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Læknablaðið - 15.03.1998, Qupperneq 20

Læknablaðið - 15.03.1998, Qupperneq 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
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