Çok Düşük Doğum Ağırlıklı İnfantlarda Tam Enteral Beslenmeye Geçiş Süresine Etki Eden Faktörler

Abstract

Amaç: Tam enteral beslenmeye erken geçiş protein katabolizmasını önleyerek bebeklerin büyüme ve gelişimine olumlu katkı sağlar. Bu çalışmada çok düşük doğum ağırlıklı preterm bebeklerde tam enteral beslenmeye geçiş süresine etki eden faktörlerin belirlenmesi amaçlandı.

Gereç ve Yöntemler: Doğum ağırlığı ≤1500 gr ve gestasyon yaşı ≤32 hafta olan preterm bebeklerin demografik verileri, tam enteral beslenmeye geçiş süreleri, hastanede yatış süreleri, taburculuktaki vücut ağırlıkları ve baş çevreleri, günlük kilo alımları, bronkopulmoner displazi (BPD), nekrotizan enterokolit (NEK), intraventriküler kanama (IVK), respiratuar distres sendromu (RDS), geç neonatal sepsis (GNS) ve mortalite oranları kaydedildi. Veriler tam enteral beslenmeye geçiş zamanına göre ilk 10 günde geçenler erken, 10 günden uzun sürede geçenler ise geç şeklinde gruplandırılarak karşılaştırıldı.

Bulgular: Çalışmaya 474 bebek dahil edildi. Bebeklerin 91’i, ilk 10 günde, 383’ü ise 10 günden sonra tam enteral beslenmeye geçen bebeklerdi. Ortanca (IQR) gestasyon haftası sırasıyla 29 (28-30) ve 28 (27-29) hafta, doğum ağırlığı 1240 (1080-1350) gr ve 1030 (850-1190) gr’dı. Tam enteral beslenmeye erken geçen bebeklerde hastanede yatış süresi daha kısa olarak saptandı (p<0.01). GNS ve BPD oranları enteral beslenmeye geç ulaşanlarda anlamlı olarak daha yüksekti (p<0.01). NEK, Grade 3-4 IVK ve mortalite oranları gruplar arasında benzerdi. Doğum ağırlığının düşük olması, RDS varlığı ve annede preeklampsi varlığı, tam enteral beslenmeye geçiş zamanının gecikmesi açısından risk faktörleri olarak bulundu.

Sonuç: Yenidoğan yoğun bakım ünitelerinde izlenen preterm bebeklerin tam enteral beslenmeye erken başlaması morbiditeler üzerine fayda sağlar. Bu durum bebeklerde hastane yatış sürelerini azaltarak büyümelerine katkı sağlayabilir. Preterm doğumların önlenmesi, RDS ve preeklampsinin engellenmesi, tam enteral beslenmeye geçişi kolaylaştırmaktadır.

Keywords

• Beslenme
• çok düşük doğum ağırlığı
• preterm
• Enteral beslenme

Factors Affecting the Full Enteral Feeding in Very Low Birth Weight Preterm Infants

Abstract

Objective: Early transition to full enteral nutrition prevents protein catabolism and has a positive impact on the growth and development of infants. The aim of this study was to determine the factors affecting the time to full enteral feeding in very low birth weight infants.

Material and Methods: Demographic data of infants with birth weight ≤1500 g and gestational age ≤32 weeks, time to full enteral feeding, weights and head circumference at discharge, daily weight gain, duration of hospital stay, bronchopulmonary dysplasia (BPD), necrotizing enterocolitis (NEC), intraventricular hemorrhage (IVH), respiratory distress syndrome (RDS), late neonatal sepsis (LNS) and mortality rates were recorded. Data were compared by grouping according to the time of transition to full enteral nutrition as early in the first 10 days and delayed in more than 10 days.

Results: Totally 474 infants were included in the study. Of those 91 infants achieved full enteral feeding in the first 10 days and 383 of them after 10 days. Median gestational age were 29 and 28 weeks and birth weights were 1240 g and 1030 g respectively. While the duration of hospital stay was shorter in the early enteral feeding group (p <0.01), late neonatal sepsis and BPD rates were significantly higher in late arriving enteral feeding (p <0.01). NEC, Grade 3-4 IVH and mortality rates were similar between the groups. Low birth weight, presence of RDS and maternal preeclampsia were found to be risk factors for delayed transition to full enteral feeding.

Conclusion: Early achievement of full enteral feeding in very low birth weight preterm infants might have beneficial effects on morbidities. This might contribute to the growth of infants by decreasing duration of hospitalization. Prevention of preterm births, prevention of RDS and preeclampsia facilitate the transition to full enteral nutrition.

Keywords

• nutrition
• preterm
• Very low birth weight infants
• Enteral feeding

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