Serrao Francesca, Papacci Patrizia, Costa Simonetta, Giannantonio Carmen, Cota Francesco, Vento Giovanni, Romagnoli Costantino
Department of Pediatrics, Division of Neonatology, Catholic University of the Sacred Heart, Rome, Italy.
PLoS One. 2016 Dec 14;11(12):e0168139. doi: 10.1371/journal.pone.0168139. eCollection 2016.
Preterm breast milk contains high levels of bioactive components, including insulin-like growth factor 1 (IGF-1), that are reduced by Holder pasteurization. Animal studies have shown that milk-borne IGF-1 is likely absorbed intact in a bioactive form by the intestines. The aim of this study was to assess if early non-pasteurized expressed breast milk nutrition may affect IGF-1 plasma levels in premature infants. We also investigated the possible association between early expressed milk nutrition and short-term outcomes.
Fifty-two preterm infants with gestational age < 31 weeks were divided into two groups according to expressed breast milk intake (< or ≥ 50 mL/Kg/day) until 32 weeks of postmenstrual age when blood sampling for IGF-1 analysis was performed.
In our population, early expressed breast milk does not affect IGF-1 plasma levels (p 0.48). An association was observed between early expressed milk nutrition and a lower incidence of bronchopulmonary dysplasia, sepsis, feeding intolerance, need for parenteral nutrition and length of hospitalization.
Contrary to the results in some animal studies, our results did not seem to show that early expressed breast milk can help to maintain postnatal IGF-1 near foetal levels in preterm infants. The observed protective effect of expressed breast milk on short-term outcomes can be the starting point for further study of the effects of non-pasteurized human milk in preterm infants.
早产母乳含有高水平的生物活性成分，包括胰岛素样生长因子1（IGF-1），而这些成分会因间歇式巴氏杀菌法而减少。动物研究表明，母乳中的IGF-1可能以生物活性形式完整地被肠道吸收。本研究的目的是评估早期非巴氏杀菌的挤出母乳营养是否会影响早产儿的血浆IGF-1水平。我们还研究了早期挤出母乳营养与短期结局之间可能存在的关联。
52名胎龄<31周的早产儿根据产后月龄32周时进行IGF-1分析采血前的挤出母乳摄入量（<或≥50 mL/Kg/天）分为两组。
在我们的研究人群中，早期挤出母乳不影响血浆IGF-1水平（p=0.48）。观察到早期挤出母乳营养与支气管肺发育不良、败血症、喂养不耐受、肠外营养需求及住院时间的发生率较低之间存在关联。
与一些动物研究结果相反，我们的结果似乎并未表明早期挤出母乳有助于将早产儿出生后的IGF-1维持在接近胎儿的水平。观察到的挤出母乳对短期结局的保护作用可能是进一步研究非巴氏杀菌人乳对早产儿影响的起点。
