预防新生儿低血糖症的早期养:系统性审查和元分析
Lily F Roberts1, Jane E Harding2, Caroline A Crowther2
1Liggins Institute, University of Auckland, Auckland, New Zealand, lily.roberts@auckland.ac.nz.
Neonatology
|January 9, 2024
概括
新生儿早期养可能会降低新生儿低血糖症的风险,但目前的证据非常不确定. 尽管如此,由于其对婴儿健康的许多其他好处,建议早期养.
科学领域:
- 新生儿护理 新生儿护理
- 儿童营养学 儿童营养学
- 基于证据的医学是基于证据的医学.
背景情况:
- 新生儿低血糖是一个严重的问题,通常与不良食有关.
- 早期养是预防高危新生儿低血糖的推干预措施.
- 早期养预防新生儿低血糖症的有效性需要进一步澄清.
研究的目的:
- 系统地审查和分析早期养在预防新生儿低血糖症方面有效性的证据.
- 评估早期养对其他新生儿结局的影响,如死亡率和住院时间.
主要方法:
- 在2023年5月24日之前,对四个数据库和三个临床试验注册表进行全面搜索.
- 包括各种研究设计,包括RCT,准RCT和与比较组的观察性研究.
- 使用Cochrane风险偏见工具或EPHPP进行质量评估,使用GRADE方法进行证据确定性. 用RevMan 5.4.1或R.进行了元分析.
主要成果:
- 分析了19项涉及175,392名参与者的研究,主要来自低收入或中低收入国家.
- 早期养可能与降低新生儿低血糖症 (OR 0.19,95% CI:0.10-0.35) 和略短住院时间有关.
- 关于早期养对新生儿死亡率的影响的证据非常不确定,一些研究表明潜在的减少 (OR0.51,95% CI:0.37-0.72).
结论:
- 早期养显示出降低新生儿低血糖发生率的潜力,尽管支持证据非常不确定.
- 尽管证据有限,但由于其已确定的新生儿更广泛的益处,建议早期养.
- 需要进一步的高质量研究来证实早期养对新生儿结果的最终影响.
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