强化母乳对早产儿早期生长影响的Meta分析

目的：评价强化母乳喂养的早产儿的早期生长情况，与非强化母乳、早产儿配方奶喂养的早产儿进行生长速率的比较。方法按照Cochrane图书馆检索策略，检索Cochrane图书馆、MEDLINE、EMBASE、PubMed、维普中文科技期刊数据库、中国期刊全文数据库、万方资源数据库，查阅会议记录、专题论文集、综述和检出文献等相关资料。收集关于强化母乳喂养早产儿的随机对照试验研究，进行文献筛选和质量评价，采用Rev Man 5．1软件进行Meta分析，计量资料采用加权均数差（ WMD）及其95％CI表示。结果研究共纳入8篇文献。 Meta分析结果显示：强化母乳喂养早产儿早期体重增长速率、头围增长速率显著大于未强化母乳喂养早产儿，两组身长增长速率无显著性差异（体重：WMD＝2．41，95％CI：1．01～3．82，P＜0．001；身长：WMD＝0．04，95％CI：-0．10～0．17，P＝0．58；头围：WMD＝0．12，95％CI：0．11～0．13，P＜0．001）；比较早产儿配方奶喂养早产儿，两组早期体重增长速率、身长增长速率、头围增长速率无显著性差异（体重：WMD＝-1．28，95％CI：-3．62～1．06，P＝0．28；身长：WMD＝-0．05，95％CI：-0．27～0．18，P＝0．68；头围：WMD＝-0．01，95％CI：-0．06～0．04，P＝0．73）。结论强化母乳喂养能较好地促进早产儿早期生长，可作为首选的喂养方式。

Meta-analysis of the influence of fortified human milk on early growth in preterm infants

Objective To evaluate the early growth of preterm infants fed with fortified human milk , and make comparison between it and that of preterm infants fed with other ways （ preterm formula or unfortified human milk ） .Methods The standard search strategy of the Cochrane Neonatal Review Group was used .This included electronic searches of the Cochrane library , MEDLINE, EMBASE, PubMed, VIP, CNKI, WanFang database.Conference proceedings, symposium, review, and related literatures were searched.Randomized controlled trials on feeding preterm infants with fortified human milk were selected , and the literatures were screened and evaluated .Then Meta-analysis was conducted with Rev Man 5.1 software.Data were manifested with weighted mean differences （ WMD） and 95%CI. Results Eight literatures were included altogether .The growth rate of weight and head circumference of preterm infants with fortified human milk was bigger than that with unfortified human milk , while length growing rate between two groups had no significant difference （ weight：WMD=2.41, 95%CI：1.01-3.82,P＆lt;0.001;length：WMD=0.04, 95%CI：-0.10-0.17,P=0.58; head circumference：WMD=0.12, 95%CI：0.11 -0.13,P＆lt;0.001）.Compared with infants fed with notified human milk , those with preterm formula were not significantly different in growth rates of weight , length and head circumference （weight： WMD=-1.28, 95%CI：-3.62-1.06,P=0.28;length：WMD=-0.05,95%CI：-0.27-0.18,P=0.68; head circumference： WMD=-0.01,95%CI：-0.06-0.04,P=0.73）.Conclusion Fortified human milk feeding can promote early growth in preterm infants , and that can be chosen as the preferred feeding way.