ArticleBMC pediatrics2025
Clinical determinants of time to full enteral feeding in preterm infants with neonatal respiratory distress syndrome: a retrospective cohort study.
Article in BMC pediatrics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo identify clinical factors influencing the time to achieve full enteral feeding (FEF) in preterm infants with respiratory distress syndrome (NRDS) and to provide evidence for optimizing nutritional management.
methodsWe conducted a retrospective cohort study of 110 preterm infants with NRDS admitted to the neonatal intensive care unit of the First Affiliated Hospital of Fujian Medical University between January 2019 and January 2022. Clinical and treatment data, including feeding practices, respiratory support, gastrointestinal symptoms, and laboratory results, were collected. FEF was defined as enteral intake ≥ 150 mL/kg/day. Kaplan-Meier survival analysis and multivariate Cox regression were used to evaluate factors associated with time to FEF.
resultsAmong the 110 infants, 67 (60.9%) achieved FEF before discharge, with a median time of 19 days, and the mean time was 21.4 ± 12.0 days. Clinical cure-defined as complete resolution of NRDS symptoms and successful withdrawal of respiratory support-was observed in 41 infants (37.3%), while clinical improvement-defined as partial symptom relief with reduced respiratory support-was seen in 69 infants (62.7%). Univariate analysis identified significant associations between time to FEF and factors such as breastfeeding, invasive ventilation, duration of non-invasive ventilation, initiation time and volume of feeding, gastric retention, constipation, pulmonary surfactant treatment, prolonged caffeine use, and antibiotic therapy (all P < 0.05). Multivariate Cox regression revealed that breastfeeding was independently associated with a shorter time to FEF (HR = 2.80, 95% CI: 1.54-5.11, P = 0.001), whereas non-invasive ventilation > 14 days, constipation, and caffeine therapy > 14 days were associated with feeding delays.
conclusionBreastfeeding, shorter duration of non-invasive ventilation, timely management of constipation, and judicious use and timely adjustment of supportive therapies, alongside optimized feeding management, may facilitate earlier achievement of FEF without compromising respiratory stability.
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