Time to full enteral feeds in hospitalised preterm and very low birth weight infants in Nigeria and Kenya
Time to full enteral feeds in hospitalised preterm and very low birth weight infants in Nigeria and Kenya
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尼日利亚和肯尼亚住院早产儿和极低出生体重儿的完全肠内喂养时间
DOI：
10.1101/2022.11.04.22281964
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发表时间：
2022
期刊：
影响因子：
--
通讯作者：
Imam Z
中科院分区：
文献类型：
--
作者：
Imam Z
研究背景早产儿(胎龄37周)和极低出生体重儿(VLBW；和1.5公斤)在出生后28天内发病和死亡的风险最大。建立完全的肠道喂养是他们临床护理的一个重要方面。主要来自高收入国家的证据表明，及早和迅速推进喂养是安全的，可以减少住院时间和不良健康后果。然而，关于撒哈拉以南非洲这些脆弱婴儿的喂养行为和影响获得完全肠内喂养的因素的数据有限。目的确定影响两个撒哈拉以南非洲国家住院早产儿和极低出生体重儿(VLBW)达到完全肠内喂养时间的因素，定义为耐受性为120ml/kg/天。结果在2280名住院新生儿中，484名为早产儿和极低出生体重儿。总体而言，222/484名婴儿(45.8%)死亡，其中超过一半的死亡(136/222；61.7%)发生在第一次喂养之前。首次喂养的中位时间(四分位数范围)为46(27，72)小时，完全肠道喂养(TFEF)的时间为8(4.5，12)天，新生儿单位之间存在显著差异。首次喂养时间(非标准化系数B1.69；95%可信区间1.11~2.26；P值0.001)、孕周(1.77；0.72~2.81；0.001)、呼吸窘迫(-1.89；-3.50~-0.79；<；0.002)和坏死性小肠结肠炎(4.31；1.00~7.62；<；0.011)。结论标准化喂养指南的使用可以减少临床实践中的差异，缩短tFEF，从而改善早产和极低出生体重的结局。
BackgroundPreterm (born < 37 weeks’ gestation) and very low birthweight (VLBW; <1.5kg) infants are at the greatest risk of morbidity and mortality within the first 28 days of life. Establishing full enteral feeds is a vital aspect of their clinical care. Evidence predominantly from high income countries shows that early and rapid advancement of feeds is safe and reduces length of hospital stay and adverse health outcomes. However, there are limited data on feeding practices and factors that influence the attainment of full enteral feeds among these vulnerable infants in sub-Saharan Africa.AimTo identify factors that influence the time to full enteral feeds, defined as tolerance of 120ml/kg/day, in hospitalised preterm and VLBW infants in neonatal units in two sub-Saharan African countries.MethodsDemographic and clinical variables were collected for newborns admitted to 7 neonatal units in Nigeria and Kenya over 6-months. Multiple linear regression analysis was conducted to identify factors independently associated with time to full enteral feeds.ResultsOf the 2280 newborn infants admitted, 484 were preterm and VLBW. Overall, 222/484 (45.8%) infants died with over half of the deaths (136/222; 61.7%) occurring before the first feed. The median (inter-quartile range) time to first feed was 46 (27, 72) hours of life and time to full enteral feeds (tFEF) was 8 (4.5,12) days with marked variation between neonatal units. Independent predictors of tFEF were time to first feed (unstandardised coefficient B 1.69; 95% CI 1.11 to 2.26; p value <0.001), gestational age (1.77; 0.72 to 2.81; <0.001), the occurrence of respiratory distress (-1.89; -3.50 to -0.79; <0.002) and necrotising enterocolitis (4.31; 1.00 to 7.62; <0.011).ConclusionThe use of standardised feeding guidelines may decrease variations in clinical practice, shorten tFEF and thereby improve preterm and VLBW outcomes.
影响因子：
2
作者：
Tongo, O. O.;Orimadegun, A. E.;Akinyinka, O. O.
通讯作者：
Akinyinka, O. O.
DOI：
--
发表时间：
2009
期刊：
影响因子：
--
作者：
R. Neal
通讯作者：
R. Neal
极低出生体重婴儿的生长速度。
影响因子：
3.6
作者：
C. Fustiñana;J. C. Cernadas;L. Lieva
通讯作者：
L. Lieva