早期喂养方式对早产儿1岁时智能发育的影响分析

Analysis of impact of early feeding patterns on intellectual development of premature infants at one year of age

摘要

目的 探讨早期喂养方式对早产儿1岁时智能发育的影响,为有效开展早产儿喂养指导提供参考依据。方法 采用回顾性队列研究方法,选择2023年6月至2024年6月于合肥市妇女儿童保健中心高危儿门诊随访的114例早产儿为研究对象。对早产儿6月龄内的喂养方式和1岁时的智能发育状况进行纵向随访,采用Gesell发育诊断量表(GDS)对幼儿进行智能发育评估。结果 6月龄不同喂养方式的早产儿在1岁时适应性、粗大动作、精细动作、语言和个人社会五个能区评分,差异均有统计学意义(F介于4.404到10.196之间,P<0.05)。多元线性回归分析显示,与人工喂养相比,早期母乳喂养的早产儿精细动作(β=3.79,95%CI:0.76~6.82)、个人社会(β=4.61,95%CI:1.77~7.45)能区得分较高,混合喂养的早产儿适应性(β=4.96,95%CI:1.55~8.38)、粗大动作(β=5.29,95%CI:0.02~10.55)、精细动作(β=5.38,95%CI:0.79~9.97)、语言(β=4.28,95%CI:0.57~8.00)、个人社会(β=6.98,95%CI:2.88~11.07)能区得分较高(均P<0.05)。结论 生命早期母乳喂养和混合喂养有助于促进早产儿1岁时的智能发育,应加强早产儿母乳喂养宣教,尽可能提高早产儿出院后的母乳喂养率。

Abstract

Objective To explore impact of early feeding patterns on intellectual development of premature infants,and provide reference for effective guidance to premature infant feeding. Methods In retrospective cohort study method,114 premature infants who were followed up at High-risk Infant Clinic of Hefei Women and Children's Health Center from June 2023 to March 2024 were selected as research subjects.Longitudinal follow-up was conducted on feeding methods of premature infants within 6 months of age and their intellectual development status at 1 year of age.Gesell Developmental Schedules (GDS) was used to evaluate intellectual level of the premature infants. Results In scores in five domains as adaptability,gross motor,fine motor,language and personal-social behavior at the age of 1 year,there were statistically significant differences among the premature infants with different feeding patterns at 6 months of age (F=4.404-10.196,all P<0.05).Multiple linear regression analysis showed that compared with artificial feeding,premature infants who were breastfed in the early stage had higher scores in fine motor (β=3.79,95%CI:0.76-6.82) and personal-social behavior (β=4.61,95%CI:1.77-7.45),while the premature infants who received mixed feeding in the early stage had higher scores in adaptive behavior (β=4.96,95%CI:1.55-8.38),gross motor (β=5.29,95%CI:0.02-10.55),fine motor (β=5.38,95%CI:0.79-9.97),language (β=4.28,95%CI:0.57-8.00) and personal-social behavior (β=6.98,95%CI:2.88-11.07). Conclusion Breastfeeding and mixed feeding in early life can promote intellectual development of premature infants at the age of one year.It is necessary to strengthen breastfeeding education to improve breastfeeding rate after discharge.

关键词

早产儿 / 喂养方式 / 智能发育 / 纵向研究

Key words

preterm infant / feeding pattern / intellectual development / longitudinal study

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基金资助

国家自然科学基金(82373580)

中国疾病预防控制中心妇幼保健中心2020年度母婴营养与健康研究项目(2020FYH002)