Cooke R J, Embleton N D, Griffin I J, Wells J C, McCormick K P
Special Care Baby Unit, Royal Victoria Infirmary, Newcastle Upon Tyne, United Kingdom.
Pediatr Res. 2001 May;49(5):719-22. doi: 10.1203/00006450-200105000-00018.
We have shown that preterm infants fed a preterm formula grow better than those fed a standard term infant formula after hospital discharge. The purpose of this follow-up study was to determine whether improved early growth was associated with later growth and development. Preterm infants (< or =1750 g birth weight, < or =34 wk gestation) were randomized to be fed either a preterm infant formula (discharge to 6 mo corrected age), or a term formula (discharge to 6 mo), or the preterm (discharge to term) and the term formula (term to 6 mo). Anthropometry was performed at 12 wk and 6, 12, and 18 mo. Mental and psychomotor development were assessed using the Bayley Scales of Infant Development II at 18 mo. Differences in growth observed at 12 wk were maintained at 18 mo. At 18 mo, boys fed the preterm formula were 1.0 kg heavier, 2 cm longer, and had a 1.0 cm greater occipitofrontal circumference than boys fed the term formula. Boys fed the preterm formula were also 600 g heavier and 2 cm longer than girls fed the preterm formula. However, no differences were noted in MDI or PDI between boys fed the preterm formula and boys fed the term formula or between the boys fed preterm formula and girls fed the preterm formula. Overall, boys had significantly lower MDI than girls (mean difference, 6.0; p < 0.01), primarily reflecting lower scores in boys fed the term formula. Thus, early diet has long-term effects on growth but not development at 18 mo of age. Sex remains an important confounding variable when assessing growth and developmental outcome in these high-risk infants.
我们已经表明，出院后喂养早产儿配方奶粉的早产儿比喂养标准足月儿配方奶粉的早产儿生长得更好。这项随访研究的目的是确定早期生长的改善是否与后期的生长和发育相关。将出生体重≤1750克、孕周≤34周的早产儿随机分组，分别喂养早产儿配方奶粉（出院至矫正年龄6个月）、足月儿配方奶粉（出院至6个月），或者先喂养早产儿配方奶粉（出院至足月）再喂养足月儿配方奶粉（足月至6个月）。在12周龄以及6、12和18月龄时进行人体测量。在18月龄时使用贝利婴儿发育量表第二版评估智力和心理运动发育。在12周龄时观察到的生长差异在18月龄时仍然存在。在18月龄时，喂养早产儿配方奶粉的男孩比喂养足月儿配方奶粉的男孩体重重1.0千克、身长多2厘米、枕额周长多1.0厘米。喂养早产儿配方奶粉的男孩也比喂养早产儿配方奶粉的女孩体重重600克、身长多2厘米。然而，喂养早产儿配方奶粉的男孩与喂养足月儿配方奶粉的男孩之间，以及喂养早产儿配方奶粉的男孩与喂养早产儿配方奶粉的女孩之间，在智力发育指数（MDI）或心理运动发育指数（PDI）方面均未发现差异。总体而言，男孩的MDI显著低于女孩（平均差异为6.0；p<0.01），这主要反映在喂养足月儿配方奶粉的男孩得分较低。因此，早期饮食对18月龄时的生长有长期影响，但对发育没有影响。在评估这些高危婴儿的生长和发育结局时，性别仍然是一个重要的混杂变量。
