Valentine Gregory C, Rue Tessa, Brandon Olivia C, Perez Krystle M, Wood Thomas R, Rent Sharla, Barbut Gal, Abadi Merhawit, Workneh Redeat, Metaferia Gesit, Abayneh Mahlet
Division of Neonatology, University of Washington, Seattle Children's Hospital, Seattle, WA 98195, USA.
Division of Neonatology, Duke University, Durham, NC 27708, USA.
Children (Basel). 2025 Jul 1;12(7):872. doi: 10.3390/children12070872.
We sought to address ongoing gaps in understanding the relationship between first-week percent maximal weight loss (MWL) and average first-week total fluid intake (TFI), enteral intake, and parenteral intake among premature newborns with adverse in-hospital outcomes born in low- and middle-income countries (LMICs). We evaluated newborns born <34 weeks gestation or <1500 g who survived at least 7 days at the St. Paul's Hospital Millennium Medical College (SPHMMC) neonatal intensive care unit in Ethiopia. We performed univariate and multivariate regression models analyzing the first-week MWL, average TFI, parenteral, and enteral intake and their relationships with adverse in-hospital outcomes. Among N = 490 moderately and very preterm newborns, multivariate regression models demonstrated that >13% MWL was associated with significantly increased odds of suspected necrotizing enterocolitis (NEC), culture-positive sepsis, retinopathy of prematurity (ROP), and a longer length of stay (LOS). An average intake of >60 mL/kg/day was significantly associated with reduced odds of all-cause mortality, suspected NEC, culture-positive sepsis, ROP, and a shorter LOS, whereas an average intake of >60 mL/kg/day was associated with increased odds of in-hospital mortality, culture-positive sepsis, ROP, and a longer LOS. In moderately and very preterm neonates in an LMIC setting, >13% MWL is associated with adverse health outcomes. Increasing the average parenteral intake over the first week after birth among moderately and very preterm neonates is significantly associated with adverse in-hospital outcomes whereas increasing the average enteral intake is associated with improved outcomes.
我们试图解决在理解低收入和中等收入国家（LMICs）出生的有不良院内结局的早产新生儿第一周最大体重减轻百分比（MWL）与平均第一周总液体摄入量（TFI）、肠内摄入量和肠外摄入量之间关系方面持续存在的差距。我们评估了在埃塞俄比亚圣保罗医院千禧医学院（SPHMMC）新生儿重症监护病房出生且孕周<34周或体重<1500克、存活至少7天的新生儿。我们进行了单变量和多变量回归模型分析第一周的MWL、平均TFI、肠外和肠内摄入量及其与不良院内结局的关系。在490例中度和极早产新生儿中，多变量回归模型表明，MWL>13%与疑似坏死性小肠结肠炎（NEC）、血培养阳性败血症、早产儿视网膜病变（ROP）的几率显著增加以及住院时间延长有关。平均摄入量>60 mL/kg/天与全因死亡率、疑似NEC、血培养阳性败血症、ROP的几率降低以及住院时间缩短显著相关，而平均摄入量>60 mL/kg/天与院内死亡率、血培养阳性败血症、ROP的几率增加以及住院时间延长有关。在LMIC环境中的中度和极早产新生儿中，MWL>13%与不良健康结局相关。中度和极早产新生儿出生后第一周肠外平均摄入量增加与不良院内结局显著相关，而肠内平均摄入量增加与结局改善相关。
