An exclusive human milk-based diet in extremely premature infants reduces the probability of remaining on total parenteral nutrition: a reanalysis of the data.
An exclusive human milk-based diet in extremely premature infants reduces the probability of remaining on total parenteral nutrition: a reanalysis of the data.
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DOI：
10.1186/1756-0500-5-188
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发表时间：
2012-04-25
影响因子：
1.8
通讯作者：
Rechtman, David J
中科院分区：
文献类型：
--
作者：
Ghandehari, Heli;Lee, Martin L;Rechtman, David J
背景：我们先前已经证明，完全以人奶为基础的饮食对极早产儿是有益的，他们有坏死性小肠结肠炎(NEC)的风险。然而，在另一个主要研究终点，完全肠外营养(TPN)的持续时间方面，没有发现显著差异。目前的分析从不同的统计角度重新评估了这些数据，考虑了在任何一天需要TPN的概率或可能性，而不是TPN的天数。这项研究包括207名早产儿，随机分为三组：一组接受母乳、配方奶粉和牛基强化剂的对照饮食(“对照饮食”)，另两组在肠内喂养过程中的不同时间开始只给予母乳和人乳基强化剂(喂食量分别为40或100毫升/公斤/天；“HM40”和“HM100”)。结果：与对照组相比，完全以人为基础饮食的两组婴儿需要全胃肠外营养的可能性降低了11-14%(HM40组和HM100组分别为0.0001和0.001)。如果剔除TPN的初始周期，这一点更加明显(p
BACKGROUND: We have previously shown that an exclusively human milk-based diet is beneficial for extremely premature infants who are at risk for necrotizing enterocolitis (NEC). However, no significant difference in the other primary study endpoint, the length of time on total parenteral nutrition (TPN), was found. The current analysis re-evaluates these data from a different statistical perspective considering the probability or likelihood of needing TPN on any given day rather than the number of days on TPN. This study consisted of 207 premature infants randomized into three groups: one group receiving a control diet of human milk, formula and bovine-based fortifier ("control diet"), and the other two groups receiving only human milk and human milk-based fortifier starting at different times in the enteral feeding process (at feeding volumes of 40 or 100 mL/kg/day; "HM40" and "HM100", respectively). The counting process Cox proportional hazards survival model was used to determine the likelihood of needing TPN in each group.RESULTS: The two groups on the completely human-based diet had an 11-14 % reduction in the likelihood of needing nutrition via TPN when compared to infants on the control diet (p=0.0001 and p=0.001, respectively for the HM40 and HM100 groups, respectively). This was even more pronounced if the initial period of TPN was excluded (p