Nutritional outcomes and risk factors of neonatal enterostomy / 中国新生儿科杂志

ABSTRACT

Objective To study the nutritional status and risk factors in neonates receiving enterostomy.Method From January 2015 to July 2017,patients who had enterostomy during neonatal period and had the stoma closed in our hospital were retrospectively studied.Z score (weight-for-age) was used to evaluate their nutritional status.The patients were divided into two groups according to the nutritional status when the stoma closed:the malnutrition group and the normal nutrition group.The differences in gender,premature birth,low birth weight,primary disease,ostomy methods,length of proximal small intestine and high output diarrhea through stoma were compared between the two groups.Multivariate Logistic regression analysis was used to determine the risk factors of malnutrition at the closure of the stoma.Result A total of 75 infants with various primary diseases were included.Among them,23 patients were diagnosed with neonatal necrotizing enterocolitis,27 patients jejunoileal atresia,5 patients meconium ileus,15 patients meconium peritonitis and 5 patients Hirschsprung's disease.The median age of enterostomy was 3 (2,8) days,and the median hospital stay after enterostomy was 26 (20,40) days.The median age of stoma closure was 6.0 (5.0,8.5) months.The median Z score at discharge and stoma closure were -1.6 (-2.9,-0.9) and-1.5 (-2.6,-0.5) respectively.No statistically significant differences existed between the two groups (P ＞ 0.05).28 infants (37.3％) were malnutrition when the stoma was closed.The incidence of low birth weight and high output diarrhea through stoma in malnutrition group were significantly higher than the normal nutrition group (35.7％ vs.10.6％,32.1％ vs.10.6％,P ＜0.05).No significant differences in gender,premature birth rate,primary disease,ostomy method and length of proximal intestine between the two groups (P ＞ 0.05).Multivariate Logistic regression analysis indicated that low birth weight,high output diarrhea and jejunoileal atresia were risk factors for malnutrition.Conclusion Malnutrition is common in neonates after enterostomy,and the risk factors for malnutrition are low birth weight,high output diarrhea through stoma and the primary disease jejunoileal atresia.