全母乳喂养与减少坏死性小肠结肠炎的发生

IF 1.6 4区医学 Q2 NURSING

Advances in Neonatal Care Pub Date : 2024-10-01 Epub Date: 2024-08-27 DOI:10.1097/ANC.0000000000001183

Lydia Harris, Stephanie Lewis, Shellye Vardaman

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引用次数: 0

摘要

背景：坏死性小肠结肠炎（NEC坏死性小肠结肠炎（NEC）常见于早产儿，尤其是妊娠不足 32 周的婴儿。每 1000 名早产儿中就有 1 人死于 NEC，死亡率为 7%。研究表明，纯母乳饮食能有效降低 NEC 发病率和相关死亡率。目的：评估现有的纯母乳饮食（EHMD）方案对极早产儿 NEC 发病率的影响。在本项目中，EHMD 被定义为母乳，无论是否添加母乳营养剂：方法：单中心回顾性准实验研究。样本包括 201 名妊娠不足 32 周、体重不足 1250 克、胎龄小（SGA）和 Apgar 评分低的婴儿。测量的结果包括 EHMD 方案启动前和启动后婴儿的 NEC 发生率、死亡率和并发症：结果：EHMD 组中仅有 4.8% 的婴儿确诊为 NEC，而采用牛疗法 (BOV) 的婴儿则为 10.5%。EHMD 组的死亡率为 1%，而 BOV 组为 6%。在住院期间，EHMD 组婴儿的体重增加显著高于 BOV 组婴儿（P = 对实践和研究的启示）：新生儿重症监护室应考虑在这一婴儿群体中使用 EHMD。未来需要开展研究，支持将 EHMD 作为标准实践进行推广。

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Exclusive Human Milk Diets and the Reduction of Necrotizing Enterocolitis.

Background: Necrotizing enterocolitis (NEC) is common in preterm infants, especially infants less than 32 weeks gestation. Mortality from NEC is 7% and occurs in 1 out of 1000 preterm infants. Studies have shown the efficacy of an exclusive milk from mother diet in decreasing rates of NEC and associated mortality.

Purpose: To evaluate the effectiveness of an existing exclusive human milk diet (EHMD) protocol on the incidence of NEC in extremely premature infants. EHMD, for the purposes of this project is defined as breast milk of mother, with or without human milk-based fortifier.

Methods: A single-center retrospective quasi-experimental study. The sample included 201 infants born less than 32 weeks gestation, weighing less than 1250 grams, small for gestational age (SGA) and with low Apgar scores. Outcomes measured included incidences of NEC, mortality, and co-morbidities in infants pre- and postinitiation of an EHMD protocol.

Results: Just 4.8% of the EHMD group had a NEC diagnosis compared to 10.5% of the bovine-based (BOV) group. There was a 1% mortality rate of the EHMD group as compared to 6% in the BOV group. The EHMD group had a statistically significant greater weight gain during hospitalization as compared to infants fed BOV ( P = < .05).

Implications for practice and research: Neonatal intensive care units should consider EHMDs for use in this infant population. Future research is needed to support dissemination of the use of EHMD as standard of practice.

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来源期刊

Advances in Neonatal Care NURSING-

CiteScore

2.60

自引率

5.90%

发文量

101

期刊介绍： Advances in Neonatal Care takes a unique and dynamic approach to the original research and clinical practice articles it publishes. Addressing the practice challenges faced every day—caring for the 40,000-plus low-birth-weight infants in Level II and Level III NICUs each year—the journal promotes evidence-based care and improved outcomes for the tiniest patients and their families. Peer-reviewed editorial includes unique and detailed visual and teaching aids, such as Family Teaching Toolbox, Research to Practice, Cultivating Clinical Expertise, and Online Features. Each issue offers Continuing Education (CE) articles in both print and online formats.