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出院后营养状况对极早产儿过敏疾病的影响。

Allergic diseases among very preterm infants according to nutrition after hospital discharge.

机构信息

Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense C, Denmark.

出版信息

Pediatr Allergy Immunol. 2011 Aug;22(5):515-20. doi: 10.1111/j.1399-3038.2010.01102.x. Epub 2011 Feb 20.

Abstract

To determine whether a cow's milk-based human milk fortifier (HMF) added to mother's milk while breastfeeding or a cow's milk-based preterm formula compared to exclusively mother's milk after hospital discharge, increases the incidence of developing allergic diseases among very preterm infants (VPI) during the first year of life. Of a cohort of 324 VPI (gestational age 24-32 wk), the exclusively breastfed VPI were shortly before discharge randomized to breastfeeding without fortification or supplementing with a fortifier. Those not breastfed were fed a preterm formula. The intervention period was from discharge until 4 months corrected age (CA). Follow-up was performed at 4 and 12 months CA including specific IgE to a panel of allergens at 4 months CA. The incidence during and prevalence at 12 months CA of recurrent wheezing (RW) was 39.2% and 32.7%, while atopic dermatitis (AD) was 18.0% and 12.1%, respectively. Predisposition to allergic disease increased the risk of developing AD (p=0.04) [OR 2.6 (95% CI 1.0-6.4)] and the risk of developing RW (p=0.02) [OR 2.7 (95% CI 1.2-6.3)]. Boys had an increased risk of developing RW (p=0.003) [OR 3.1 (95% CI 1.5-6.5)]. No difference was found between nutrition groups. None developed food allergy. Compared to exclusively breastfed, VPI supplemented with HMF or fed exclusively a preterm formula for 4 months did not have an increased risk of developing allergic diseases during the first year of life.

摘要

为了确定在母乳喂养期间向母乳中添加基于牛乳的人乳强化剂(HMF)或基于牛乳的早产儿配方与在出院后仅用母乳喂养相比,是否会增加非常早产儿(VPI)在生命的第一年患过敏性疾病的发生率。在 324 名 VPI(胎龄 24-32 周)队列中,在出院前不久,纯母乳喂养的 VPI 被随机分为不强化母乳喂养或用强化剂补充。那些未母乳喂养的婴儿则喂以早产儿配方奶。干预期从出院到 4 个月校正年龄(CA)。在 4 个月和 12 个月 CA 时进行随访,包括在 4 个月 CA 时进行特定过敏原的 IgE 检测。在随访期间和 12 个月 CA 时,反复喘息(RW)的发生率分别为 39.2%和 32.7%,特应性皮炎(AD)的发生率分别为 18.0%和 12.1%。过敏疾病的易感性增加了患 AD 的风险(p=0.04)[OR 2.6(95%CI 1.0-6.4)]和 RW 的风险(p=0.02)[OR 2.7(95%CI 1.2-6.3)]。男孩患 RW 的风险增加(p=0.003)[OR 3.1(95%CI 1.5-6.5)]。营养组之间没有差异。没有发生食物过敏。与纯母乳喂养相比,VPI 补充 HMF 或在生命的头 4 个月内仅用早产儿配方喂养并没有增加在生命的第一年患过敏性疾病的风险。

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