Early human milk feeding is associated with a lower risk of necrotizing enterocolitis in very low birth weight infants
Early human milk feeding is associated with a lower risk of necrotizing enterocolitis in very low birth weight infants
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DOI：
10.1038/sj.jp.7211758
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发表时间：
2007-07-01
影响因子：
2.9
通讯作者：
O'Shea, T. M.
中科院分区：
文献类型：
--
作者：
Sisk, P. M.;Lovelady, C. A.;O'Shea, T. M.
背景：坏死性小肠结肠炎（NEC）是极低出生体重儿（VLBW）死亡和发病的常见原因。母乳（HM）喂养与NEC的风险较低有关。然而，极低出生体重婴儿的母亲经常遇到产奶不足，导致混合喂养人乳和配方奶粉。此外，医疗并发症往往限制了他们可以给予的喂养量。方法：这是一项对VLBW婴儿的前瞻性队列研究，根据前14天内HM肠道喂养的比例进行分组：< 50%（低人乳，LHM，n = 46）和>= 50%（高人乳，HHM，n = 156）。感兴趣的结果是NEC（贝尔2或3期）的发展。Logistic回归分析估计比值比（OR）和95%可信区间（CI），并评估潜在的混杂因素，由于围产期的危险因素。确诊NEC发生在5/46（10.6%）的LHM组，相比之下，5/156（3.2%）的HHM。孕龄是唯一与NEC风险相关的围产期因素。经胎龄校正后，HHM与NEC发生风险降低相关（OR = 0.17，95%CI：0.04 ~ 0.68，P = 0.01）。结论：出生后14 d内含至少50%HM的肠内喂养与NEC发生几率降低6倍相关。
Background: Necrotizing enterocolitis (NEC) is a frequent cause of mortality and morbidity in very low birth weight (VLBW) infants. Human milk (HM) feeding has been associated with lower risk of NEC. However, mothers of VLBW infants often experience insufficient milk production, resulting in mixed feedings of HM and formula. Moreover, medical complications often limit the volume of feeding they can be given.Objective: To determine if high proportions of (50% or greater) HM enteral feeding within the first 14 days of life are protective against NEC.Method: This was a prospective cohort study of VLBW infants who were grouped according to the HM proportion of enteral feeding in the first 14 days: < 50% (low human milk, LHM, n = 46) and >= 50% ( high human milk, HHM, n = 156). The outcome of interest was development of NEC (Bell stage 2 or 3). Logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI) and to assess potential confounding due to perinatal risk factors.Result: Two hundred and two infants were studied. Confirmed NEC occurred in 5/46 (10.6%) of the LHM group, as compared with 5/156 (3.2%) of the HHM. Gestational age was the only perinatal factor associated with risk of NEC. After adjustment for gestational age, HHM was associated with a lower risk of NEC (( OR = 0.17, 95% CI: 0.04 to 0.68), P = 0.01).Conclusion: Enteral feeding containing at least 50% HM in the first 14 days of life was associated with a sixfold decrease in the odds of NEC.