Department of Life, Health and Environmental Sciences, University of L'Aquila, 67100 L'Aquila, Italy.
Department of Pediatrics, University of L'Aquila, 67100 L'Aquila, Italy.
Nutrients. 2020 May 6;12(5):1322. doi: 10.3390/nu12051322.
Premature infants receiving breastfeed have a lower incidence of NEC than those fed preterm formula. This study aimed: (1) to update a systematic review and meta-analyses to evaluate the relationship between feeding and necrotizing enterocolitis (NEC) in low weight premature infants; (2) to conduct meta-regression analyses by subgroups; (3) to describe geographical distribution of milk banks in the world.
Papers included in the meta-analysis were updated as of June 2019. Relative risks were used as a measure of effect size. Random effect models were used to account for different sources of variation among studies. For milk banks, the data reviewed by the literature were integrated with the information collected from countries' institutional sites and milk bank networks.
Thirty-two papers were included in meta-analysis: six randomized controlled trials (RCTs) and 26 observational studies (OS). The census has found 572 milk banks around in the world. Brazil has the most active milk banks. RCTs meta-analysis indicates a risk reduction of NEC using human milk respect to formula: Relative risk (RR) = 0.62 (0.42-0.93). Seven OS compared quantities lower than human milk or higher than the 50th quantile showing a risk reduction of NEC:RR = 0.51 (0.31-0.85); 3 OS that evaluated human milk versus mixed feeding showing that human milk has a protective role on the development of NEC:RR = 0.74 (0.63-0.91). Results of subgroups analysis show that the risk reduction is statistically significant only for studies in which premature infants are given both their own and donated breastmilk.
The possibility of preserving human milk and promoting donations guarantees an improvement in the health of newborns.
接受母乳喂养的早产儿患坏死性小肠结肠炎（NEC）的发病率低于接受早产儿配方奶粉喂养的早产儿。本研究旨在：（1）更新系统评价和荟萃分析，评估低体重早产儿喂养与 NEC 的关系；（2）进行亚组荟萃回归分析；（3）描述世界范围内母乳库的地理分布。
纳入荟萃分析的论文更新至 2019 年 6 月。相对风险作为效应量的度量。随机效应模型用于解释研究之间的不同来源的变异。对于母乳库，文献综述中审查的数据与从国家机构网站和母乳库网络收集的信息进行了整合。
共有 32 篇论文纳入荟萃分析：6 项随机对照试验（RCT）和 26 项观察性研究（OS）。普查发现全球有 572 家母乳库。巴西拥有最多的活跃母乳库。RCT 荟萃分析表明，使用人乳喂养相对于配方奶喂养可以降低 NEC 的风险：相对风险（RR）=0.62（0.42-0.93）。7 项 OS 比较了低于人乳量或高于第 50 分位数的量，结果表明人乳喂养可降低 NEC 的风险：RR=0.51（0.31-0.85）；3 项 OS 评估了人乳与混合喂养，结果表明人乳对 NEC 的发展具有保护作用：RR=0.74（0.63-0.91）。亚组分析结果表明，只有当早产儿同时接受自己的母乳和捐赠母乳时，风险降低才有统计学意义。
保存母乳和促进捐赠的可能性保证了新生儿健康状况的改善。
