NICU早产儿初乳喂养现状及影响因素分析

doi:10.3761/j.issn.0254-1769.2022.22.004

摘要/Abstract

摘要：

目的了解NICU早产儿初乳喂养的现状，并探讨其影响因素。方法采取便利抽样法，选取2020年1月—2021年12月在温州市某三级甲等医院产科出生并入住NICU的851例早产儿为调查对象，根据生后7 d内是否接受初乳喂养分为初乳喂养组与无初乳喂养组;按初乳喂养量占比，初乳喂养组又分为高、中等及低比例初乳喂养组，回顾性分析早产儿初乳喂养率及其影响因素。结果接受初乳喂养的早产儿共374例（43.95%）。其中，低比例初乳喂养126例（33.69%）、中等比例初乳喂养183例（48.93%）、高比例初乳喂养65例（17.38%）。二分类Logistic回归分析结果显示，新生儿科护士初乳喂养宣教次数>2次（OR=1.846）、父亲支持母乳喂养（OR=1.349）、产科护士初乳喂养宣教次数>2次（OR=2.467）及母亲产后24 h内泵乳次数≥12次（OR=2.724）是NICU早产儿初乳喂养的保护因素，母亲为初中及以下文化水平（OR=0.278）、母亲孕期存在健康问题（OR=0.462）是危险因素（P<0.05）。多分类有序Logistic回归分析结果显示，低比例、高比例初乳喂养组比较，母亲产后24 h内泵乳次数≥12次（OR=3.647）、产科护士初乳喂养宣教次数>2次（OR=1.906）与新生儿科护士初乳喂养宣教次数>2次（OR=1.535）是早产儿接受高比例初乳喂养的保护因素（P<0.05）;低比例、中等比例初乳喂养组比较，母亲产后24 h内泵乳次数≥12次（OR=2.995）、父亲支持母乳喂养（OR=1.203）是早产儿接受中等比例初乳喂养的保护因素（P<0.05）。结论 NICU早产儿的初乳喂养率较低。临床医护人员应重视母婴分离早产儿家长的初乳喂养宣教，并协助母亲建立产后规律的泵乳行为。

关键词: 重症监护病房，新生儿, 早产儿, 初乳, 母乳喂养, 影响因素分析, 新生儿护理

Abstract:

Objective To investigate the status of colostrum feeding of hospitalized premature infants in NICU and to explore the influencing factors. Methods From January 2020 to December 2021，851 premature infants who were born in the obstetrics department and admitted to NICU of a tertiary hospital in Wenzhou，Zhejiang province were selected as research subjects. According to whether colostrum feeding within 7 days after birth，they were divided into a colostrum feeding group and a non-colostrum feeding group. According to the proportion of colostrum feeding amount，the colostrum feeding group was divided into 3 groups，namely high，medium and low，and the colostrum feeding rate and influencing factors of premature infants were analyzed. Results A total of 374 premature infants（43.95%） received colostrum feeding. Among them，126 cases（33.69%） were fed with low proportion colostrum feeding，183 cases（48.93%） with medium，65 cases（17.38%） with high. Binary logistic regression analysis showed that the protective factors of colostrum feeding were education by neonatology nurses>2 times（OR=1.846），father’s support of breastfeeding（OR=1.349），education by obstetric nurses >2 times（OR=2.467） and mothers pump-ing milk≥12 times within 24 hours after delivery（OR=2.724）. Maternal education level of junior middle school or below（OR=0.278） and maternal health problems（OR=0.462） were risk factors（P<0.05）. Multiple logistic regression showed that，compared with the low and high proportion of colostrum feeding groups，the protective factors of premature infants receiving high proportion colostrum feeding were the mothers pumping milk≥12 times within 24 hours after delivery（OR=3.647），education by obstetric nurses >2 times（OR=1.906） and education by neonatology nurses >2 times（OR=1.535）. Compared with the low and medium proportion colostrum feeding groups，the protective factors of preterm infants receiving medium proportion colostrum feeding were the mothers pumping milk ≥12 times within 24 hours after delivery（OR=2.995） and father’s support of breastfeeding（OR=1.203）. Conclusion The colostrum feeding rate of hospitalized premature infants in NICU was low. Clinical medical staff should pay attention to the colostrum education of the families of premature infants separated from mother and infant，and assist mothers to establish regular milk pumping behavior after delivery.

Key words: Intensive Care Units,Neonatal, Premature Infants, Colostrum, Breastfeeding, Root Cause Analysis, Neonatal Nursing

陈晓春, 高英, 闵玉晓. NICU早产儿初乳喂养现状及影响因素分析[J]. 中华护理杂志, 2022, 57(22): 2714-2721.

CHEN Xiaochun, GAO Ying, MIN Yuxiao. Investigation and analysis of factors related to colostrum feeding of premature infants in NICU[J]. Chinese Journal of Nursing, 2022, 57(22): 2714-2721.

图/表 3

表1 NICU早产儿初乳喂养情况的单因素分析

Table 1 Single factor analysis of colostrum feeding of premature infants in NICU

表2 NICU早产儿接受初乳喂养的二分类Logistic回归分析

Table 2 Binary logistic regression analysis of colostrum feeding of premature infants in NICU

表3 NICU早产儿接受不同比例初乳喂养的多分类有序Logistic回归分析

Table 3 Multiple logistic regression analysis of colostrum feeding of premature infants in NICU

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