Department of Neonatology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.
Breastfeed Med. 2023 Sep;18(9):636-644. doi: 10.1089/bfm.2023.0093.
To analyze the effect of different feeding types on bronchopulmonary dysplasia (BPD) in very low birth weight preterm infants. The Cochrane Library, PubMed, Embase, China National Knowledge Infrastructure (CNKI), Wanfang Data Knowledge Service Platform, China Biomedical Literature Database (CBM) were searched for literature related to breastfeeding and BPD, with a search period from their inception to January 2023. Two researchers independently screened the literature, extracted data, and assessed the quality of included studies before analyzing the data using Stata16 and RevMan5.4.1 software. A total of 17 studies were included. The results showed that there was no significant difference in the frequency of BPD between human milk (HM) and donor human milk (DHM) (OR = 0.54, 95% CI: 0.29-1.03, = 0.07). However, DHM had a significant effect in reducing the frequency of BPD compared to preterm formula (PF) (OR = 0.62, 95% CI: 0.41-0.94, = 0.02). Exclusive HM also had a significant effect in reducing the frequency of BPD compared to exclusive PF (OR = 0.51, 95% CI: 0.34-0.78, = 0.002), as well as compared to any PF (OR = 0.57, 95% CI: 0.37-0.88, = 0.01). Furthermore, mainly (>50%) HM had a significant effect in reducing the frequency of BPD compared to mainly PF (OR = 0.72, 95% CI: 0.55-0.93, = 0.01). However, there was no statistically significant difference between any HM and exclusive PF (OR = 0.88, 95% CI: 0.62-1.23, = 0.46). Our study findings suggest that both HM and DHM have a significant protective effect in reducing the frequency of BPD occurrence compared to PF. Furthermore, even when the amount of HM is insufficient, feeding more than 50% of the HM volume still provides a protective effect against the frequency of BPD. Therefore, we recommend feeding infants with more than 50% of HM to harness the protective effect of HM against BPD occurrence.
分析不同喂养方式对极低出生体重早产儿支气管肺发育不良（BPD）的影响。检索 Cochrane 图书馆、PubMed、Embase、中国知网（CNKI）、万方数据知识服务平台、中国生物医学文献数据库（CBM）中与母乳喂养和 BPD 相关的文献，检索时限均从建库至 2023 年 1 月。由 2 位研究者独立筛选文献、提取数据并评价纳入研究的质量，采用 Stata16 和 RevMan5.4.1 软件进行数据分析。共纳入 17 项研究。结果显示，人乳（HM）与捐赠人乳（DHM）喂养的 BPD 发生率差异无统计学意义（OR=0.54，95%CI：0.29-1.03，=0.07）。但 DHM 较早产儿配方奶（PF）降低 BPD 发生率的效果更显著（OR=0.62，95%CI：0.41-0.94，=0.02）。HM 纯母乳喂养较 PF 纯母乳喂养降低 BPD 发生率的效果也更显著（OR=0.51，95%CI：0.34-0.78，=0.002），且较任何配方奶（OR=0.57，95%CI：0.37-0.88，=0.01）均降低 BPD 发生率的效果更显著。此外，HM 喂养量＞50%较 PF 喂养降低 BPD 发生率的效果更显著（OR=0.72，95%CI：0.55-0.93，=0.01）。但任何 HM 与 PF 纯母乳喂养比较，差异均无统计学意义（OR=0.88，95%CI：0.62-1.23，=0.46）。本研究结果表明，与 PF 相比，HM 和 DHM 均有降低 BPD 发生率的显著保护作用。此外，即使 HM 量不足，喂养＞50%的 HM 量仍有降低 BPD 发生率的保护作用。因此，我们建议采用＞50%的 HM 喂养婴儿，以发挥 HM 对 BPD 发生的保护作用。
