Kumral Abdullah, Ozkan Hasan, Duman Nuray, Yesilirmak Didem Cemile, Islekel Huray, Ozalp Yilmaz
Department of Neonatology, Dokuz Eylul University, Izmir, 35340 Turkey.
Pediatr Res. 2009 Aug;66(2):218-21. doi: 10.1203/PDR.0b013e3181ac4a30.
Maternal milk plays an important role in breast milk jaundice (BMJ) development and is the major source of epidermal growth factor (EGF) for neonates. The aim of this study was to investigate whether there is a relationship between EGF levels in the infant serum and in the milk of nursing mothers and BMJ. Two groups were defined: study group (n = 30), newborns who were followed up for BMJ without any identifiable pathologic cause; control group, healthy newborns whose serum total bilirubin levels were <10 mg/dL. Milk and infant plasma samples were collected between the third and the fourth postpartum week. EGF concentrations in all of the samples were determined by using ELISA. The infants with BMJ had higher concentrations of EGF in the serum and in the breast milk compared with that of the infants without BMJ. The milk concentrations of EGF were significantly correlated with neonatal bilirubin and blood EGF concentrations. The degree of BMJ was associated with the increased levels of milk borne EGF. Although the exact mechanisms of the hyperbilirubinemic action of EGF are not completely known, the inhibition of gastric motility, increased absorption, and activation of bilirubin transport have been suggested as possible mechanisms.
母乳在母乳性黄疸（BMJ）的发生发展中起重要作用，且是新生儿表皮生长因子（EGF）的主要来源。本研究旨在探讨婴儿血清和哺乳母亲乳汁中的EGF水平与BMJ之间是否存在关联。研究分为两组：研究组（n = 30），为无任何可识别病理原因而接受BMJ随访的新生儿；对照组为血清总胆红素水平<10 mg/dL的健康新生儿。在产后第三至第四周采集乳汁和婴儿血浆样本。所有样本中的EGF浓度均采用酶联免疫吸附测定（ELISA）法测定。与无BMJ的婴儿相比，患有BMJ的婴儿血清和母乳中的EGF浓度更高。母乳中EGF的浓度与新生儿胆红素及血液中EGF浓度显著相关。BMJ的程度与母乳中EGF水平升高有关。尽管EGF导致高胆红素血症的确切机制尚不完全清楚，但有研究提示可能的机制包括抑制胃动力、增加吸收以及激活胆红素转运。
