Memorial Hospital, Savannah, Georgia (Dr Harris); and Troy University, Phenix City, Alabama (Drs Lewis and Vardaman).
Adv Neonatal Care. 2024 Oct 1;24(5):400-407. doi: 10.1097/ANC.0000000000001183. Epub 2024 Aug 27.
Necrotizing enterocolitis (NEC) is common in preterm infants, especially infants less than 32 weeks gestation. Mortality from NEC is 7% and occurs in 1 out of 1000 preterm infants. Studies have shown the efficacy of an exclusive milk from mother diet in decreasing rates of NEC and associated mortality.
To evaluate the effectiveness of an existing exclusive human milk diet (EHMD) protocol on the incidence of NEC in extremely premature infants. EHMD, for the purposes of this project is defined as breast milk of mother, with or without human milk-based fortifier.
A single-center retrospective quasi-experimental study. The sample included 201 infants born less than 32 weeks gestation, weighing less than 1250 grams, small for gestational age (SGA) and with low Apgar scores. Outcomes measured included incidences of NEC, mortality, and co-morbidities in infants pre- and postinitiation of an EHMD protocol.
Just 4.8% of the EHMD group had a NEC diagnosis compared to 10.5% of the bovine-based (BOV) group. There was a 1% mortality rate of the EHMD group as compared to 6% in the BOV group. The EHMD group had a statistically significant greater weight gain during hospitalization as compared to infants fed BOV ( P = < .05).
Neonatal intensive care units should consider EHMDs for use in this infant population. Future research is needed to support dissemination of the use of EHMD as standard of practice.
坏死性小肠结肠炎（NEC）在早产儿中很常见，尤其是胎龄小于 32 周的婴儿。NEC 的死亡率为 7%，每 1000 例早产儿中就有 1 例发生。研究表明，采用母亲的纯人奶喂养可降低 NEC 的发生率和相关死亡率。
评估现有的人奶喂养方案（EHMD）对极早产儿 NEC 发病率的影响。EHMD 在本研究中定义为母亲的人奶，可添加或不添加人奶强化剂。
这是一项单中心回顾性准实验研究。样本包括 201 名胎龄小于 32 周、体重小于 1250 克、小于胎龄（SGA）且 Apgar 评分低的婴儿。测量的结果包括 NEC 发生率、死亡率和婴儿在开始 EHMD 方案前后的合并症。
EHMD 组的 NEC 诊断率仅为 4.8%，而牛奶制品（BOV）组为 10.5%。EHMD 组的死亡率为 1%，而 BOV 组为 6%。与 BOV 组相比，EHMD 组住院期间的体重增加有显著统计学意义（P<0.05）。
新生儿重症监护病房应考虑在该婴儿人群中使用 EHMD。需要进一步研究以支持将 EHMD 的使用作为标准实践进行推广。
