The Nutrition Status And Influencing Factors Analysis Of Premature Infants In NICU

Objective To study the nutrition supplement and status in early postnatal stage and high-risk factors of extrauterine growth retardation(EUGR) of premature infants.Methods Cases of 110 low birth weight preterm infants admitted in our NICU(neonatal intensive care unit) from August 2007 to September 2008 were collected and reviewed,analyzed their nutrition supplement and status in early postnatal stage,and the influencing risk factors to growth of premature infants. Enumeration data was analyzed by x~2test,measurement data coinciding with normal distribution was analyzed by t test,coinciding with abnormal distribution was analyzed by rank sum test.Because there were many independent variable,we screened them first in high-risk factors analysis,and analyzed those independent variable having significance with multiple factor Logistic regression analysis.Result 1.The incidence of EUGR of premature infants in our hospital: Evaluating with weight,height and head circumference,there were 53.64%,31.8% and 10%of these premature infants had EUGR,and it was increased 24.54%,17.32% and 4.6%comparing with SGA.2.Nutrition supplement and status:①Enteral nutrition:The average age beginning enteral nutrition was 2.7 days(1～21d).There were 49 cases having feeding intolerance and the incidence was 44.5%.56%of them, 23 cases were feed with minute dose.②)Abenteric nutrition:97.5%of these preterm infants received abenteric nutrition.The average age using amino acid was 1.2(1～7)d, the speed of adding amino acid was(0.5±0.12)g/(kg.d),the average time using amino acid was(11.48±9.47)d,the cumulative amount of amino acid was(46.5±35.4)g; The age using fat milk was 3.9(2～15)d,the speed of adding fat milk was(0.48± 0.1)g/(kg.d),the average time using fat milk was(6.8±3.4)d,the cumulative amount of fat milk was(19.8±16.98)g.98%of these preterm infants got total calorie 120Kcal(kg.d).③During hospitalization 98%of these 110 cases received total calorie 120Kcal/(kg.d),and the average age reaching the standard was(16.21±7.28)d;95.5% of them received calorie 100Kcal/(kg.d) per os,and the average age reaching the standard was(16.5±9.78)d.④Physique development:The average birth gestational age was(33.9±1.89)week,the average weight was(2.01±0.35)kg,the average height was(42.89±3.21)cm,the average head circumference was(30.62±1.65)cm.And 29.1%of them,32 cases were SGA.By discharge,the average gestational age was(36.58±1.70)d,the average weight was(2.27±0.31)kg,the average height was (45.22±2.94)cm,the average head circumference was(31.17±4.05)cm.During hospitalization,the average extent of physiological weight decline was(9.2±4.52)% of birth weight,the age gaining weight was(7.07±2.06),the average age reaching birth weight was(11.12±4.98)d.After reaching birth weight during hospitalization, the average speed of weight increase was(12.8±9.93)g/(kg.d).⑤Monitoring of blood biochemical criterion:By admission,110 cases of premature infants are carried out monitoring of blood biochemical indices and the average concentration of blood total protein was(46.16±7.12)g/L,blood albumin was(32.49±5.125)g/L,blood carbamide was(3.575±2.89)mmol/L,blood creatinine was(56.39±32.48)umol/L, total cholesterol was(2.38±2.07)mmol/L,triacylglycerol was(1.04±0.07)mmol/L, the blood calcium was(2.31±0.085)mmol/L,blood phosphorus was(1.98±0.685)mmol/L,By discharge,collected blood biochemical integrity of the 35 cases of premature infant,the average concentration of blood total protein was(44.78±4.67)g/L,blood albumin was(31.51±4.96)g/L,blood carbamide was(2.975±0.69)mmol/L,blood creatinine was(36.28±10.71)umol/L,total cholesterol was(1.92±0.63)mmol/L,triacylglycerol was(1.02±0.29)mmol/L,the blood calcium was(2.15±0.043)mmol/L,blood phosphorus was(1.4±0.36)mmol/L。Comparison of the biochemical indicators of the time they are discharged and admitted at the time of biochemical,the the accidence of biochemical abnormalities admission hypocalcemia,hypoalbuminemia was significantly(P＜0.05) and the admission of blood total protein,blood urea nitrogen,creatinine,phosphorus,total cholesterol, triglycerides was no significant difference(P＞0.05).3.Risk factors of EUGR:By Logistic regression analysis of multiple factors,the high-risk factors of EUGR included:SGA(OR=1684.61,P＜0.05),low birth weight(OR=800.02,P＜0.05),the low speed of weight increase during hospitalization(OR=1.230,P＜0.05),the large extent of physiological weight decline(OR=0.664,P＜0.05),long time to reach qualified calorie per os,infant complicated with inflammation(OR=8.203,P＜0.05),mother suffering from complications(OR=23.835,P＜0.05).Conclusions 1.According to development parameter as weight,length and head circumference,evaluating the relevant percentage of adjusted gestational age by discharge,the incidence of EUGR is 53.64%,31.8%and 10%in premature infants in our hospital,the nutrition and development of them is unsatisfied.2.The high-risk factors of EUGR in premature infants include:SGA,low birth weight,the large extent of physiological weight decline,the low speed of weight increase during hospitalization,long time to reach standard calorie per os.,mother suffering from complications,inflammation during neonatal period.These factors all can influence the weight increase and are high-risk factors of EUGR in premature infants.More aggressive nutritional support strategy needs to be considered for improving the nutritional status and development of premature infants.