捐赠人母乳储存和早产婴儿的胃肠道疾病:一个病例控制研究
Terence James M Camilon1,2, Mary Galemmo1, Whitney Savino1
1C.P. Darby Department of Pediatrics, Division of Neonatal-Perinatal Medicine, Shawn Jenkins Children's Hospital, Medical University of South Carolina, Charleston, South Carolina, USA.
JPEN. Journal of parenteral and enteral nutrition
|June 8, 2025
概括
供体母乳的长期储存增加了早产婴儿死性肠球炎和自发性肠穿孔的风险. 对于高风险的新生儿,建议更短的储存时间.
科学领域:
- 新生儿科学 新生儿科学
- 儿科胃肠病学 儿科胃肠病学
- 人类牛奶研究研究
背景情况:
- 捐赠人乳 (DHM) 的生物活性成分可能会随着长时间的储存而改变,影响早产婴儿的健康.
- 之前没有研究将DHM储存时间与死角性肠球炎 (NEC) 或自发性肠孔 (SIP) 联系起来.
研究的目的:
- 调查捐赠人母乳储存时间与早产婴儿中NEC或SIP发生率之间的关联.
- 为了确定与新生儿重症监护室 (NICU) 设置中延长DHM存储相关的潜在风险.
主要方法:
- 从2022年2月到2024年1月,对早产婴儿 (<32周GA或<1700克出生体重) 的回顾性病例控制研究.
- 病例 (n=36) 有NEC (贝尔阶段≥2A) 或SIP;对照组 (n=226) 没有疾病.
- 对妊娠年龄,出生体重和并发症进行调整后勤回归,以评估DHM储存时间 (从表达到消费的几天).
主要成果:
- 与对照组 (244.5天) 相比,患有NEC或SIP的婴儿的DHM储存时间平均较长 (258.6天).
- 每增加一天的DHM储存与NEC或SIP的调整后几率增加3.6% (95% CI,1.17-5.5;P<0.001).
- 这种联系特别在体重小于750克的早产婴儿中被注意到.
结论:
- 长期储存捐赠人母乳与脆弱的早产婴儿中NEC和SIP风险增加有显著的关联.
- 目前的DHM储存准则可能需要对高风险新生儿进行重新评估.
- 需要进一步的多中心研究来验证这些发现,并为更新的储存建议提供信息.
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