The University of Adelaide, Robinson Research Institute, North Adelaide, South Australia, Australia.
South Australian Health and Medical Research Institute Limited, Adelaide, South Australia, Australia.
BMJ Paediatr Open. 2023 Nov;7(1). doi: 10.1136/bmjpo-2023-002195.
This study aims: (a) to evaluate patterns of domperidone dispensing to mothers of very preterm (<32 weeks gestation) infants born before and after 2014 when international recommendations were made to limit its use and (b) to examine characteristics associated with domperidone dispensing and impacts on breast milk feeding rates at infant hospital discharge.
Retrospective audit using linked electronic medical records and hospital pharmacy records.
Tertiary-referral neonatal intensive care unit at the Women's and Children's Hospital in South Australia.
Mothers of preterm infants admitted to neonatal intensive care from January 2004 to December 2018.
Rate of domperidone dispensing compared pre-2014 and post-2014 recommendations using interrupted time series analyses, and breast milk feeding rates at infant discharge based on domperidone treatment status, adjusted for other factors known to influence breast milk production.
Overall, domperidone was dispensed to 691 (41%) of 1688 mothers. Prior to 2014 recommendations, the proportion of women dispensed domperidone was stable. Following the recommendations, there was a significant reduction in trend (-2.55% per half year, 95% CI -4.57% to -0.53%;), reflecting less domperidone dispensing.Breast milk feeding rates at discharge remained consistently lower in infants of women dispensed domperidone than those who were not (adjusted OR 0.58, 95% CI 0.45 to 0.75).
Domperidone dispensing in mothers of hospitalised very preterm infants has declined over time following international regulatory warnings. Breast milk feeding rates remain lower in mothers prescribed domperidone, suggesting further research is needed to optimise lactation support for mothers of very preterm infants.
本研究旨在：(a) 评估 2014 年国际建议限制多潘立酮使用前后，非常早产(<32 周妊娠)婴儿的母亲使用多潘立酮的模式；(b) 研究与多潘立酮配药相关的特征及其对婴儿出院时母乳喂养率的影响。
使用电子病历和医院药房记录进行回顾性审核。
南澳大利亚妇女儿童医院的三级转诊新生儿重症监护病房。
2004 年 1 月至 2018 年 12 月入住新生儿重症监护病房的早产儿的母亲。
采用中断时间序列分析比较 2014 年建议前后多潘立酮的配药率，以及根据多潘立酮治疗情况调整其他已知影响母乳生成因素后，婴儿出院时的母乳喂养率。
总体而言，1688 名母亲中有 691 名(41%)接受了多潘立酮治疗。在 2014 年建议之前，接受多潘立酮治疗的女性比例保持稳定。在建议之后，趋势显著下降(-每半年 2.55%，95%置信区间-4.57%至-0.53%；)，表明多潘立酮的配药减少。接受多潘立酮治疗的母亲的婴儿出院时母乳喂养率仍明显低于未接受多潘立酮治疗的母亲(调整后的比值比 0.58，95%置信区间 0.45 至 0.75)。
在国际监管警告后，接受多潘立酮治疗的住院极早产儿母亲的配药率随时间推移而下降。接受多潘立酮治疗的母亲的母乳喂养率仍然较低，这表明需要进一步研究以优化极早产儿母亲的哺乳支持。
