Ekcharoen Chanikarn, Tantibhaedhyangkul Ruangvith
J Med Assoc Thai. 2015 Dec;98(12):1179-86.
To evaluate whether a high energy, high-protein, MCT-containing formula (HPMCT) is as appropriate as a post-discharge formula (PDF) for feeding preterm infants after hospital discharge by comparing growth, adverse effects, and cost per gram of bodyweight gain.
The present study was a randomized controlled trial. The calculated sample size was 20 infants for each intervention group. After the consent procedure, preterm infants who had postconceptional age (PCA) 35⁺¹ to 36⁺⁰ weeks and weight between 1,800 and 3,000 g at hospital discharge were randomly enrolled to receive either PDF or HPMCT starting from the discharge day. Intervention period lasted at least 28 days and until the infant's weight was at least 3,000 g or PCA was at least 40⁺⁰ weeks. Body weight, length, and head circumference were measured on days 0, 14, 28, 56, and 84 after hospital discharge. Formula intakes and adverse symptoms (abdominal distension, diarrhea, and constipation) were recorded by parents before each visit in diaries provided by the study group. Cost was calculated from estimated actual formula intakes.
There were six and five infants enrolled into PDF and HPMCT group, respectively. Demographic data were not different between the two groups. There were no significant differences of growth rates in both groups at days 28, 56, and 84 after hospital discharge. Adverse effects and costs were not different either.
PDF and HPMCT might be comparably appropriate for feeding catching-up preterm infants after hospital discharge, as noted from growth rates, adverse effects, and costs. However, further studies involving biochemical and neurodevelopmental evaluation, with long-term follow-up in larger populations are needed to clearly compare both formulas.
通过比较生长情况、不良反应以及每增加一克体重的成本,评估一种高能量、高蛋白、含中链甘油三酯的配方奶(HPMCT)是否与出院后配方奶(PDF)一样适合出院后的早产儿喂养。
本研究为随机对照试验。每个干预组计算得出的样本量为20名婴儿。在获得同意程序后,将出院时孕龄(PCA)为35⁺¹至36⁺⁰周且体重在1800至3000克之间的早产儿从出院日起随机纳入,分别接受PDF或HPMCT喂养。干预期至少持续28天,直至婴儿体重至少达到3000克或PCA至少达到40⁺⁰周。在出院后的第0、14、28、56和84天测量体重、身长和头围。家长在每次就诊前在研究组提供的日记中记录配方奶摄入量和不良症状(腹胀、腹泻和便秘)。成本根据估计的实际配方奶摄入量计算。
分别有6名和5名婴儿纳入PDF组和HPMCT组。两组的人口统计学数据无差异。出院后第28、56和84天,两组的生长速率均无显著差异。不良反应和成本也无差异。
从生长速率、不良反应和成本来看,PDF和HPMCT可能同样适合喂养出院后的追赶生长早产儿。然而,需要进一步开展涉及生化和神经发育评估的研究,并对更大规模人群进行长期随访,以明确比较这两种配方奶。