SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, SA 5006, Australia.
Adelaide Medical School, The University of Adelaide, Adelaide, SA 5006, Australia.
Nutrients. 2021 Jun 18;13(6):2089. doi: 10.3390/nu13062089.
Human milk (HM) is the gold standard for feeding infants but has been associated with slower growth in preterm infants compared with preterm formula. This systematic review and meta-analysis summarises the post-1990 literature to examine the effect of HM feeding on growth during the neonatal admission of preterm infants with birth weight ≤1500 g and/or born ≤28 weeks' gestation. Medline, PubMed, CINAHL, and Scopus were searched, and comparisons were grouped as exclusive human milk (EHM) vs. exclusive preterm formula (EPTF), any HM vs. EPTF, and higher vs. lower doses of HM. We selected studies that used fortified HM and compared that with a PTF; studies comparing unfortified HM and term formula were excluded. Experimental and observational studies were pooled separately. The GRADE system was used to evaluate risk of bias and certainty of evidence. Forty-four studies were included with 37 ( = 9963 infants) included in the meta-analyses. In general, due to poor quality studies, evidence of the effect of any HM feeds or higher versus lower doses of HM was inconclusive. There was a possible effect that lower doses of HM compared with higher doses of HM improved weight gain during the hospital admission, and separately, a possible effect of increased head circumference growth in infants fed EPTF vs. any HM. The clinical significance of this is unclear. There was insufficient evidence to determine the effects of an exclusive HM diet on any outcomes.
人乳（HM）是喂养婴儿的金标准，但与早产儿配方奶相比，它与早产儿的生长速度较慢有关。本系统评价和荟萃分析总结了 1990 年后的文献，以检查 HM 喂养对出生体重≤1500 克和/或出生≤28 周的早产儿在新生儿入院期间的生长的影响。检索了 Medline、PubMed、CINAHL 和 Scopus，并将比较分为纯人乳（EHM）与纯早产儿配方奶（EPTF）、任何 HM 与 EPTF 以及更高与更低剂量的 HM。我们选择了使用强化 HM 并将其与 PTF 进行比较的研究；排除了比较未强化 HM 和足月配方的研究。实验和观察研究分别进行汇总。使用 GRADE 系统评估偏倚风险和证据确定性。有 44 项研究被纳入，其中 37 项（=9963 名婴儿）被纳入荟萃分析。总的来说，由于研究质量较差，任何 HM 喂养或更高与更低剂量的 HM 的效果证据不确定。与较高剂量的 HM 相比，较低剂量的 HM 可能对改善住院期间的体重增加有影响，并且 EPTF 与任何 HM 喂养相比，婴儿的头围增长可能有影响。其临床意义尚不清楚。没有足够的证据来确定纯 HM 饮食对任何结果的影响。
