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Previous issue date: 2018-01-25 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / Objectives: to investigate if exclusive breastfeeding at discharge of very low birth weight preterm infants would be reduced in mothers who expressed breast milk less frequently. To assess clinical factors associated with exclusive breastfeeding failure at discharge of very low birth weight preterm infants. Methods: prospective cohort study, including infants with gestational age ? 30 weeks and / or birth weight ? 1500g. Patients with genetic syndromes, malformations, absolute contraindications to breast milk or those who died were excluded. Patients were divided into two groups, according to times when mothers could express milk at home (Group 1) or not (Group 2). Dependent variable was diet at discharge (exclusive breastmilk, breastmilk and supplement, exclusive supplement) and independent variables were evaluated through Student's t test (parametric quantitative), Mann-Whittney (non- parametric quantitative) and exact test of Fischer (categorical variables) in a univariate model. The variables with p <0.05 were included in a logistic regression model. The project was approved by the institution?s ethics committee. Results: of the 433 patients followed up until hospital discharge, 147 were included in Group 1 and 286 in Group 2. Group 2 received prenatal corticosteroids more frequently, had lower gestational age, higher frequency of enterocolitis and remained hospitalized longer (p <0.001). Group 2 patients received less exclusive breast milk at discharge (p = 0.01). The reduction with increasing patients using formula to complement breast milk (p = 0.04). In a multivariate logistic regression model, only corrected age remained independently associated with exclusive breastfeeding failure at discharge. Conclusion: less opportunities to stimulate milk expression and longer hospital stay are associated with reduction of exclusive breastfeeding at discharge. Each additional week of hospitalization reduces the chance of exclusive breastfeeding by 10%. / Objetivos: investigar se houve redu??o no aleitamento materno exclusivo na alta de prematuros de muito baixo peso associada a redu??o da frequ?ncia de esgota do leite. Descrever fatores cl?nicos associados ? falha do aleitamento materno exclusivo na alta de prematuros de muito baixo peso. M?todos: estudo de coorte prospectivo, incluindo prematuros com idade gestacional ? 30 semanas e/ou peso de nascimento ? 1500g. Foram exclu?dos portadores de s?ndromes gen?ticas, malforma??es, contraindica??es absolutas ao leite materno ou que evolu?ram ao ?bito. Os pacientes foram divididos em dois grupos, de acordo com o per?odo de tempo em que as m?es podiam trazer leite ordenhado em casa (Grupo 1) ou s? podia ser utilizado o leite retirado no hospital (Grupo 2). A vari?vel dependente foi a dieta no momento da alta (leite materno exclusivo, leite materno e complemento, complemento exclusivo) e as independentes foram avaliadas atrav?s deTeste t de Student (quantitativas param?tricas), Mann-Whittney (quantitativas n?o-param?tricas) e teste exato de Fischer (vari?veis categ?ricas) em modelo univariado. As vari?veis com p<0,05 foram inclu?das em modelo de regress?o log?stica. O projeto foi aprovado no comit? de ?tica. Resultados: do total de 433 pacientes acompanhados at? a alta hospitalar, 147 foram inclu?dos no Grupo 1 e 286 no Grupo 2. O Grupo 2 recebeu corticoides com maior frequ?ncia, apresentavam menor idade gestacional, maior frequ?ncia de enterocolite e permaneceram internados por mais tempo, pela idade corrigida na alta (p<0,001). Os pacientes do Grupo 2 receberam menos leite materno exclusivo na alta (p=0,01). A redu??o se deu ?s custas do aumento de aleitamento misto (p=0,04). Quando colocado em modelo de regress?o log?stica, apenas a idade corrigida permaneceu associada de forma independente ? falha de aleitamento materno exclusivo na alta. Conclus?o: a menor frequ?ncia de est?mulo para ordenha e o maior tempo de interna??o hospitalar est?o associados ? redu??o do aleitamento materno exclusivo na alta. Cada semana adicional de interna??o, reduz em 10% a chance de aleitamento materno exclusivo na alta.
| Identifer | oai:union.ndltd.org:IBICT/oai:tede2.pucrs.br:tede/7892 |
| Date | 25 January 2018 |
| Creators | Oliveira, Mariana Gonz?lez de |
| Contributors | Fiori, Humberto Holmer |
| Publisher | Pontif?cia Universidade Cat?lica do Rio Grande do Sul, Programa de P?s-Gradua??o em Medicina/Pediatria e Sa?de da Crian?a, PUCRS, Brasil, Escola de Medicina |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/doctoralThesis |
| Format | application/pdf |
| Source | reponame:Biblioteca Digital de Teses e Dissertações da PUC_RS, instname:Pontifícia Universidade Católica do Rio Grande do Sul, instacron:PUC_RS |
| Rights | info:eu-repo/semantics/openAccess |
| Relation | 3098206005268432148, 500, 500, 500, 600, -224747486637135387, -969369452308786627, 2075167498588264571 |
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