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牛奶的气味和味道对早产儿喂养参数的影响：一项更新的荟萃分析。

Effect of Smell and Taste of Milk on Feeding Parameters in Preterm Neonates: An Updated Meta-Analysis.

作者信息

Alenezi Sarah, Aldaihani Manal, Alqabandi Sabah, Alkandari Ahmad A, Almukaimi Bader A, Almutairi Latifah, Abualqassim Mohamed, Kanaan Ziad A, Ameen Manaal H, Farahat Yara H, Abu-Zaid Ahmed

机构信息

Department of Medicine and Surgery, Kuwait Institute for Medical Specializations, Kuwait City, KWT.

College of Medicine and Medical Sciences, Arabian Gulf Univesity, Manama, BHR.

出版信息

Cureus. 2024 Dec 21;16(12):e76110. doi: 10.7759/cureus.76110. eCollection 2024 Dec.

DOI:10.7759/cureus.76110
PMID:39711931
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11662373/
Abstract

Smell and taste sensations have been linked to positive outcomes in the feeding of premature infants, though the impact on the time required to transition to oral feeding remains unclear. This study aimed to evaluate the beneficial effects of smell and taste interventions on clinical outcomes in preterm infants. We conducted a search in PubMed, Scopus, Web of Science, and the Cochrane Central Register of Controlled Trials from inception through September 2024 for randomized controlled trials (RCTs) examining the effects of smell and taste on clinical outcomes in preterm infants with a gestational age of less than 34 weeks. The quality of the included studies was evaluated using the updated Cochrane's Risk of Bias tool (version 2). The primary outcome was the time required to achieve oral feeds. Secondary outcomes included the time to reach full enteral feeds, length of hospital stay, postmenstrual age, the need for parenteral nutrition, and the incidence of nosocomial infections. The outcomes were summarized as mean difference (MD) or odds ratio (OR) with 95% confidence intervals (CI) using a random-effects model. A total of 12 RCTs involving 1,638 preterm infants were included in the analysis. The results showed that smell and taste interventions significantly reduced the time needed to reach oral feeds (MD = -1.37 days, 95% CI [-2.26, -0.48], p < 0.001; I² = 42.15%) compared to no intervention. These findings were consistent across subgroup analyses based on birth weight at admission, type of exposure, and sample size. However, no significant differences were found for the other secondary outcomes. In conclusion, smell and taste interventions significantly reduced the time to reach oral feeds, with similar outcomes for other clinical measures compared to no intervention. These findings suggest that smell and taste interventions could be used in the care of preterm infants, with the need for large-volume RCTs and long-term assessments being warranted.

摘要

嗅觉和味觉感受已与早产儿喂养的积极结果相关联，尽管其对过渡到经口喂养所需时间的影响仍不明确。本研究旨在评估嗅觉和味觉干预对早产儿临床结局的有益效果。我们在PubMed、Scopus、Web of Science以及Cochrane对照试验中心注册库中进行了检索，检索时间从建库至2024年9月，以查找随机对照试验（RCT），这些试验研究了嗅觉和味觉对胎龄小于34周的早产儿临床结局的影响。使用更新后的Cochrane偏倚风险工具（第2版）评估纳入研究的质量。主要结局是实现经口喂养所需的时间。次要结局包括达到完全肠内喂养的时间、住院时间、月经后年龄、肠外营养的需求以及医院感染的发生率。使用随机效应模型将结局总结为平均差（MD）或比值比（OR）以及95%置信区间（CI）。分析共纳入了12项涉及1638名早产儿的RCT。结果显示，与未干预相比，嗅觉和味觉干预显著缩短了达到经口喂养所需的时间（MD = -1.37天，95% CI [-2.26, -0.48]，p < 0.001；I² = 42.15%）。基于入院时出生体重、暴露类型和样本量的亚组分析结果一致。然而，其他次要结局未发现显著差异。总之，嗅觉和味觉干预显著缩短了达到经口喂养的时间，与未干预相比，其他临床指标的结果相似。这些发现表明，嗅觉和味觉干预可用于早产儿护理，有必要开展大规模RCT和长期评估。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1eca/11662373/1ee284ddee09/cureus-0016-00000076110-i17.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1eca/11662373/baec066f6db5/cureus-0016-00000076110-i08.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1eca/11662373/06c00bdad555/cureus-0016-00000076110-i09.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1eca/11662373/f5a4e710e429/cureus-0016-00000076110-i10.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1eca/11662373/2725dcf2c67f/cureus-0016-00000076110-i11.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1eca/11662373/5a016036ba0f/cureus-0016-00000076110-i12.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1eca/11662373/453a3de4044d/cureus-0016-00000076110-i13.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1eca/11662373/99b1458d4cc8/cureus-0016-00000076110-i14.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1eca/11662373/7906b50d5b7c/cureus-0016-00000076110-i15.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1eca/11662373/1ee284ddee09/cureus-0016-00000076110-i17.jpg

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本文引用的文献

1
Exposure to the smell and taste of milk to accelerate feeding in preterm infants.接触牛奶的气味和味道以加速早产儿的喂养。
Cochrane Database Syst Rev. 2024 May 9;5(5):CD013038. doi: 10.1002/14651858.CD013038.pub3.
2
Effects of olfactory and/or gustatory stimuli on feeding of preterm infants: A systematic review and meta-analysis.嗅觉和/或味觉刺激对早产儿喂养的影响：系统评价和荟萃分析。
PLoS One. 2024 May 7;19(5):e0301186. doi: 10.1371/journal.pone.0301186. eCollection 2024.
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Nutritional Support for Moderate-to-Late-Preterm Infants - A Randomized Trial.
中重度早产儿的营养支持 - 一项随机试验。
N Engl J Med. 2024 Apr 25;390(16):1493-1504. doi: 10.1056/NEJMoa2313942.
4
Effects of human milk odor stimulation on feeding in premature infants: a systematic review and meta-analysis.母乳气味刺激对早产儿喂养的影响：系统评价和荟萃分析。
Sci Rep. 2024 Apr 18;14(1):8964. doi: 10.1038/s41598-024-59175-4.
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National, regional, and global estimates of preterm birth in 2020, with trends from 2010: a systematic analysis.2020 年全球、区域和国家早产估计数及其 2010 年以来的变化趋势：系统分析。
Lancet. 2023 Oct 7;402(10409):1261-1271. doi: 10.1016/S0140-6736(23)00878-4.
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Late-onset Sepsis in Preterm Neonates is Associated with Higher Risks of Cerebellar Hemorrhage and Lower Motor Scores at Three Years of Age.早产儿迟发性败血症与三岁时发生小脑出血的较高风险及较低运动评分相关。
Oman Med J. 2022 Mar 22;37(2):e368. doi: 10.5001/omj.2022.41. eCollection 2022 Mar.
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Lancet Child Adolesc Health. 2022 Feb;6(2):106-115. doi: 10.1016/S2352-4642(21)00311-4. Epub 2021 Nov 17.
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Early Enteral Feeding in Preterm Infants: A Narrative Review of the Nutritional, Metabolic, and Developmental Benefits.早产儿的早期肠内喂养：营养、代谢和发育益处的叙述性综述。
Nutrients. 2021 Jul 1;13(7):2289. doi: 10.3390/nu13072289.
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Effects on Growth of Smell and Taste of Milk During Tube Feeding of Preterm Infants: A Randomized Clinical Trial.管饲喂养早产儿对奶味和口感生长的影响：一项随机临床试验。
JAMA Pediatr. 2021 Nov 1;175(11):1115-1123. doi: 10.1001/jamapediatrics.2021.2336.
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The PRISMA 2020 statement: an updated guideline for reporting systematic reviews.《PRISMA 2020声明：报告系统评价的更新指南》
Syst Rev. 2021 Mar 29;10(1):89. doi: 10.1186/s13643-021-01626-4.