Mariana González de Oliveira, Desirée de Freitas Valle Volkmer, Arthur Pille, Jonas Wolf, Marôla Flores da Cunha Scheeren
{"title":"极低出生体重儿在新生儿重症监护室出院时母乳量低的相关因素--一项队列研究。","authors":"Mariana González de Oliveira, Desirée de Freitas Valle Volkmer, Arthur Pille, Jonas Wolf, Marôla Flores da Cunha Scheeren","doi":"10.1089/bfm.2023.0266","DOIUrl":null,"url":null,"abstract":"<p><p><b><i>Background:</i></b> Mother's own milk (MOM) provides health benefits for infants with very low birth weight (VLBW). This study aimed to describe the incidence and factors associated with low volumes of MOM (<50% of total diet volume) at discharge for VLBW infants. <b><i>Methods:</i></b> A prospective cohort study of infants with VLBW and gestational age of <30 weeks, who survived to discharge and had no contraindication to MOM. We conducted bivariate analyses to investigate associations with the volume of MOM at discharge, using chi-square, <i>t</i>, and Mann-Whitney tests. All <i>p</i>-value analyses were two-tailed. The variables significantly associated with \"low volumes of MOM\" entered the multivariable analysis. Univariate and multivariate relative risk (confidence interval [CI] 95%) estimates were obtained from Poisson regression with a robust estimate of variance and controlled by the length of hospital stay. <b><i>Results:</i></b> Of 414 infants included and followed until discharge, 32.9% (<i>n</i> = 136) received less than 50% of the total daily volume of MOM. This outcome was associated with gestational age <28 weeks, lower birth weight, multiple births, developing bronchopulmonary dysplasia, and longer lengths of stay. After Poisson regression, low volumes of MOM at discharge were associated only with being born multiples (RR 2.01; CI 95% 1.53-2.64, <i>p</i> < 0.001) and with longer length of stay (RR 1.07; CI 95% 1.01-1.14, <i>p</i> = 0.01). <b><i>Conclusions:</i></b> Most VLBW infants were discharged home receiving predominantly MOM. Each neonatal intensive care unit (NICU) should acknowledge which clinical characteristics of mothers and VLBW infants are associated with difficulties maintaining MOM volumes until discharge.</p>","PeriodicalId":9142,"journal":{"name":"Breastfeeding Medicine","volume":null,"pages":null},"PeriodicalIF":2.1000,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Factors Associated with Low Volumes of Mother's Own Milk at Neonatal Intensive Care Unit Discharge of Very Low Birth Weight Infants-a Cohort Study.\",\"authors\":\"Mariana González de Oliveira, Desirée de Freitas Valle Volkmer, Arthur Pille, Jonas Wolf, Marôla Flores da Cunha Scheeren\",\"doi\":\"10.1089/bfm.2023.0266\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p><b><i>Background:</i></b> Mother's own milk (MOM) provides health benefits for infants with very low birth weight (VLBW). This study aimed to describe the incidence and factors associated with low volumes of MOM (<50% of total diet volume) at discharge for VLBW infants. <b><i>Methods:</i></b> A prospective cohort study of infants with VLBW and gestational age of <30 weeks, who survived to discharge and had no contraindication to MOM. We conducted bivariate analyses to investigate associations with the volume of MOM at discharge, using chi-square, <i>t</i>, and Mann-Whitney tests. All <i>p</i>-value analyses were two-tailed. The variables significantly associated with \\\"low volumes of MOM\\\" entered the multivariable analysis. Univariate and multivariate relative risk (confidence interval [CI] 95%) estimates were obtained from Poisson regression with a robust estimate of variance and controlled by the length of hospital stay. <b><i>Results:</i></b> Of 414 infants included and followed until discharge, 32.9% (<i>n</i> = 136) received less than 50% of the total daily volume of MOM. This outcome was associated with gestational age <28 weeks, lower birth weight, multiple births, developing bronchopulmonary dysplasia, and longer lengths of stay. After Poisson regression, low volumes of MOM at discharge were associated only with being born multiples (RR 2.01; CI 95% 1.53-2.64, <i>p</i> < 0.001) and with longer length of stay (RR 1.07; CI 95% 1.01-1.14, <i>p</i> = 0.01). <b><i>Conclusions:</i></b> Most VLBW infants were discharged home receiving predominantly MOM. Each neonatal intensive care unit (NICU) should acknowledge which clinical characteristics of mothers and VLBW infants are associated with difficulties maintaining MOM volumes until discharge.</p>\",\"PeriodicalId\":9142,\"journal\":{\"name\":\"Breastfeeding Medicine\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2024-06-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Breastfeeding Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1089/bfm.2023.0266\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/4/17 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"OBSTETRICS & GYNECOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Breastfeeding Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1089/bfm.2023.0266","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/4/17 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
背景:母乳(MOM)对极低出生体重儿(VLBW)的健康有益。本研究旨在描述低量母乳喂养的发生率和相关因素(方法:对 VLBW 和胎龄为 t 的婴儿进行前瞻性队列研究:对 VLBW 和胎龄为 t 的婴儿进行前瞻性队列研究,并进行 Mann-Whitney 检验。所有 p 值分析均采用双尾法。与 "MOM 量低 "明显相关的变量进入多变量分析。单变量和多变量相对风险(置信区间[CI] 95%)的估计值是通过泊松回归和稳健的方差估计得出的,并受到住院时间的控制。结果:在纳入并随访至出院的 414 名婴儿中,有 32.9% 的婴儿(n = 136)每天接受的 MOM 总量不足 50%。这一结果与胎龄(P < 0.001)和住院时间(RR 1.07; CI 95% 1.01-1.14, P = 0.01)有关。结论大多数超低体重儿出院回家时主要接受 MOM。每个新生儿重症监护病房(NICU)都应认识到,母亲和 VLBW 婴儿的哪些临床特征与出院前维持 MOM 容量的困难有关。
Factors Associated with Low Volumes of Mother's Own Milk at Neonatal Intensive Care Unit Discharge of Very Low Birth Weight Infants-a Cohort Study.
Background: Mother's own milk (MOM) provides health benefits for infants with very low birth weight (VLBW). This study aimed to describe the incidence and factors associated with low volumes of MOM (<50% of total diet volume) at discharge for VLBW infants. Methods: A prospective cohort study of infants with VLBW and gestational age of <30 weeks, who survived to discharge and had no contraindication to MOM. We conducted bivariate analyses to investigate associations with the volume of MOM at discharge, using chi-square, t, and Mann-Whitney tests. All p-value analyses were two-tailed. The variables significantly associated with "low volumes of MOM" entered the multivariable analysis. Univariate and multivariate relative risk (confidence interval [CI] 95%) estimates were obtained from Poisson regression with a robust estimate of variance and controlled by the length of hospital stay. Results: Of 414 infants included and followed until discharge, 32.9% (n = 136) received less than 50% of the total daily volume of MOM. This outcome was associated with gestational age <28 weeks, lower birth weight, multiple births, developing bronchopulmonary dysplasia, and longer lengths of stay. After Poisson regression, low volumes of MOM at discharge were associated only with being born multiples (RR 2.01; CI 95% 1.53-2.64, p < 0.001) and with longer length of stay (RR 1.07; CI 95% 1.01-1.14, p = 0.01). Conclusions: Most VLBW infants were discharged home receiving predominantly MOM. Each neonatal intensive care unit (NICU) should acknowledge which clinical characteristics of mothers and VLBW infants are associated with difficulties maintaining MOM volumes until discharge.
期刊介绍:
Breastfeeding Medicine provides unparalleled peer-reviewed research, protocols, and clinical applications to ensure optimal care for mother and infant. The Journal answers the growing demand for evidence-based research and explores the immediate and long-term outcomes of breastfeeding, including its epidemiologic, physiologic, and psychological benefits. It is the exclusive source of the Academy of Breastfeeding Medicine protocols.
Breastfeeding Medicine coverage includes:
Breastfeeding recommendations and protocols
Health consequences of artificial feeding
Physiology of lactation and biochemistry of breast milk
Optimal nutrition for the breastfeeding mother
Breastfeeding indications and contraindications
Managing breastfeeding discomfort, pain, and other complications
Breastfeeding the premature or sick infant
Breastfeeding in the chronically ill mother
Management of the breastfeeding mother on medication
Infectious disease transmission through breast milk and breastfeeding
The collection and storage of human milk and human milk banking
Measuring the impact of being a “baby-friendly” hospital
Cultural competence and cultural sensitivity
International public health issues including social and economic issues.