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胎龄≤32周早产儿中重度支气管肺发育不良与早期母乳喂养的相关性分析

Correlation between moderate to severe bronchopulmonary dysplasia and early breastfeeding in preterm infants with a gestational age of ≤32 weeks

    摘要
  • 摘要:
    目的 探讨胎龄≤32周早产儿中重度支气管肺发育不良(BPD)与早期母乳喂养的相关性。
    方法 回顾性分析220例胎龄≤32周早产儿的临床资料，根据是否发生中重度BPD将早产儿分为中重度BPD组37例和对照组183例，比较2组早产儿的临床特征、母乳喂养量和亲母母乳(MOM)喂养率，并分析母乳喂养与早产儿发生中重度BPD的关系。
    结果 单因素分析结果显示，中重度BPD组出生体质量 < 1 500 g、出生胎龄 < 28周、分娩方式为阴道分娩、出生后1 min Apgar评分≤7分、机械通气时间≥7 d者占比均高于对照组，静脉营养时间长于对照组，差异有统计学意义(P < 0.05); 中重度BPD组出生后0~7 d母乳摄入量、MOM摄入量、MOM喂养率和出生后8~14 d母乳摄入量均低于对照组，差异有统计学意义(P < 0.05)。多因素Logistic回归分析结果显示，出生后0~7 d母乳喂养量高是早产儿发生中重度BPD的独立保护因素(OR=0.865, 95%CI: 0.767~0.976, P < 0.05), 胎龄 < 28周(OR=5.238, 95%CI: 1.158~23.686, P < 0.05)、机械通气时间≥7 d(OR=22.386, 95%CI: 6.769~74.030, P < 0.05)是早产儿发生中重度BPD的独立危险因素。
    结论 出生后早期母乳喂养可显著降低胎龄≤32周早产儿发生中重度BPD的风险，临床应积极推行早期母乳喂养措施。

     

    Abstract:
    Objective To explore the correlation between moderate to severe bronchopulmonary dysplasia (BPD) and early breastfeeding in preterm infants with a gestational age of ≤32 weeks.
    Methods A retrospective analysis was conducted on the clinical data of 220 preterm infants with a gestational age of ≤32 weeks. The preterm infants were dividedinto moderate to severe BPD group (37 cases) and control group (183 cases) based on whether moderate to severe BPD occurred or not. The clinical characteristics, breastfeeding volume, and mother's own milk (MOM) feeding rate were compared between the two groups, and the relationship between breastfeeding and the occurrence of moderate to severe BPD in preterm infants was analyzed.
    Results Univariate analysis showed that the moderate to severe BPD group had a higher proportion of infants with birth weight < 1 500 g, gestational age < 28 weeks, vaginal delivery, Apgar score ≤ 7 at 1 minute after birth, and mechanical ventilation time ≥ 7 days compared to the control group(P < 0.05). The duration of intravenous nutrition was longer in the moderate to severe BPD group (P < 0.05). The moderate to severe BPD group had lower breast milk intake from 0 to 7 days after birth, MOM intake, MOM feeding rate, and breast milk intake from 8 to 14 days after birth compared to the control group (P < 0.05). Multivariate Logistic regression analysis showed that a high volume of breastfeeding from 0 to 7 days after birth was an independent protective factor for the occurrence of moderate to severe BPD in preterm infants (OR=0.865, 95%CI, 0.767 to 0.976, P < 0.05). Gestational age < 28 weeks (OR=5.238, 95%CI, 1.158 to 23.686, P < 0.05), and mechanical ventilation time ≥7 days (OR=22.386, 95%CI, 6.769 to 74.030, P < 0.05) were independent risk factors for the occurrence of moderate to severe BPD in preterm infants.
    Conclusion Early breastfeeding after birth can significantly reduce the risk of moderate to severe BPD in preterm infants with a gestational age of ≤32 weeks, and clinical measures should be actively implemented to promote early breastfeeding.

     

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