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The Relevant Factors of Weight Growth in the 68 Preterm Infants

Author: YaoQingYuan
Tutor: YanChaoYing
School: Jilin University
Course: Clinical
Keywords: Preterm infants Weight gain Relevant factors
CLC: R722.6
Type: Master's thesis
Year: 2009
Downloads: 78
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Abstract


Preterm infants have immature organs and systems , they are prone to a variety of complications, therefore, most preterm infants need some time for treatment and care in hospital , especially in the prevention of premature delivery ,the reducement of perinatal mortality and the improvement of the quality of the newborn , we should strengthen the care in preterm infants after their birth and make it sure that preterm infants weight gain not only in the shortest time , but also is scheduled to meet standards to reduce malnutrition mortality rates of the low birth weight infant. The growth of body weight is the criteria of the effective treatment and development of preterm infants , the ideal physical development is the intrauterine growth rate so that the study of relevant factors of weight gain in preterm infants is very important.We should make a good control of the impact of relevant factors of weight gain in preterm infants, in order to promote the normal physical development and reduce the incidence of sequelae of preterm infants. weight gain in preterm infants is effected by a number of complex factors,most factors has been established to promote the weight growth of preterm infants ,such as touching, holding, rational nutrition,prone position feeding, early starting of milk. And most factors have been identified to hinder the weight growth of preterm infants,such as noise, light, infection, pain.But there are still many relevant factors at the stage of research, such as gestational age, birth weight, components and time of parenteral nutrition , nosocomial infections.In order to explore the relevant factors of the weight growth in preterm infants,get quantitative realization of the influencing extent of the relevant factors to the weight growth in preterm infants to proceed to provide a realiable basis for the clinical treatment and nursing of preterm infants. We selected sixty-eight cases of preterm Infants diagnosed and treated in the Newborn Department of our hospital from January 2006 to December 2008 to analyze retrospectively, in accordance with the relationship between the discharge and the tenth percentile weight in the same gestational age,they are divided into the weight-gain-good growp and the weight-gain-bad growp. Each case has a complete record of the regular weight and diet records , at the same time ,we collect information on each case and establish a unified questionnaire, finally we put all the information in Excel to create data files and use SPSS 10.0 statistical software for analysis.First,we compare the percentage of early feedin- g and nasogastric feeding of the two groups.Secondly,we analyzed 15 factors with the method of single-factor analysis :Gestational age, birth weight, hospitalization time, feeding time,rational parenteral nutrition,, milk-srarting time≤24h, intracranial hemorrhage, sepsis (non-nosocomial infections caused), asphyxia, pneumonia, electrolyte disorders, jaundice, hypoalbuminemia, anemia, ventilator-assisted support.At last, we put all the risk factors into a logistic regression model to go on multivariate analysis, and selected the effecting factor with stepwise regression methods.The study finded that earlier enteral feeding and more energy intake in feeding after birth are conducive to weight gain.After a single factor analysis of the 15 related factors, it showed there were gestational age, feeding time, rational parenteral nutrition, milk-srarting time≤24h, intracranial hemorrhage, sepsis (non-nosocomial infections caused), pneumonia, ventilator-assisted support. All the risk factors were analyzed with the method of multi-regression analysis.The result manifested that larger gestational age in the same birth weight , pneumonia and sepsis were risk factors for weight gain in preterm Infants.Overall,the conclusion was that we shoud establish a rational enteral feeding (after birth 12h ~ 24h)in preterm infants without complications as early as possible,gradually increase the volume in the tolerance of the stomach,in order to promote the maturation of gastrointestinal function and weight gain in preterm infants. At the same time, in accordance with the actual day-old of preterm infants,we should give them the early, correct and standardize the intravenous nutritional support ,in order to make it sure that preterm infants receive sufficient energy necessary for their early growth and development after birth. On the other hand, small for gest- ational age (SGA) , sepsis, pneumonia are the independent risk factors to weight gain in premature infants. Ventilator-assisted support and intracranial hemorrhage in premature infants may be the risk factors to weight gain in premature infant.We should strengthen the protection of early pregnancy and the preterm infants care, improve the clinical skills, make an aggressive treatment of complications to ensure that the preterm infants grow and develope healthly.

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CLC: > Medicine, health > Pediatrics > Newborns, premature children disease > Preterm children disease
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