Lu Anfeng, Huang Peilu, Guo Xin, Zhu Li, Bi Lei, Xing Ruirui, Yu Zhangbin, Tang Hong, Huang Guosheng
Department of Neonatology, Qinzhou Maternity and Child Health Care Hospital, Qinzhou, Guangxi, China.
Department of Neonatology, Longgang District Maternity & Child Healthcare Hospital of Shenzhen City (Longgang Maternity and Child Institute of Shantou University Medical College), Shenzhen, Guangdong, China.
Front Pediatr. 2025 Mar 20;13:1534773. doi: 10.3389/fped.2025.1534773. eCollection 2025.
Very preterm infants are highly vulnerable to complications, imposing a significant economic burden on healthcare systems. Human milk has protective effects on these infants, but there is no systematic review on its economic impact.
We conducted a comprehensive review of studies assessing the economic evaluations of human milk for very preterm infants.
Our literature search covered PubMed, Embase, the Cochrane Library, and Web of Science. Two reviewers independently extracted data on economic evaluations and assessed study quality using the Pediatric Quality Appraisal Questionnaire (PQAQ).
Fourteen studies of moderate quality, conducted in the United States, Germany, and Canada, met the inclusion criteria. However, the studies analyzed had notable variations and shortcomings. The majority of these studies ( = 11) performed economic evaluations from a healthcare system perspective, utilizing cost-consequence analysis ( = 6) up to the point of neonatal discharge ( = 11). All human milk interventions indicated cost-effective or cost saving results; only a minority included discounting ( = 2).
This systematic review suggests that economic evaluation of human milk for very preterm infants is an expanding area of research. Human milk for very preterm infants offers substantial economic advantages during neonatal intensive care unit hospitalization. Standardized and high-quality studies are needed to determine the cost-effectiveness of human milk for very preterm infants in the future.
https://www.crd.york.ac.uk/PROSPERO, identifier (CRD42024539574).
极早产儿极易出现并发症，给医疗保健系统带来巨大经济负担。母乳对这些婴儿具有保护作用，但尚无关于其经济影响的系统评价。
我们对评估母乳对极早产儿经济评价的研究进行了全面综述。
我们的文献检索涵盖了PubMed、Embase、Cochrane图书馆和Web of Science。两名评价员独立提取经济评价数据，并使用儿科质量评估问卷（PQAQ）评估研究质量。
在美国、德国和加拿大进行的14项质量中等的研究符合纳入标准。然而，所分析的研究存在显著差异和不足。这些研究中的大多数（n = 11）从医疗保健系统的角度进行经济评价，采用成本后果分析（n = 6），直至新生儿出院（n = 11）。所有母乳干预措施均显示出具有成本效益或节省成本的结果；只有少数研究（n = 2）考虑了贴现。
本系统评价表明，母乳对极早产儿的经济评价是一个不断扩展的研究领域。在新生儿重症监护病房住院期间，极早产儿食用母乳具有显著的经济优势。未来需要开展标准化的高质量研究，以确定母乳对极早产儿的成本效益。
