母乳库数据库登记NEC病例分析。

IF 2 3区 医学 Q2 PEDIATRICS
Frontiers in Pediatrics Pub Date : 2025-09-17 eCollection Date: 2025-01-01 DOI:10.3389/fped.2025.1679676
Katsumi Mizuno, Yuka S Wada, Motoichiro Sakurai, Yuki Tani, Masafumi Miyata, Jun Shindo, Shigeru Nishimaki, Hiroki Den
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引用次数: 0

摘要

背景:坏死性小肠结肠炎(NEC)仍然是极低出生体重婴儿(ELBWIs)发病和死亡的主要原因,尽管广泛使用供体母乳(DHM)。本研究调查了DHM接受者中的NEC病例,以探索潜在的影响因素。方法:回顾性分析日本母乳库数据库(2018-2023)登记的1425名婴儿。Bell期≥II期NEC病例由主治医师确诊。排除NEC发病后才接受DHM治疗的婴儿。病例按发病时间及相关临床因素分类。结果:1324例极低出生体重儿中,21例(1.58%)发生NEC,其中20例需要手术干预。中位胎龄和出生体重分别为25.1周和637 g。NEC发病分类如下:出生后7天内(n = 5)、2个月后(n = 5)、使用配方奶粉或强化食品后(n = 6)、伴有血流动力学改变(n = 7)或病因不明(n = 4)。常见因素包括症状性PDA、先天性心脏病、感染、配方奶粉暴露和眼科手术。结论:尽管使用DHM, NEC仍可发展,通常与早期感染、PDA或强化有关。进一步降低NEC发病率的策略应包括血液动力学不稳定的管理,延迟配方奶粉的引入,以及使用纯母乳饮食。进一步的研究应探讨眼科干预和母乳强化剂在NEC发展中的潜在作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Analysis of NEC cases registered in the human milk bank database.

Analysis of NEC cases registered in the human milk bank database.

Background: Necrotizing enterocolitis (NEC) remains a major cause of morbidity and mortality in extremely low birth weight infants (ELBWIs), despite widespread donor human milk (DHM) use. This study examined NEC cases among DHM recipients to explore potential contributing factors.

Methods: We retrospectively analyzed 1,425 infants registered in Japan's human milk bank database (2018-2023). NEC cases at Bell stage ≥ II were confirmed by attending physicians. Infants who received DHM only after NEC onset were excluded. Cases were categorized by onset timing and associated clinical factors.

Results: Among 1,324 very low birth weight infants, 21 (1.58%) developed NEC, with 20 requiring surgical intervention. Median gestational age and birth weight were 25.1 weeks and 637 g, respectively. NEC onset was classified as follows: within 7 days of birth (n = 5), after 2 months (n = 5), after formula or fortifier use (n = 6), associated with hemodynamic changes (n = 7), or of unknown etiology (n = 4). Common factors included symptomatic PDA, congenital heart disease, infection, formula exposure, and ophthalmologic procedures.

Conclusion: NEC can develop despite DHM use, often in association with early infections, PDA, or fortification. Strategies to further reduce NEC incidence should include management of hemodynamic instability, delayed formula introduction, and use of exclusive human milk-based diets. Further research should explore potential roles of ophthalmologic interventions and human milk fortifiers in NEC development.

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来源期刊
Frontiers in Pediatrics
Frontiers in Pediatrics Medicine-Pediatrics, Perinatology and Child Health
CiteScore
3.60
自引率
7.70%
发文量
2132
审稿时长
14 weeks
期刊介绍: Frontiers in Pediatrics (Impact Factor 2.33) publishes rigorously peer-reviewed research broadly across the field, from basic to clinical research that meets ongoing challenges in pediatric patient care and child health. Field Chief Editors Arjan Te Pas at Leiden University and Michael L. Moritz at the Children''s Hospital of Pittsburgh are supported by an outstanding Editorial Board of international experts. This multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide. Frontiers in Pediatrics also features Research Topics, Frontiers special theme-focused issues managed by Guest Associate Editors, addressing important areas in pediatrics. In this fashion, Frontiers serves as an outlet to publish the broadest aspects of pediatrics in both basic and clinical research, including high-quality reviews, case reports, editorials and commentaries related to all aspects of pediatrics.
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