Alsaleem Mahdi, Dusin Jarrod, Akangire Gangaram
University of Kansas Medical Center, Wichita, KS, USA.
Children's Mercy Hospital, Kansas City, MO, USA.
Glob Pediatr Health. 2021 Jul 22;8:2333794X211035258. doi: 10.1177/2333794X211035258. eCollection 2021.
The use of low lactose formula (LLF) in term and near-term infants in infants with neonatal abstinence syndrome (NAS) has been increasing recently. However, the clinical evidence of such use is limited. Our aim in this paper was to systematically review the current literature about the use of LLF in infants with NAS. We searched PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, and Cochrane Database of Systematic Reviews for articles published between 2015 and 2020. Only randomized controlled trials, prospective, and retrospective studies. The risk of bias was assessed by using published tools appropriate for the study type. The certainty of the evidence was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Forty-one titles and/or abstracts were screened independently by 2 reviewers (MA and GA). After an indepth review, 4 studies answered the study question (1 randomized controlled trial (RCT), 2 retrospective studies, and 1 quality improvement study). A meta-analysis could not be completed due to the study type difference and how the outcomes were reported. The studies found no benefit to feeding LLF to infants with NAS regarding short-term outcomes (length of stay, duration, and need for pharmacological therapy and growth). Certainty in the evidence is low. In conclusion we found no beneficial effects regarding the need for pharmacological therapy, duration of pharmacological treatment, length of hospital stay, and growth of using LLF compared to the standard formula in infants with NAS.
近期，在患有新生儿戒断综合征（NAS）的足月儿和近足月儿中，低乳糖配方奶粉（LLF）的使用呈上升趋势。然而，关于这种使用方式的临床证据有限。本文的目的是系统回顾当前有关LLF在NAS婴儿中使用的文献。我们检索了PubMed、Embase、护理学与健康相关文献累积索引以及Cochrane系统评价数据库，查找2015年至2020年间发表的文章。仅纳入随机对照试验、前瞻性和回顾性研究。采用适用于研究类型的已发表工具评估偏倚风险。使用推荐分级评估、制定与评价（GRADE）来评估证据的确定性。由两名审阅者（MA和GA）独立筛选41篇标题和/或摘要。经过深入审查，4项研究回答了研究问题（1项随机对照试验（RCT）、2项回顾性研究和1项质量改进研究）。由于研究类型差异以及结果报告方式，无法完成荟萃分析。这些研究发现，就短期结局（住院时间、持续时间、药物治疗需求和生长情况）而言，给NAS婴儿喂食LLF并无益处。证据的确定性较低。总之，与标准配方奶粉相比，我们发现LLF在NAS婴儿的药物治疗需求、药物治疗持续时间、住院时间和生长方面并无有益效果。
