摘要
目的 探究喂养方式对高危新生儿生长发育的影响,并分析影响新生儿高危的因素.方法 回顾性选取2017年3月至2023年3月在秦皇岛市第一医院出生且采用人工喂养的60例高危新生儿作为人工喂养组,选取同期在本院出生的60例采用母乳喂养的高危新生儿作为母乳喂养组.分析两组新生儿出生时及3月龄时的身长、体重、身长别体重Z评分(WLZ)和年龄别体重指数Z评分(BAZ)情况,比较两组新生儿3月龄时的发育指数[智力发育指数(MDI)和运动发育指数(PDI)]、气质类型及免疫水平.另选50名正常新生儿作为正常组,收集其临床资料,探究影响高危新生儿发生的相关因素.结果 与出生时比较,人工喂养组与母乳喂养组患儿在3月龄时身长、体重、WLZ评分、BAZ评分均升高,差异均有统计学意义(P＜0.05),但两组出生时和3月龄时的身长、体重、WLZ评分、BAZ评分组间比较,差异均无统计学意义(P＞0.05).3月龄时,母乳喂养组患儿的MDI评分和PDI评分分别为(108.55±10.98)、(108.16±10.61)分,均高于人工喂养组[(99.12±8.79)、(98.01±9.21)分],差异均有统计学意义(P＜0.05),但两组的气质类型比较,差异无统计学意义(P＞0.05).母乳喂养组患儿的免疫球蛋白(Ig)G、IgM、IgA和CD3+、CD4+、CD8+水平分别为(7.11±0.67)×10-6g/L、(0.77±0.11)× 10-6g/L、(0.46±0.08)× 10-6g/L、(49.06±6.15)％、(50.33 ±5.78)％、(36.33±5.16)％,均高于人工喂养组[(6.12±0.78)× 10-6g/L、(0.68±0.16)× 10-6g/L、(0.33±0.07)× 10-6g/L、(46.33±4.56)％、(47.55±6.12)％、(28.55±6.11)％],差异均有统计学意义(P＜0.05).单因素分析可知,高危组和正常组在有无生殖道感染、有无人工终止妊娠手术史、有无腹压增高、有无胎位异常方面差异存在统计学意义(P＜0.05).多因素Logistic回归分析结果显示存在生殖道感染、患儿出生体重低于2 500 g为高危新生儿发生的影响因素(P＜0.05).结论 母乳喂养对于高危新生儿的生长发育和免疫功能具有积极的影响.同时,生殖道感染和低出生体重因素与高危新生儿的发生密切相关.
Abstract
Objective To explore the effects of feeding methods on the growth and development of high-risk newborns,and analyze the fac-tors affecting the occurrence of high-risk newborns.Methods A total of 120 high-risk neonates born in the First Hospital of Qinhuangdao from March 2017 to March 2023 were selected and divided into groups according to feeding methods:60 neonates were included in the artificial feeding group and adopted artificial feeding,and 60 neonates were included in the breast feeding group and adopted breast feeding.The body length,body weight,body weight by length Z score(WLZ)and body mass index by age Z score(BAZ)at birth and 3 months of age were analyzed.The develop-ment index[mental development index(MDI),psychomotor development index(PDI)],temperament type and immune level of newborns at 3 months of age were compared between the two groups.Another 50 normal neonates were selected as the normal group.Clinical data were collected to explore the related factors affecting the risk of neonates.Results Compared with birth,the body length,body weight,WLZ score and BAZ score of the artificial feeding group and the breast feeding group were increased at 3 months of age,the differences were statistically significant(P＜0.05),but there were no statistically significant differences between the two groups in body length,body weight,WLZ and BAZ scores at birth and 3 months of age(P＞0.05).At 3 months of age,the MDI and PDI scores of children in the breast feeding group were(108.55±10.98),(108.16±10.61)points,which were higher than those in the artificial feeding group[(99.12±8.79),(98.01±9.21)points],the differences were statistically sig-nificant(P＜0.05),but there was no statistically significant significance in temperament type between the two groups(P＞0.05).The levels of immunoglobulin(Ig)G,IgM,IgA,CD3+,CD4+and CD8+in the breast feeding group were(7.11±0.67)×10-6g/L,(0.77±0.11)×10-6g/L,(0.46±0.08)×10-6g/L,(49.06±6.15)％,(50.33±5.78)％,(36.33±5.16)％,which were higher than those in the artificial feeding group[(6.12±0.78)×10-6g/L,(0.68±0.16)×10-6g/L,(0.33±0.07)×10-6g/L,(46.33±4.56)％,(47.55±6.12)％,(28.55± 6.11)％],the differences were statistically significant(P＜0.05).Univariate analysis showed that there were statistically significant differences between the high risk group and the normal group in terms of genital tract infection,history of artificial termination of pregnancy,increased abdomi-nal pressure and abnormal fetal position(P＜0.05).Multivariate logistic regression analysis showed that reproductive tract infection and birth weight below 2500g were the influential factors for the occurrence of high-risk newborns(P＜0.05).Conclusion Breast feeding has a positive effect on the growth and immune function of high-risk newborns.At the same time,reproductive tract infection and low birth weight factors are closely related to the occurrence of high-risk newborns.
基金项目
河北省卫生计生委科研项目(20180852)
秦皇岛市科学技术研究与发展计划(202004A026)
维普
万方数据