Peng Bo, Yu Lei, Qian Jing, Zheng Baoying, Zhang Yi, Zhu Chunmei
Department of Respiratory, Children's Hospital Affiliated to Capital Institute of Pediatrics, Beijing, China.
Infection Management Division, Children's Hospital Affiliated to Capital Institute of Pediatrics, Beijing, China.
Evid Based Complement Alternat Med. 2023 Apr 7;2023:7378064. doi: 10.1155/2023/7378064. eCollection 2023.
Necrotizing enterocolitis (NEC) and late-onset sepsis (LOS) are the major contributors to mortality and morbidity in preterm infants. This updated meta-analysis was aimed to assess the effects of mother's milk on the incidence of NEC, LOS, and other clinical outcomes in preterm infants.
PubMed, Embase, and the Cochrane library were searched for papers published up to October 2022.
A total of 13 RCTs with 1330 infants were included in the final analysis. Significant difference in NEC (stage 2 or 3) was found between the intervention group and the control group (RR = 0.508, 95% CI: 0.314-0.822, and =0.008). The incidence of proven LOS (RR = 0.809, 95% CI: 0.610-1.071, and =0.139) and death (RR = 0.800, 95% CI: 0.571-1.122, and =0.196) was comparable between the two groups. Statistical differences in the incidence of proven or probable LOS (RR = 0.705, 95% CI: 0.577-0.862, and =0.001) and length of hospitalization (WMD = -4.868, 95% CI: -6.608 to -3.128, and < 0.001) between the intervention group and the control group were observed.
The results of this updated meta-analysis showed that compared to the placebo, mother's milk provides better effects in reducing the incidences of NEC, proven or probable LOS, and the length of stay, whereas no significant benefit of mother's milk was observed in reducing the incidence of proven LOS and death.
坏死性小肠结肠炎（NEC）和晚发性败血症（LOS）是导致早产儿死亡和发病的主要因素。这项更新的荟萃分析旨在评估母乳对早产儿NEC、LOS发病率及其他临床结局的影响。
检索了截至2022年10月在PubMed、Embase和Cochrane图书馆发表的论文。
最终分析纳入了13项随机对照试验中的1330名婴儿。干预组和对照组在NEC（2期或3期）方面存在显著差异（RR = 0.508，95% CI：0.314 - 0.822，P = 0.008）。两组在确诊LOS（RR = 0.809，95% CI：0.610 - 1.071，P = 0.139）和死亡（RR = 0.800，95% CI：0.571 - 1.122，P = 0.196）的发生率上具有可比性。观察到干预组和对照组在确诊或疑似LOS的发生率（RR = 0.705，95% CI：0.577 - 0.862，P = 0.001）和住院时间（WMD = -4.868，95% CI：-6.608至-3.128，P < 0.001）方面存在统计学差异。
这项更新的荟萃分析结果表明，与安慰剂相比，母乳在降低NEC、确诊或疑似LOS的发生率以及住院时间方面具有更好的效果，而在降低确诊LOS的发生率和死亡方面未观察到母乳有显著益处。
