重症监护病房极低出生体重儿出院时母乳喂养的影响因素分析

Analysis of influencing factors of breastfeeding for very low birth weight infants discharged from intensive care unit

目的 探讨重症监护病房极低出生体重儿(VLBWI)出院时母乳喂养的影响因素。方法 采用便利抽样法,选取2019年1月至2023年6月在安徽省阜阳市人民医院新生儿重症监护病房住院的VLBWI及其母亲146例为研究对象,根据出院时是否接受母乳分为母乳喂养组与非母乳喂养组。采用自行设计调查表收集VLBWI及其母亲的基线资料。通过logistic回归探讨影响VLBWI出院时母乳喂养的可能因素。结果 收集VLBWI共146例,最后纳入129例,母乳喂养组78例,非母乳喂养组51例,出院时VLBWI的母乳喂养率为60.47%。两组坏死性小肠结肠炎和迟发性败血症发生率、住院时间、母乳喂养宣教次数、24 h吸奶频率比较,差异有统计学意义(P<0.05)。logistic回归显示:住院时间(OR=-1.003,95%CI:-0.480~-2.010,P=0.042)、24 h吸奶频率(OR=1.181,95%CI:1.027~4.336,P=0.016)、母乳喂养宣教次数(OR=1.124,95%CI:1.016~3.942,P=0.023)、迟发性败血症(OR=0.954,95%CI:0.761~2.784,P=0.035)和坏死性小肠结肠炎(OR=0.886,95%CI:0.639~2.563,P=0.028)是VLBWI出院时母乳喂养的独立影响因素。结论 重症监护病房中VLBWI的母乳喂养不容乐观,可通过尽量缩短住院时间、增加住院期间母乳喂养次数和母乳喂养宣教次数相关护理策略予以干预。

Objective To investigate the influencing factors of breastfeeding for very low birth weight infants(VLBWI)discharged from neonatal intensive care unit.Methods A total of 146 VLBWI and their mothers admitted to neonatal intensive care unit of Fuyang People’s Hospital in Anhui Province from January 2019 to June 2023 were selected as the research subjects by using convenient sampling.They were divided into breastfeeding group and non-breastfeeding group based on whether they received breast milk at the time of discharge.Baseline data from VLBWI and their mothers were collected by using self-designed questionnaires.The possible factors affecting breastfeeding at discharge in VLBWI were explored through logistic regression.Results A total of 146 cases of VLBWI were collected and 129 cases were finally included,78 cases in breastfeeding group and 51 cases in non-breastfeeding group,and the breastfeeding rate at the time of VLBWI at discharge was 60.47%.There were significant differences in the incidence of necrotizing enterocolitis and delayed sepsis,length of hospitalization,frequency of breastfeeding education,and 24-hour pumping frequency between two groups(P<0.05).Logistic regression showed that length of hospitalization(OR=-1.003,95%CI:-0.480 to-2.010,P=0.042),24-hour pumping frequency(OR=1.181,95%CI:1.027 to 4.336,P=0.016),frequency of breastfeeding education(OR=1.124,95%CI:1.016 to 3.942,P=0.023),delayed sepsis(OR=0.954,95%CI:0.761 to 2.784,P=0.035)and necrotizing enterocolitis(OR=0.886,95%CI:0.639 to 2.563,P=0.028)were independent influencing factors for breastfeeding at discharge in VLBWI.Conclusion Breastfeeding for VLBWI in intensive care units is not optimistic,and can be intervened through nursing strategies such as minimizing hospitalization time,increasing the number of breastfeeding times during hospitalization,and increasing the number of breastfeeding education sessions.