Læknablaðið - 15.03.1998, Blaðsíða 20

202
LÆKNABLAÐIÐ 1998; 84
Áhættuþættir og fæðugjafir í faraldri
þarmadrepsbólgu nýbura
Kristín Theodóra Hreinsdóttir12), Atli Dagbjartsson'-2), Jóhann Heiöar Jóhannsson31
Hreinsdóttir KT, Dagbjartsson A, Jóhannsson JH
Feeding patterns and risk factors in an epidemic
of neonatal necrotizing enterocolitis
Læknablaðið 1998; 84: 202-7
Objective: To study the relationship between neona-
tal feeding patterns and the emergence of neonatal
necrotizing enterocolitis during the epidemic of this
disease in lceland in 1987-1990.
Material and methods: This was a retrospective
case-controlled study of 18 newboms that developed
neonatal necrotizing enterocolitis during a four year
epidemic of the disease. Two newborns of similar
weight and gestational age served as controls for
each case. The amount of food given per kilogram of
body weigth was recorded every 12 hours for each
group and plotted against time. The differences in
amount of food for the individuals of each group
were calculated, regression lines found and these
compared by t-test.
The type of food the children received was also not-
ed and compared, as was the presence of several
other possible risk factors.
Results: The statistical calculation (t-test) showed
that there was no significant difference between the
patients and the controls as regards the amount of
food given and the increase in the amount of each
feeding (p=0.6).
Sixteen (88.9%) of the patients had been fed before
the occurrence of the disease. All had been fed
through a gastric tube but only 20 (55.6%) of the
controls, this is a significant difference (p=0.03).
Three (18.8%) of the patients and 18 (50%) of the
Frá,|læknadeild Háskóla íslands, 2lBarnaspítala Hringsins,
3)Rannsóknastofu Háskóla íslands í meinafræöi.
Fyrirspurnir, bréfaskipti: Atli Dagbjartsson, Barnaspítala
Hringsins, Landspítalanum, 101 Reykjavík.
Lykilorð: þarmadrepsbólga, nýburar, fæöugjöf, áhættu-
þættir.
controls were given breast milk at their first feed.
This difference however is not statistically signifi-
cant (p=0.07).
Comparison was also made of the occurrence of the
following risk factors: umbilical catheter, perinatal
asphyxia, polycythemia, acute or semiacute cesarian
section, respiratory distress and being small for ges-
tational age. Only births by cesarian section showed
a significant difference between the groups (p=
0.004). Comparison of the number of risk factors did
not show a statistically significant difference (p=
0.05). However there was a linear trend towards the
patients having more risk factors than the controls
(p=0.01).
Conclusion: The study did not show that the epi-
demic of neonatal necrotizing enterocolitis in Iceland
in 1987-1990 was caused by the increments in feed-
ing given prior to the development of the disease.
Two possible risk factors, feeding by gastric tube and
birth by acute or semiacute cesarian section, were
significantly more often found in the patient group
than in the control group
Keywords: necrotizing enterocolitis, neonates, feeding,
risk factors.
Ágrip
Markmið: Að kanna hugsanleg tengsl fæðu-
gjafa og tilkomu þarmadrepsbólgu nýbura í far-
aldri á árunum 1987-1990.
Efniviður og aðferðir: Gerð var afturvirk
samanburðarrannsókn á fæðugjöfum 18 nýbura
sem veiktust meðan á þessum faraldri stóð.
Fyrir hvert sjúkratilfelli voru til samanburðar
valin tvö börn úr fæðingarskrám. Valið var með
tilliti til fæðingardags, fæðingarþyngdar og
meðgöngulengdar.
Fæðumagn á þyngdareiningu var reiknað á
12 tíma fresti og sett upp í dreifirit. Gerð var
línuleg aðhvarfsgreining á mismunargildum
einstaklinganna og hóparnir bornir saman með
t-prófi. Einnig var skráð hvaða fæðutegundir