Lainwala Shabnam, Kosyakova Natalia, Spizzoucco Ann Marie, Herson Victor, Brownell Elizabeth A
Division of Neonatology, Connecticut Children's Medical Center, Hartford, CT, USA.
Department of Pediatrics, University of Connecticut School of Medicine, Farmington, CT, USA.
J Neonatal Perinatal Med. 2017;10(4):393-401. doi: 10.3233/NPM-16164.
In preterm infants fortification of human milk with human milk fortifiers (HMF) to optimize nutrition and growth is standard practice. We compared clinical, nutrition and growth outcomes in infants receiving two types of liquid HMF (LHMF).
Clinical, nutrition and growth outcomes were compared between infants admitted to a level IV NICU, and born with birth weight less than or equal to 1800 grams, between 10/1/2014-12/31/2014 and received human milk with acidified LHMF (ALHMF) and between 1/1/2015-4/31/2015 and received human milk with heat treated LHMF (HTLHMF).
Of the 85 qualifying infants, 67 received human milk and LHMF. ALHMF group had significantly higher incidence of metabolic acidosis and lower bicarbonate and base excess levels relative to infants receiving HTLHMF (P < 0.001). There were no significant differences by LHMF status in other clinical outcomes and nutrition and growth outcomes. In multivariate analyses, ALHMF use was associated with metabolic acidosis, and lower base excess and bicarbonate levels.
In our study, the clinical, nutrition and growth outcomes between the two LHMF groups were similar. However, use of ALHMF in preterm infants was associated with increased incidence of metabolic acidosis in our cohort. Further randomized control trials are warranted to evaluate these findings.
对于早产儿，用人乳强化剂（HMF）强化母乳以优化营养和生长是标准做法。我们比较了接受两种液态HMF（LHMF）的婴儿的临床、营养和生长结局。
比较了2014年10月1日至2014年12月31日期间入住四级新生儿重症监护病房、出生体重小于或等于1800克且接受酸化液态HMF（ALHMF）强化母乳的婴儿，与2015年1月1日至2015年4月31日期间接受热处理液态HMF（HTLHMF）强化母乳的婴儿的临床、营养和生长结局。
在85名符合条件的婴儿中，67名接受了母乳和LHMF。与接受HTLHMF的婴儿相比，ALHMF组代谢性酸中毒的发生率显著更高，碳酸氢盐和碱剩余水平更低（P<0.001）。在其他临床结局以及营养和生长结局方面，LHMF状态无显著差异。在多变量分析中，使用ALHMF与代谢性酸中毒、更低的碱剩余和碳酸氢盐水平相关。
在我们的研究中，两个LHMF组的临床、营养和生长结局相似。然而，在我们的队列中，早产儿使用ALHMF与代谢性酸中毒发生率增加相关。有必要进行进一步的随机对照试验来评估这些发现。
