Clinical Features And Influence Factors Of Feeding Intolerance In Twins Late Preterm Infants

Background:As the assisted reproductive technology,the development of perinatology and emergency medicine,selective cesarean section rate increased,the birth of multiples proportion is also increasing,and twin pregnancy is one of the leading causes of preterm infant.The incidence of preterm infants is on the rise in recent years,The world health organization reported that the incidence of preterm infants was 9.6%,and the incidence of late preterm is important reason,accounting for 75%of all preterm infants.Because of late preterm infant close to maturity,medical personnel value degree is not enough,is often seen as low-risk populations.But compared with the term infants,late preterm infants have a higher morbidity and mortality,faced with serious health problems,such as neonatal jaundice,hypoglycemia,respiratory disease and feeding problems,and is on the rise.Twins late preterm relative to term infants,immature gastrointestinal function,sucking,swallowing and breathing neural development is immature,so feeding problems is one of the most common problems of the twins late preterm infants.Objective:To explore and summarize the clinical features and preliminary factors of feeding intolerance in twins late preterm infant,in order to provide basis for clinical diagnosis and therapy for twins late preterm infants.Methods:(1)The 144 pairs of twins(288 cases)late preterm infants hospitalized in the Department of Neonatology of the Renmin Hospital of Hubei University of Medicine between January 2015 and December 2018 were retrospectively,and 240 cases single late preterm infants from the same period of were extracted randomly,finally according to the inclusion and exclusion,112pairs of twins late preterm infants and 240 cases single late preterm infants were analysis in the study,observation group for twins late preterm infants,the control for single late preterm infants,observation of feeding intolerance,vomiting,abdominal distension and gastric residuals and cases of extending the length of hospital time because of feeding intolerance;(2)In twins late preterm infants group(observation group),to describe the clinical features,and analysis the single factors,the single factor analysis(P(27)0.05)project again into the multi-factor stepwise regression analysis,Logistic regression model is established,using Logistic regression to analysis the possible factor of feeding intolerance in twins late preterm infants.Results:Twins in the late preterm infant feeding intolerance rate is higher than single fetal late preterm.Feeding intolerance in twins late preterm infants focus on the period after being and feed within 48-96 hours,stomach brown color was the main clinical manifestation.Compared with feeding tolerance group,the feeding intolerance group is statistical difference in asphyxia(?~2=17.254,P(27)0.005),the patent ductus arteriosus(?~2=4.855,P(27)0.01),the use of mechanical ventilation(?~2=12.069,P(27)0.01),but is nor statistical difference in type of delivery(?~2=0.139,P(29)0.05),gender(?~2=0.852,P(29)0.05).Binary Logistic regression analysis shows that asphyxia(OR=2.796,P(27)0.05,95%CI=1.046~7.476),the patent ductus arteriosus(OR=1.11,P(27)0.05,95%CI=1.01~1.954),the use of mechanical ventilation(OR=3.910,P(27)0.05,95%CI=1.265~12.086)are the risk factors in twins late preterm infants.Conclusion:Twins in the late preterm infant feeding intolerance rate is higher than single fetal late preterm.Asphyxia,patent ductus arteriosus,mechanical ventilation are the risk factors.The clinical manifestations of feeding intolerance need to be found as early as possible,and to solve them.