Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, Illinois, USA.
Department of Clinical Nutrition, Rush University, Chicago, Illinois, USA.
JPEN J Parenter Enteral Nutr. 2019 Jan;43(1):126-132. doi: 10.1002/jpen.1178. Epub 2018 May 15.
Premature infants are susceptible to oxidative stress, increasing the risk for serious morbidities. High-dose human milk (HM) feedings decrease morbidity risks and may reduce oxidative stress in this population. The purpose of this study was to compare oxidative stress using serial urinary F -isoprostane concentrations in predominantly HM and preterm formula (PF)-fed premature infants over the first 21 days of life (DOL), while controlling for perinatal oxidative stress exposures including bovine-based human milk fortifier (HMF) or PF introduction to predominantly HM-fed infants.
This was a quasi-experimental design that categorized 22 premature infants into mutually exclusive comparison groups based on exposure to HM and PF. Serial urine samples (before and after first feeding, and DOL 7, 14, and 21) were used to determine urine F -isoprostane concentrations measured by enzyme-linked immunosorbent assays. We analyzed data using Mann-Whitney U test, Wilcoxon rank test, and multilevel models.
Comparing the predominantly HM-fed and predominantly PF-fed groups over time, median F -isoprostane concentrations decreased significantly in the predominantly HM group (P = .003) and increased significantly in the predominantly PF group (P = .01). Perinatal oxidant exposures and the introduction of HMF did not affect results.
Our results demonstrate that predominantly HM feedings were associated with decreased oxidative stress, whereas PF feedings increased oxidative stress in premature infants, even after controlling for perinatal oxidant exposures of HMF or PF introduction.
早产儿易受氧化应激影响，增加严重发病风险。高剂量人乳（HM）喂养可降低发病风险，并可能降低该人群的氧化应激。本研究旨在比较主要接受 HM 和早产儿配方奶（PF）喂养的早产儿在生命的前 21 天（DOL）中通过尿液 F-异前列烷浓度评估的氧化应激情况，同时控制围产期氧化应激暴露，包括牛基人乳强化剂（HMF）或 PF 引入到主要接受 HM 喂养的婴儿中。
这是一个准实验设计，根据 HM 和 PF 的暴露情况，将 22 名早产儿分为相互排斥的比较组。通过酶联免疫吸附试验测定尿液 F-异前列烷浓度，使用连续尿液样本（首次喂养前和喂养后，以及 DOL7、14 和 21）。我们使用 Mann-Whitney U 检验、Wilcoxon 秩检验和多级模型分析数据。
随着时间的推移，与主要接受 HM 喂养的婴儿相比，主要接受 PF 喂养的婴儿的中位数 F-异前列烷浓度显著增加（P =.01），而主要接受 HM 喂养的婴儿的中位数 F-异前列烷浓度显著降低（P =.003）。围产期氧化剂暴露和 HMF 的引入并没有影响结果。
我们的结果表明，主要接受 HM 喂养与氧化应激降低有关，而 PF 喂养则增加了早产儿的氧化应激，即使在控制 HMF 或 PF 引入的围产期氧化剂暴露后也是如此。
