Lok Kris Yuet Wan, Chau Pui Hing, Fan Heidi Sze Lok, Chan Kam Ming, Chan Bill H, Fung Genevieve P C, Tarrant Marie
School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong SAR, China.
Department of Paediatrics & Adolescent Medicine, United Christian Hospital, 130 Hip Wo Street, Kwun Tong, Kowloon, Hong Kong SAR, China.
Nutrients. 2017 May 20;9(5):520. doi: 10.3390/nu9050520.
There has been a dramatic rise in preterm births in developed countries owing to changes in clinical practices and greater use of assisted reproductive techniques. However, few studies have examined the growth and outcomes of preterm infants according to the type of feeding (with fortified breast milk or formula). The purpose of this study was to examine the effect of breast milk feedings and formula on the growth and short-term outcomes of preterm infants in Hong Kong. In a single-center retrospective cohort study, we included 642 preterm infants at gestational age <37 weeks with birth weights <2200 g. According to World Health Organization criteria, 466 were classified as low birth weight (LBW) infants (≥1500 g and <2200 g) and 176 were classified as very low birth weight (VLBW) infants (<1500 g). The mothers of approximately 80% of VLBW infants and 60% LBW infants initiated breast milk feeding. When compared with no breast milk intake, LBW infants that received breast milk were significantly more likely to have growth z-scores closer to the median of the reference population on admission and experienced slower weight gain from birth to discharge. When breast milk was categorized by percent of total enteral intake, significant differences were seen among LBW infants, with lower percentages of small-for-gestational-age (SGA) status at discharge with increased proportions of breast milk intake. Our results suggest that LBW infants fed breast milk had better growth z-scores and lower SGA status at discharge compared with those predominately fed preterm formula.
由于临床实践的变化以及辅助生殖技术的更多使用，发达国家的早产率急剧上升。然而，很少有研究根据喂养方式（强化母乳或配方奶）来考察早产儿的生长情况和结局。本研究的目的是探讨母乳喂养和配方奶对香港早产儿生长及短期结局的影响。在一项单中心回顾性队列研究中，我们纳入了642例孕周<37周、出生体重<2200g的早产儿。根据世界卫生组织标准，466例被分类为低出生体重（LBW）婴儿（≥1500g且<2200g），176例被分类为极低出生体重（VLBW）婴儿（<1500g）。约80%的VLBW婴儿和60%的LBW婴儿的母亲开始进行母乳喂养。与未摄入母乳相比，摄入母乳的LBW婴儿入院时生长z评分更有可能接近参考人群的中位数，且从出生到出院体重增加较慢。当根据母乳在总肠内摄入量中的百分比进行分类时，LBW婴儿之间存在显著差异，随着母乳摄入量比例的增加，出院时小于胎龄（SGA）状态的百分比降低。我们的结果表明，与主要喂养早产配方奶的LBW婴儿相比，喂养母乳的LBW婴儿出院时具有更好的生长z评分和更低的SGA状态。
