供体母乳可及性对母乳使用及坏死性小肠结肠炎发病率的影响。
Impact of Donor Milk Availability on Breast Milk Use and Necrotizing Enterocolitis Rates.
作者信息
Kantorowska Agata, Wei Julia C, Cohen Ronald S, Lawrence Ruth A, Gould Jeffrey B, Lee Henry C
机构信息
University of Rochester School of Medicine and Dentistry, Rochester, New York;
Berkeley School of Public Health, University of California, Berkeley, California;
出版信息
Pediatrics. 2016 Mar;137(3):e20153123. doi: 10.1542/peds.2015-3123. Epub 2016 Feb 22.
OBJECTIVES
To examine the availability of donor human milk (DHM) in a population-based cohort and assess whether the availability of DHM was associated with rates of breast milk feeding at NICU discharge and rates of necrotizing enterocolitis (NEC).
METHODS
Individual patient clinical data for very low birth weight infants from the California Perinatal Quality Care Collaborative were linked to hospital-level data on DHM availability from the Mothers' Milk Bank of San José for 2007 to 2013. Trends of DHM availability were examined by level of NICU care. Hospitals that transitioned from not having DHM to having DHM availability during the study period were examined to assess changes in rates of breast milk feeding at NICU discharge and NEC.
RESULTS
The availability of DHM increased from 27 to 55 hospitals during the study period. The availability increased for all levels of care including regional, community, and intermediate NICUs, with the highest increase occurring in regional NICUs. By 2013, 81.3% of premature infants cared for in regional NICUs had access to DHM. Of the 22 hospitals that had a clear transition to having availability of DHM, there was a 10% increase in breast milk feeding at NICU discharge and a concomitant 2.6% decrease in NEC rates.
CONCLUSIONS
The availability of DHM has increased over time and has been associated with positive changes including increased breast milk feeding at NICU discharge and decrease in NEC rates.
目的
在一个基于人群的队列中研究捐赠人乳（DHM）的可获得性，并评估DHM的可获得性是否与新生儿重症监护病房（NICU）出院时的母乳喂养率及坏死性小肠结肠炎（NEC）的发生率相关。
方法
来自加利福尼亚围产期质量保健协作组织的极低出生体重婴儿的个体患者临床数据，与2007年至2013年圣何塞母乳库的医院层面关于DHM可获得性的数据相链接。通过NICU护理水平来研究DHM可获得性的趋势。对在研究期间从没有DHM转变为有DHM可获得性的医院进行研究，以评估NICU出院时母乳喂养率和NEC发生率的变化。
结果
在研究期间，有DHM可获得的医院从27家增加到55家。包括区域、社区和中级NICU在内的所有护理水平的可获得性均有所增加，其中区域NICU的增加幅度最大。到2013年，在区域NICU接受护理的早产儿中有81.3%能够获得DHM。在22家明确转变为有DHM可获得性的医院中，NICU出院时的母乳喂养率提高了10%，同时NEC发生率下降了2.6%。
结论
随着时间的推移，DHM的可获得性有所增加，并与积极的变化相关，包括NICU出院时母乳喂养的增加和NEC发生率的降低。
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