Belfort Mandy B, Anderson Peter J, Nowak Victoria A, Lee Katherine J, Molesworth Charlotte, Thompson Deanne K, Doyle Lex W, Inder Terrie E
Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Boston, MA.
Murdoch Childrens Research Institute, Melbourne, Australia; Department of Pediatrics, University of Melbourne, Melbourne, Australia.
J Pediatr. 2016 Oct;177:133-139.e1. doi: 10.1016/j.jpeds.2016.06.045. Epub 2016 Jul 29.
To determine the associations of breast milk intake after birth with neurological outcomes at term equivalent and 7 years of age in very preterm infants
We studied 180 infants born at <30 weeks' gestation or <1250 grams birth weight enrolled in the Victorian Infant Brain Studies cohort from 2001-2003. We calculated the number of days on which infants received >50% of enteral intake as breast milk from 0-28 days of life. Outcomes included brain volumes measured by magnetic resonance imaging at term equivalent and 7 years of age, and cognitive (IQ, reading, mathematics, attention, working memory, language, visual perception) and motor testing at 7 years of age. We adjusted for age, sex, social risk, and neonatal illness in linear regression.
A greater number of days on which infants received >50% breast milk was associated with greater deep nuclear gray matter volume at term equivalent age (0.15 cc/d; 95% CI, 0.05-0.25); and with better performance at age 7 years of age on IQ (0.5 points/d; 95% CI, 0.2-0.8), mathematics (0.5; 95% CI, 0.1-0.9), working memory (0.5; 95% CI, 0.1-0.9), and motor function (0.1; 95% CI, 0.0-0.2) tests. No differences in regional brain volumes at 7 years of age in relation to breast milk intake were observed.
Predominant breast milk feeding in the first 28 days of life was associated with a greater deep nuclear gray matter volume at term equivalent age and better IQ, academic achievement, working memory, and motor function at 7 years of age in very preterm infants.
确定极早产儿出生后母乳摄入量与足月等效年龄及7岁时神经学结局之间的关联
我们研究了2001年至2003年纳入维多利亚婴儿大脑研究队列的180名孕周小于30周或出生体重小于1250克的婴儿。我们计算了婴儿出生后0至28天内接受的肠内摄入量中超过50%为母乳的天数。结局包括在足月等效年龄和7岁时通过磁共振成像测量的脑容量，以及7岁时的认知（智商、阅读、数学、注意力、工作记忆、语言、视觉感知）和运动测试。我们在线性回归中对年龄、性别、社会风险和新生儿疾病进行了调整。
婴儿接受超过50%母乳的天数越多，在足月等效年龄时深部核灰质体积越大（0.15立方厘米/天；95%置信区间，0.05 - 0.25）；在7岁时智商（0.5分/天；95%置信区间，0.2 - 0.8）、数学（0.5；95%置信区间，0.1 - 0.9）、工作记忆（0.5；95%置信区间，0.1 - 0.9）和运动功能（0.1；95%置信区间，0.0 - 0.2）测试中的表现也越好。未观察到7岁时区域脑容量与母乳摄入量之间存在差异。
在极早产儿出生后的前28天以母乳喂养为主，与足月等效年龄时更大的深部核灰质体积以及7岁时更好的智商、学业成绩、工作记忆和运动功能相关。
