极/超低出生体重儿住院期间人乳喂养情况多中心回顾性分析  

Breastfeeding of very low birth weight and extremely low birth weight infants during hospitalization:a multi-center retrospective study

作　　者：无 韩树萍[2] 无;Han Shuping(Jiangsu Multicenter Study Collaborative Group for Breastmilk Feeding in Neonatal Intensive Care Units;Department of Neonatology,Women's Hospital of Nanjing Medical University,Nanjing Maternity and Child Health Care Hospital,Nanjing 210004,China)

机构地区：[1]江苏省NICU母乳喂养质量改进临床研究协作组 [2]南京医科大学附属妇产医院(南京市妇幼保健院)新生儿科,210004

出　　处：《中华新生儿科杂志（中英文）》2020年第3期164-168,共5页Chinese Journal of Neonatology

基　　金：南京市医学科技发展基金(ZKX16062、YKK17176);江苏省妇幼健康科研项目(F201642);江苏省妇幼健康重点人才(FRC201740)。

摘　　要：目的探讨极低出生体重儿(very low birth weight infant,VLBWI)和超低出生体重儿(extremely low birth weight infant,ELBWI)住院期间人乳喂养情况。方法采用多中心回顾性病例队列研究,病例来源于2018年江苏省NICU母乳喂养质量改进临床研究协作组中的19家单位,选择胎龄≤35周且生后24 h内入院的VLBWI/ELBWI临床资料。人乳喂养包括亲母母乳喂养和(或)捐赠母乳喂养,人乳喂养率为住院期间接受过亲母母乳和(或)捐赠母乳喂养的比例。结果(1)共收治VLBWI/ELBWI 1359例,占早产儿总数的9.5%(1359/14346)。符合纳入标准的1132例VLBWI/ELBWI中VLBWI 986例(87.1%),男580例(51.2%),胎龄(29.8±2.0)周,出生体重1257(1100,1390)g,多胎280例(24.7%)。(2)19家单位中仅有1家VLBWI/ELBWI在住院期间均有人乳喂养,有6家单位无纯人乳喂养,其余12家单位均为人乳喂养、人乳喂养+配方奶喂养和配方奶喂养3种喂养方式;19家单位VLBWI/ELBWI住院期间平均人乳喂养率为73.8%,1家单位达100%,最低19.4%,其中15家在50%以上,2家单位在40%以下。(3)19家单位住院期间人乳喂养量占比中位数为70.6%,最高100%;日均人乳喂养量中位数为46.3 ml/(kg·d),最高118.0 ml/(kg·d),4家单位日均人乳喂养量中位数为0 ml/(kg·d)。(4)19家单位VLBWI/ELBWI生后0~7 d人乳喂养占比在50%以下,随着日龄的增长逐渐增加,0~28 d为75.0%。日均人乳喂养量也呈上升趋势,生后0~7 d<5 ml/(kg·d),0~28 d为12.7 ml/(kg·d)。(5)住院期间的人乳喂养量占比和日均人乳喂养量成线性相关。结论2018年江苏省NICU母乳喂养质量改进临床研究协作组19家单位VLBWI/ELBWI人乳喂养率、人乳喂养量占比、日均人乳喂养量存在很大差距,需加强VLBWI/ELBWI住院期间人乳喂养质量改进工作,提高人乳喂养率。Objective To study the breastfeeding status of very low birth weight(VLBW)infants and extremely low birth weight(ELBW)infants during hospitalization.Method Among the 19 hospitals of the Jiangsu Multicenter Study Collaborative Group for Breastmilk Feeding in Neonatal Intensive Care Units in 2018,a multi-center retrospective cohort study was performed in VLBW and ELBW infants with gestational age≤35 weeks admitted to the hospital within 24 hours after birth.Breastfeeding meant feeding the babies breast milk of their mothers and/or donators.The proportion of those who have received breast milk of mothers and/or donators during hospitalization among all VLBW/ELBW infants was calculated as the breastfeeding rate.The proportion of breastfeeding milk in all the infants intake was calculated as the breastfeeding%.Result(1)A total of 1359 cases of VLBW/ELBW infants were admitted[VLBW:986 cases(87.1%)],accounting for 9.5%(1359/14346)of all the premature infants.Among the 1132 eligible preterms,580(51.2%)cases were male,the average gestational age was(29.8±2.0)weeks,the average birth weight was 1257(1100,1390)g,and 280(24.7%)cases were multiple births.(2)Only 1 hospital performed breastfeeding for every preterm infant during hospitalization.6 hospitals did not have any case fully breastfed.Preterms in the other 12 hospitals were fed using breast milk and/or formula milk.The average breastfeeding rate was 73.8%among 19 hospitals,with 1 hospital reaching 100%,and the lowest rate was 19.4%.15 hospitals were above 50%and 2 units were below 40%.(3)The median breastfeeding%during hospitalization in 19 hospitals was 70.6%,with the highest 100%.The median daily breastfeeding amount is 46.3 ml/(kg·d),with the highest 118.0 ml/(kg·d).However,the median daily breastfeeding amount of 4 hospitals is 0 ml/(kg·d).(4)Breastfeeding rate was less than 50%within the first week after birth in 19 hospitals,and the rate increased as time went,reaching 75%at 28-day.The average daily breastfeeding volume also increased from less

关 键 词：婴儿 极低出生体重 婴儿 超低出生体重 母乳喂养 

分 类 号：R72[医药卫生—儿科]