| 中文摘要 |
背景與目的：發燒在新生兒被認為是全身性感染的一個警訊，然而有文獻指出脫水是新生兒發燒的主要原因之一，特別是在剛出生的前幾天。本研究探討在嬰兒室非感染造成新生兒發燒的相關危險因子。方法：本研究為病歷回溯性病例對照研究，病例組為41名因發燒轉入新生兒中重度病房的個案，對照組則為同一期間在本院出生進入嬰兒室且未發燒的新生兒164 名。結果：病例組及對照組的新生兒在懷孕週數、出生體重、體重減輕率及出生後第一次哺育時間有顯著差異（p < 0.05）。以邏輯迴歸分析發現出生後第一次哺育時間（Odds ratio 0.731, 95% C.I. 0.570-0.937）、體重減輕率（Odds ratio 0.733, 95%C.I. 0.615-0.873）及新生兒的出生體重（Odds ratio 0.998, 95% C.I. 0.997-0.999) 是發燒的重要預測因子。結論：本研究雖無法控制新生兒的出生體重，但根據研究結果，若能在新生兒出生後密切觀察新生兒體重變化，儘早開始首次哺育，避免新生兒體重減輕率過高，應有助於減少新生兒脫水及發燒的發生。 |
| 英文摘要 |
Background and Purpose: Fever during the neonatal period is considered an alarming sign of systemic infection. However, as mentioned in the previous report, dehydration is the primary cause of fever, especially during the first days of life. The purpose of this study was to identify the epidemiological features and clinical manifestations of neonatal fever in a nursery. Methods: We collected data by chart-review to evaluate the possible factors associated with neonatal fever. The 41 newborns with fever were the case group. A total of 164 babies were randomly selected from the name list of newborns during the same period of admission. Results: Compared with the control group, in the gestational age, the birth weight, mean body weight loss rate and the average time to the first feed postpartum were all significantly higher (p < 0.05). For logistic regression analysis, the risk factors associated with neonatal fever were the time of first feeding (Odds ratio 0.731, 95% C.I. 0.570-0.937), body weight loss rate (Odds ratio 0.733, 95% C.I. 0.615-0.873), and birth weight (Odds ratio 0.998, 95% C.I. 0.997-0.999). Conclusion: Our study found these newborns need to be given more attention and evaluation, to avoid delays in feeding, which could cause body weight loss and dehydration. Breast-feeding as early as possible, improving breast-feeding skill, close monitoring of neonatal body weight and fluid supplements when indicated could help decrease the incidence of dehydration and fever. |
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