Adhisivam Bethou, Kohat Dilesh, Tanigasalam Vasanthan, Bhat Vishnu, Plakkal Nishad, Palanivel C
a Department of Neonatology , Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) , Puducherry , India.
J Matern Fetal Neonatal Med. 2019 Oct;32(19):3232-3237. doi: 10.1080/14767058.2018.1461828. Epub 2018 Apr 18.
To compare the effect of fortified pasteurized donor human milk (PDHM) versus unfortified PDHM on the incidence of necrotizing enterocolitis (NEC) and immediate outcome among preterm neonates. This randomized controlled trial (RCT) conducted in a tertiary care teaching hospital, south India included 80 healthy preterm neonates randomized to two groups (Group A and B). Neonates in Group A and B were fed with fortified PDHM and unfortified PDHM, respectively. Neonates in both groups were managed uniformly as per standard NICU protocol. The primary outcome was the incidence of NEC and the secondary outcomes included severity of NEC, incidence of sepsis, mortality, duration of hospital stay, number of days to reach full enteral feeds and weight gain. Neonates were followed up for 28 days or discharge whichever was earlier. The baseline maternal and neonatal characteristics in both groups were comparable. There was no increase in incidence of NEC in fortified PDHM group compared to unfortified PDHM group (2.5 versus 7.5%, = .31). Severity of NEC, incidence of sepsis, mortality, duration of hospital stay, number of days to reach full enteral feeds and weight gain were also similar in both groups. Standard fortification of PDHM does not increase the incidence of NEC among preterm neonates.
比较强化巴氏消毒捐赠人乳（PDHM）与未强化PDHM对早产儿坏死性小肠结肠炎（NEC）发病率及近期预后的影响。这项随机对照试验（RCT）在印度南部一家三级护理教学医院开展，纳入80例健康早产儿并随机分为两组（A组和B组）。A组和B组新生儿分别喂养强化PDHM和未强化PDHM。两组新生儿均按照标准新生儿重症监护病房（NICU）方案进行统一管理。主要结局是NEC的发病率，次要结局包括NEC的严重程度、败血症的发病率、死亡率、住院时间、达到完全肠内喂养的天数和体重增加。对新生儿随访28天或至出院，以先到者为准。两组的基线产妇和新生儿特征具有可比性。与未强化PDHM组相比，强化PDHM组NEC的发病率没有增加（2.5%对7.5%，P = 0.31）。两组NEC的严重程度、败血症的发病率、死亡率、住院时间、达到完全肠内喂养的天数和体重增加也相似。PDHM的标准强化不会增加早产儿NEC的发病率。
