极低出生体重儿使用医院建立的早产儿母乳库可降低坏死性小肠结肠炎的发生率。
Low rate of necrotizing enterocolitis in extremely low birth weight infants using a hospital-based preterm milk bank.
机构信息
Department of Pediatrics, SUNY Upstate Medical University, Syracuse, NY, USA.
Department of Neonatology, Crouse Hospital, Syracuse, NY, USA.
出版信息
J Perinatol. 2019 Jan;39(1):108-114. doi: 10.1038/s41372-018-0235-3. Epub 2018 Oct 5.
OBJECTIVE
We examined the effect of two strategies to prevent necrotizing enterocolitis (NEC) in extremely low birth weight (ELBW) infants-adherence to a standardized feeding protocol and use of a hospital-based milk bank to provide exclusive preterm human milk feedings.
STUDY DESIGN
We conducted a single-center observational study from 2010 to 2015. Infants received preterm human milk, initially trophic feeds from days 7 to 14 after birth, followed by advancement of 15 mL/kg/day to reach a goal of 180 mL/kg/day. Fortification was used selectively for weight gain < 15 g/kg/day. We determined the incidence of NEC, other morbidities, and growth.
RESULTS
The cohort included 398 ELBW infants who survived to day 14 without congenital anomalies. Mean gestational age was 26.2 ± 1.9 weeks. Maternal milk was used as the sole feeding in 62% of infants; preterm donor milk was used solely or as supplement in 29%. Full feeds were reached at a median of 27 (IQR 23, 33) days. Four infants (1%) developed NEC.
CONCLUSION
Use of standardized feedings with a hospital-based milk bank is associated with an incidence of NEC lower than previously reported.
目的
我们研究了两种预防极低出生体重（ELBW）婴儿坏死性小肠结肠炎（NEC）的策略的效果 - 遵循标准化喂养方案和使用医院内的母乳库提供纯早产儿母乳喂养。
研究设计
我们进行了一项 2010 年至 2015 年的单中心观察性研究。婴儿接受早产儿母乳，最初在出生后 7 至 14 天给予营养性喂养，然后每天增加 15 毫升/公斤，以达到每天 180 毫升/公斤的目标。根据体重增加 < 15 克/公斤/天的情况选择性添加强化剂。我们确定了 NEC 的发生率、其他并发症和生长情况。
结果
队列包括 398 名幸存至 14 天且无先天畸形的 ELBW 婴儿。平均胎龄为 26.2±1.9 周。母亲的母乳是 62%婴儿的唯一喂养来源；早产儿捐赠母乳单独或作为补充使用占 29%。中位数为 27（IQR 23，33）天达到全量喂养。4 名婴儿（1%）发生 NEC。
结论
使用标准化喂养方案和医院内的母乳库与之前报道的 NEC 发生率较低相关。
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