背景:关于母乳喂养对大量早产儿人群短期结局的影响的证据有限。
目的:探讨人乳喂养对坏死性小肠结肠炎和继发性脓毒症的主要结局的影响,支气管肺发育不良,严重的早产儿视网膜病变,死亡,以及极低出生体重婴儿出院时实现完全肠内喂养的时间。
方法:本研究是一项回顾性研究,纵向,观察性两组比较队列研究。中国25个新生儿重症监护病房共4470名极/极低出生体重儿,2015年4月至2018年5月,纳入本研究.使用倾向评分对独家人乳喂养和配方喂养的参与者进行匹配。匹配后,母乳喂养参与者(n=1379)和配方奶喂养参与者(n=1378)被纳入分析.坏死性小肠结肠炎的可能性,支气管肺发育不良,脓毒症,严重的早产儿视网膜病变,死亡,比较两组实现全肠内喂养的时间。
结果:独家母乳喂养与坏死性小肠结肠炎的几率较低相关(2.90%vs.8.42%,或0.33,95%CI[0.22,0.47]),支气管肺发育不良(15.74%vs.20.26%,或0.69,95%CI[0.56,0.86]),重度早产儿视网膜病变(1.45%vs.2.39%,或0.50,95%CI[0.27,0.93]),和死亡(6.02%vs.10.38%,OR0.44,95%CI[0.32,0.61])与配方喂养相比。两组之间在实现完全肠内喂养的时间或败血症的几率方面没有显着差异。
结论:独家母乳喂养与减少坏死性小肠结肠炎有关,支气管肺发育不良,严重的早产儿视网膜病变,以及极低/极低出生体重婴儿的死亡率。
背景:Clinicaltrials.gov,2015年11月9日(NCT02600195)。
BACKGROUND: There is limited evidence about the influence of human milk feeding on short-term outcomes in a large preterm infant population.
OBJECTIVE: To explore the influences of human milk feeding on the primary outcome of necrotizing enterocolitis and secondarily sepsis, bronchial pulmonary dysplasia, severe retinopathy of prematurity, death, and the time to achieve full enteral feeding at discharge in very/extremely low-birth-weight infants.
METHODS: This study was a retrospective, longitudinal, observational two-group comparison cohort study. A total of 4470 very/extremely low-birth-weight infants from 25 neonatal intensive care units in
China, between April 2015 and May 2018, were enrolled in this study. Exclusive human milk-fed and formula-fed participants were matched using propensity scores. After matching, human milk-fed participants (n = 1379) and formula-fed participants (n = 1378) were included in the analyses. The likelihood of necrotizing enterocolitis, bronchopulmonary dysplasia, sepsis, severe retinopathy of prematurity, death, and the time to achieve full enteral feeding were compared between the two groups.
RESULTS: Exclusive human milk feeding was associated with lower odds of necrotizing enterocolitis (2.90% vs. 8.42%, OR 0.33, 95% CI [0.22, 0.47]), bronchopulmonary dysplasia (15.74% vs. 20.26%, OR 0.69, 95% CI [0.56, 0.86]), severe retinopathy of prematurity (1.45% vs. 2.39%, OR 0.50, 95% CI [0.27, 0.93]), and death (6.02% vs. 10.38%, OR 0.44, 95% CI [0.32, 0.61]) compared with formula feeding. No significant differences in the time to achieve full enteral feeding or the odds of sepsis were found between the two groups.
CONCLUSIONS: Exclusive human milk feeding is associated with a reduction in necrotizing enterocolitis, bronchopulmonary dysplasia, severe retinopathy of prematurity, and mortality among very/extremely low-birth-weight infants.
BACKGROUND: Clinicaltrials.gov on November 9, 2015 (NCT02600195).