Feng Wei, Xiang Xiao, Die Xiaohong, Hou Jinping, Guo Zhenhua, Liu Wei, Hou Jinfeng, Wang Yi
Department of General and Neonatal Surgery, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Structural Birth Defect and Reconstruction, Chongqing, China.
Front Nutr. 2025 Jul 2;12:1553133. doi: 10.3389/fnut.2025.1553133. eCollection 2025.
Feeding pattern is closely related to physical development and health, but the benefit of breast feeding on clinical outcomes of Hirschsprung's disease (HSCR) remains unknown. This study aimed to investigate the influences of feeding patterns on postoperative outcomes of HSCR using propensity score matching (PSM) analysis.
The clinical data of 296 patients with HSCR who underwent Laparoscopic-assisted pull-through surgery were retrospectively analyzed. Patients were dichotomized into breast and formula feeding groups. Using propensity score matching (PSM), the two groups were compared for baseline differences and postoperative outcomes. Furthermore, Univariate/multivariate Logistic regression analysis was used to identify feeding pattern as an independent factor of postoperative HAEC and bowel dysfunction.
Of the 296 patients, breast feeding was 73% (216/296). After PSM, patients with formula feeding had higher rates of postoperative undernutrition (risk of malnutrition: 21.05% vs. 8.77%; malnutrition: 28.07% vs. 15.79%, = 0.023), HAEC (47.37% vs. 22.81%, = 0.006), and bowel dysfunction (64.29% vs. 42.11%, = 0.018). Multivariate Logistic regression analysis revealed that formula feeding was an independent risk factor for postoperative HAEC [OR (95% CI) = 6.86 (1.76 ~ 26.79)] and bowel dysfunction [OR (95% CI) = 2.88 (1.06 ~ 7.83)].
Following adjustment for patient characteristics, HSCR patients with breast feeding were associated with lower rates of postoperative undernutrition, HAEC, and bowel dysfunction.
喂养方式与身体发育和健康密切相关，但母乳喂养对先天性巨结肠症（HSCR）临床结局的益处尚不清楚。本研究旨在使用倾向评分匹配（PSM）分析来探讨喂养方式对HSCR术后结局的影响。
回顾性分析296例行腹腔镜辅助拖出术的HSCR患者的临床资料。将患者分为母乳喂养组和配方奶喂养组。采用倾向评分匹配（PSM），比较两组的基线差异和术后结局。此外，使用单因素/多因素逻辑回归分析来确定喂养方式是术后HAEC和肠功能障碍的独立因素。
296例患者中，母乳喂养率为73%（216/296）。PSM后，配方奶喂养患者术后营养不良发生率较高（营养不良风险：21.05%对8.77%；营养不良：28.07%对15.79%，P = 0.023）、HAEC发生率较高（47.37%对22.81%，P = 0.006）和肠功能障碍发生率较高（64.29%对42.11%，P = 0.018）。多因素逻辑回归分析显示，配方奶喂养是术后HAEC [OR（95%CI）= 6.86（1.7626.79）]和肠功能障碍[OR（95%CI）= 2.88（1.067.83）]的独立危险因素。
在对患者特征进行调整后，母乳喂养的HSCR患者术后营养不良、HAEC和肠功能障碍的发生率较低。
