Donor human milk (DHM) is an alternative to preterm infant formula if the mother’s own milk is not available. Since the lactation period and preservation treatment of DHM are different from those of mother’s own milk, we aimed to determine the reduction in the length of hospital stay by DHM compared to preterm infant formula. In this systematic review, we searched PubMed/MEDLINE, EMBASE, and the Cochrane Library to retrieve studies on the impact of DHM on the clinical outcomes of preterm infants published before 1 November 2019. The study included very low birthweight (VLBW) infants taking either DHM or infant formula with data on the length of hospital stay. Data were analysed using Review Manager 5.3 software. The literature search yielded 136 articles, and four randomised controlled trials (RCTs) and eight observational studies met the inclusion criteria. A meta-analysis of the RCTs (N = 725) showed no reduction in the length of hospital stay in both the DHM and infant formula groups (− 0.22 days; 95% CI -6.38, 5.95 days), whereas that of the eight observational studies (N = 2496) showed a significant reduction in the length of hospital stay in the DHM group (− 11.72 days; 95% CI -22.07, − 1.37 days). A subgroup analysis of the RCTs revealed that the incidence of necrotising enterocolitis (NEC) was significantly lower in the DHM group when the analysis included high-quality RCTs (RR = 0.32; 95% CI 0.15, 0.69). This systematic review of RCTs showed that DHM neither prolonged nor shortened the length of hospital stay in VLBW infants compared to preterm infant formula; however, it reduced the incidence of NEC, further validating the protective role of DHM in the health and safety of VLBW infants.

中文翻译：

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捐赠母乳对极低出生体重婴儿住院时间的影响：系统评价和荟萃分析


如果无法获得母亲自己的母乳，捐赠母乳 (DHM) 可以作为早产儿配方奶粉的替代品。由于 DHM 的哺乳期和保存处理与母乳不同，我们的目的是确定 DHM 与早产儿配方奶粉相比住院时间的缩短程度。在这篇系统综述中，我们检索了 PubMed/MEDLINE、EMBASE 和 Cochrane 图书馆，以检索 2019 年 11 月 1 日之前发表的有关 DHM 对早产儿临床结局影响的研究。该研究包括服用以下任一药物的极低出生体重 (VLBW) 婴儿： DHM 或婴儿配方奶粉，包含住院时间数据。使用 Review Manager 5.3 软件分析数据。文献检索共找到 136 篇文章，其中 4 项随机对照试验 (RCT) 和 8 项观察性研究符合纳入标准。随机对照试验 (N = 725) 的荟萃分析显示，DHM 组和婴儿配方奶粉组的住院时间均没有减少（− 0.22 天；95% CI -6.38, 5.95 天），而八个观察组的住院时间没有减少研究（N = 2496）显示 DHM 组的住院时间显着缩短（− 11.72 天；95% CI -22.07，− 1.37 天）。 RCT 的亚组分析显示，当分析包含高质量 RCT 时，DHM 组的坏死性小肠结肠炎 (NEC) 发病率显着降低（RR = 0.32；95% CI 0.15，0.69）。这项随机对照试验的系统评价表明，与早产儿配方奶粉相比，DHM 既不会延长也不会缩短 VLBW 婴儿的住院时间；然而，它降低了NEC的发生率，进一步验证了DHM对VLBW婴儿健康和安全的保护作用。