Impact of standardised feeding regimens on incidence of neonatal necrotising enterocolitis: a systematic review and meta-analysis of observational studies
Impact of standardised feeding regimens on incidence of neonatal necrotising enterocolitis: a systematic review and meta-analysis of observational studies
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DOI：
10.1136/adc.2004.059741
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发表时间：
2005-03-01
期刊：
影响因子：
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通讯作者：
De Klerk, N.
中科院分区：
文献类型：
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作者：
Patole, S. K.;De Klerk, N.
背景：自从实施标准化喂养方案以来，一直观察到坏死性小肠结肠炎（NEC）的发病率显着且长期下降，在一些中心几乎完全消除。目的：系统回顾报告早产、低出生体重 (LBW) 新生儿实施标准化喂养方案“之前”和“之后”NEC 发生率的观察性研究。方法：分别于 2003 年 7 月和 2003 年 10 月检索了 Cochrane 对照试验中央注册库（CENTRAL，Cochrane 图书馆，第 4 期，2002 年）、Medline、Embase、Cinahl 和儿科学术协会会议记录（自 1980 年起在儿科研究中出版）。检索了已确定的观察性研究的参考文献列表和个人档案。没有语言限制。关键词是：标准化、肠内、喂养、新生儿、坏死性小肠结肠炎。我们联系了作者以澄清数据。结果：确定了六项合格的研究（1978-2003）。各项研究之间存在显着的异质性，表明 25 年期间种群特征和喂养方式的变化。使用随机效应模型对六项研究进行荟萃分析显示，汇总风险比为 0.13（95% 置信区间为 0.03 至 0.50），也就是说，采用标准化喂养方案可将 NEC 的发生率降低 87%。结论：标准化喂养方案可能为预防/减少早产儿 NEC 提供最重要的全球工具。需要进行随机对照试验。
Background: A significant and prolonged decline in the incidence of necrotising enterocolitis (NEC), nearing virtual elimination in some centres, has been observed consistently since implementation of a standardised feeding regimen. Aim: To systematically review the observational studies reporting incidence of NEC in preterm, low birth weight (LBW) neonates "before" and "after" implementation of a standardised feeding regimen. Methods: The Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 4, 2002), Medline, Embase, Cinahl, and proceedings of the Pediatric Academic Societies (published in Pediatric Research from 1980) were searched in July and again in October 2003. The reference lists of identified observational studies, and personal files, were searched. No language restriction was applied. Key words were: standardised, enteral, feeding, neonates, necrotising enterocolitis. Authors were contacted for clarification of data. Results: Six eligible studies (1978-2003) were identified. A significant heterogeneity was noted between the studies indicating the variations in the population characteristics and feeding practices over a period of 25 years. Meta-analysis of the six studies using a random effects model revealed a pooled risk ratio of 0.13 (95% confidence interval 0.03 to 0.50) - that is, introduction of a standardised feeding regimen reduced the incidence of NEC by 87%. Conclusion: Standardised feeding regimens may provide the single most important global tool to prevent/minimise NEC in preterm neonates. Randomised controlled trials are needed.