多潘立酮增加母乳量以满足早产儿母乳喂养需求：系统评价和荟萃分析。
Domperidone for increasing breast milk volume in mothers expressing breast milk for their preterm infants: a systematic review and meta-analysis.
机构信息
Adelaide Medical School, The Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia.
Flinders Medical Centre, SA Pharmacy, SA Health, Adelaide, SA, Australia.
出版信息
BJOG. 2018 Oct;125(11):1371-1378. doi: 10.1111/1471-0528.15177. Epub 2018 Mar 27.
BACKGROUND
Mothers of preterm infants often struggle to produce enough breast milk to meet the nutritional needs of their infant. Galactagogues such as domperidone are often prescribed to increase breast milk supply but evidence supporting their role in clinical practice is uncertain.
OBJECTIVE
To evaluate the efficacy and safety of domperidone for increasing breast milk volume in mothers expressing breast milk for their preterm infants.
SEARCH STRATEGY
MEDLINE, Embase and Web of Science were searched without language restrictions from first publication until January 2017. Bibliographies of articles and reviews were hand-searched for additional reports.
SELECTION CRITERIA
Randomised controlled trials that compared domperidone with placebo in mothers of preterm infants (<37 weeks' gestation) experiencing insufficient milk supply.
DATA COLLECTION AND ANALYSIS
Two review authors independently assessed studies for inclusion, extracted data and evaluated study quality. Differences in breast milk volume and adverse events were combined using fixed effects meta-analysis.
MAIN RESULTS
The pooled analysis of five trials consisting of 194 women demonstrated a moderate increase in daily breast milk volume of 88.3 ml/day (95% CI 56.8-119.8) with the use of domperidone compared with placebo. No difference was evident with respect to maternal adverse events (odds ratio 1.05, 95% CI 0.65-1.71), with no reported cases of prolonged QTc syndrome or sudden cardiac death. Sensitivity analyses showed no important differences in the estimates of effects.
CONCLUSIONS
Domperidone is well tolerated and results in a moderate short-term increase in expressed breast milk volume among mothers of preterm infants previously identified as having insufficient breast milk supply.
TWEETABLE ABSTRACT
Domperidone leads to short-term improvements in breast milk volume in mothers of preterm infants.
背景
早产儿的母亲常常难以分泌足够的母乳来满足婴儿的营养需求。常开催乳剂如多潘立酮来增加母乳供应，但支持其在临床实践中应用的证据并不确定。
目的
评估多潘立酮增加母乳喂养早产儿的母亲泌乳量的疗效和安全性。
检索策略
检索 MEDLINE、Embase 和 Web of Science，无语言限制，检索时间从首次发表至 2017 年 1 月。同时手工检索文章和综述的参考文献以获取额外的报告。
选择标准
比较多潘立酮与安慰剂治疗母乳不足的早产儿（<37 周妊娠）母亲的随机对照试验。
数据收集和分析
两名综述作者独立评估纳入研究、提取数据并评价研究质量。使用固定效应荟萃分析合并母乳量和不良事件的差异。
主要结果
对 5 项试验（共 194 名妇女）的汇总分析显示，与安慰剂相比，多潘立酮使每日母乳量平均增加 88.3 ml/天（95%CI 56.8-119.8）。多潘立酮与安慰剂相比，母亲不良事件无差异（比值比 1.05，95%CI 0.65-1.71），无报道的 QT 间期延长综合征或心脏性猝死病例。敏感性分析表明，影响的估计值没有明显差异。
结论
多潘立酮耐受良好，可使先前被诊断为母乳不足的早产儿的母亲在短期内母乳量适度增加。
推文摘要
多潘立酮可使早产儿母亲的母乳量在短期内增加。
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