳喂养率,应使所有早产儿出院时实现纯母乳喂养。出院后,应对所有早产儿,尤其是极早早产儿继续提供母乳喂养支持并密切随访。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/11e6/12093387/25784d78a095/tap-60-3-280_f001.jpg

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