Jasani B, Patole S
Department of Neonatal Paediatrics, King Edward Memorial Hospital for Women, Perth, WA, Australia.
Centre for Neonatal Research and Education, School of Paediatrics and Child Health, University of Western Australia, Perth, WA, Australia.
J Perinatol. 2017 Jul;37(7):827-833. doi: 10.1038/jp.2017.37. Epub 2017 Mar 30.
A systematic review (2005) of observational studies has reported 87% reduction in the incidence of necrotizing enterocolitis (NEC) after introducing standardized feeding regimen (SFR) in preterm infants. Considering the many new studies in this field since 2005 and the continued health burden of NEC, we aimed to systematically review the incidence of NEC in preterm infants 'before' vs 'after' implementing a SFR.
PubMed, EMBASE, CINAHL and E-abstracts from the Pediatric Academic Society meetings and other pediatric and neonatal conference proceedings were searched in May 2016. Observational studies reporting incidence of NEC before and after implementing a SFR were included. Relevant data were extracted independently by two reviewers. Meta-analysis was conducted using random effects model (REM) and results rechecked with fixed effects model.
Pooled results from 15 observational studies (N=18 160) using REM showed that SFR significantly reduced the incidence of NEC (risk ratio 0.22; 95% confidence interval 0.13 to 0.36; P<0.00001; I=74%). The results remained significant after comparing studies in two epochs (1978 to 2003 vs 2004 to 2016).
SFR continues to be an important tool in prevention of NEC in preterm infants.
一项2005年对观察性研究的系统评价报告称，在早产儿中引入标准化喂养方案（SFR）后，坏死性小肠结肠炎（NEC）的发病率降低了87%。鉴于2005年以来该领域有许多新研究，且NEC的健康负担持续存在，我们旨在系统评价实施SFR之前与之后早产儿中NEC的发病率。
于2016年5月检索了PubMed、EMBASE、CINAHL以及儿科学术协会会议和其他儿科及新生儿会议论文集的电子摘要。纳入报告实施SFR前后NEC发病率的观察性研究。两位审阅者独立提取相关数据。使用随机效应模型（REM）进行荟萃分析，并用固定效应模型重新检查结果。
15项观察性研究（N = 18160）采用REM的汇总结果表明，SFR显著降低了NEC的发病率（风险比0.22；95%置信区间0.13至0.36；P < 0.00001；I² = 74%）。在比较两个时期（1978年至2003年与2004年至2016年）的研究后，结果仍然显著。
SFR仍然是预防早产儿NEC的重要工具。
