Leaf A
Minerva Pediatr. 2010 Jun;62(3 Suppl 1):31-3.
Pregnancies complicated by abnormal antenatal Doppler blood flow often result in the preterm delivery of a growth restricted baby. These babies have a high risk of milk intolerance and necrotising enterocolitis (1), and introduction of milk feeds is frequently delayed. Our aim was to determine the effect of early or late introduction on success of achieving full milk feeds and on adverse outcomes including NEC.
Eligible babies with birthweight below 10th centile and gestation below 34+6 weeks, born after abnormal antenatal Dopplers, were randomised between 20 and 48 hours to either early (24-48 hours) or late (120-144 hours) introduction of milk feeds. Babies with major congenital anomaly, in-utero transfusion, multi-organ failure or need for inotropes were excluded. Feed volumes and rate of increase were standardised, and were the same for both groups. Daily feed logs were kept.
404 babies were randomised from 56 units in U.K. and Ireland (202 in each group). There were no important differences between groups at randomisation.
growth restricted preterm infants born after absent or reversed end-diastolic flow in the umbilical artery who are fed from the second day after birth achieve full feeds faster than those commencing feeds on day six. No difference was been seen in the incidence of NEC, in preliminary analysis. Final data analysis is currently being completed and will be presented at the conference.
孕期出现异常的产前多普勒血流常导致胎儿生长受限并早产。这些婴儿出现牛奶不耐受和坏死性小肠结肠炎的风险很高（1），开始喂奶的时间也常常推迟。我们的目的是确定早期或晚期开始喂奶对完全实现全奶喂养的成功率以及包括坏死性小肠结肠炎在内的不良结局的影响。
产前多普勒检查异常后出生、出生体重低于第10百分位数且孕周小于34 + 6周的符合条件的婴儿，在出生20至48小时之间被随机分为两组，分别在早期（24 - 48小时）或晚期（120 - 144小时）开始喂奶。患有严重先天性畸形、宫内输血、多器官功能衰竭或需要使用强心剂的婴儿被排除。两组的喂奶量和增加速度均标准化且相同。每天记录喂奶情况。
来自英国和爱尔兰56个单位的404名婴儿被随机分组（每组202名）。随机分组时两组之间没有重要差异。
脐动脉舒张末期血流缺失或逆流后出生的生长受限早产儿，出生后第二天开始喂奶比第六天开始喂奶能更快实现全奶喂养。在初步分析中，坏死性小肠结肠炎的发生率没有差异。最终数据分析目前正在完成，将在会议上公布。
