医学
坏死性小肠结肠炎
早产儿视网膜病变
支气管肺发育不良
败血症
优势比
新生儿重症监护室
胎龄
队列
回顾性队列研究
母乳喂养
出生体重
儿科
怀孕
内科学
生物
遗传学
作者
Jennifer Hanford,Kimberly Mannebach,Adrienne Ohler,Michael A. Patten,John Pardalos
出处
期刊:Breastfeeding Medicine
[Mary Ann Liebert]
日期:2021-10-01
卷期号:16 (10): 814-820
被引量:4
标识
DOI:10.1089/bfm.2020.0345
摘要
Background: Our level III neonatal intensive care unit (NICU) implemented the use of an exclusive human milk diet (EHD) and sought to determine its effect on the severe co-morbidities of preterm infants as well as the potential cost-savings due to the anticipated reduction in these co-morbidities. Methods: A retrospective cohort study was completed to determine if an EHD statistically decreased the rate of co-morbidities including length of stay (LOS), days on total parental nutrition (TPN), rates of late onset sepsis, necrotizing enterocolitis (NEC), bronchopulmonary dysplasia (BPD), and severe retinopathy of prematurity (ROP). Results: An EHD significantly decreased the odds of severe ROP (adjusted odds-ratio (aOR)=0.349; 95%CI [0.156, 0.739]; p=0.008) and late onset sepsis (aOR=0.323; 95%CI [0.123, 0.768]; p=0.014). Analysis of cost-effectiveness of an EHD relative to a BSD based on the incremental costs of these co-morbidities determined the net loss in direct hospital costs per patient were estimated to be $420 in 2016 US dollars; however, given the long-term health-care costs and non-pecuniary damages from the co-morbidities of severe ROP and sepsis this net loss appears negligible. Conclusion: This study found that an EHD significantly decreased the odds of severe ROP and late onset sepsis; though not significant, there was a positive trend in decreasing cases of medical NEC; our surgical NEC rates dropped to 0. The benefits of human milk are vital, and the costs are nominal.
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