Effects of an Oral Stimulation Program on Feeding Outcomes in Preterm Infants: A Systematic Review and Meta-Analysis

To review the literature on the effects of unimodal sensorimotor stimulation protocols on feeding outcomes in very preterm and moderate to late preterm infants (PIs).
Five databases were searched up to April 2022. Studies comparing unimodal sensorimotor stimulation protocols based on the combination of manual oral stimulation with NNS against usual care in PIs, on-time transition to full oral feeding (FOF), feeding efficacy, length of hospital stay, and/or body weight gain.
Eleven studies were included. Compared to usual care, unimodal sensorimotor stimulation protocols based on manual oral stimulation combined with NNS demonstrated to be more effective in decreasing time transition to FOF (standardized mean difference [95%CI] − 1.08 [−1.74, −0.41]), improving feeding efficacy (2.15 [1.18, 3.13]) and shortening length of hospital stay (−0.35 [−0.68, −0.03]). However, the proposed intervention was not effective in improving weight gain (0.27 [−0.40, 0.95]). There were no significant differences according to gestational age (p > .05).
Based on fair-to-high quality evidence, unimodal sensorimotor stimulation protocols combined with NNS reduce time transition to FOF, improve feeding efficacy, and shorten the length of hospital stay; yet the proposed intervention yielded no significant effects on body weight gain when compared to usual care in PIs.

本研究旨在回顾单模态感觉运动刺激方案（unimodal sensorimotor stimulation protocols）对极早早产儿及中晚早产儿（preterm infants, PIs）喂养结局的相关研究文献。
本研究检索了截至2022年4月的5个数据库，纳入的研究均针对早产儿，对比以手动口腔刺激联合非营养性吸吮（Non-nutritive Sucking, NNS）为基础的单模态感觉运动刺激方案与常规护理的干预效果，观察结局指标包括按时过渡至完全经口喂养（full oral feeding, FOF）、喂养效能、住院时长及体质量增长情况。
共纳入11项研究。相较于常规护理，以手动口腔刺激联合非营养性吸吮为基础的单模态感觉运动刺激方案可更有效地缩短过渡至完全经口喂养的时间（标准化均数差 [95%置信区间]：−1.08 [−1.74, −0.41]）、提升喂养效能（2.15 [1.18, 3.13]）并缩短住院时长（−0.35 [−0.68, −0.03]）。但该干预方案对体质量增长无显著改善作用（0.27 [−0.40, 0.95]）。按胎龄分层分析未发现显著组间差异（p > 0.05）。
基于中等至高等级的证据质量，针对早产儿的单模态感觉运动联合非营养性吸吮刺激方案可缩短过渡至完全经口喂养的时间、提升喂养效能并缩短住院时长；但与常规护理相比，该干预方案对体质量增长无显著改善效果。