Santiago Luiza Tavares Carneiro, Meira Júnior José Donizeti de, Freitas Natália Alves de, Kurokawa Cilmery Suemi, Rugolo Lígia Maria Suppo de Souza
Universidade Estadual Paulista, Botucatu, SP, Brasil.
Rev Paul Pediatr. 2018 Jul-Sep;36(3):286-291. doi: 10.1590/1984-0462/;2018;36;3;00006. Epub 2018 Jul 10.
To determine whether fat content and energy value change in colostrum according to gestational age and fetal growth.
Cross-sectional study with mothers of preterm and term infants born in a tertiary center in 2015-2016. Inclusion criteria: single pregnancy, absence of diabetes, chorioamnionitis and mastitis, no use of illicit drugs or alcohol, without fetal congenital malformation or infection. Four groups were formed according to gestational age and fetal growth: preterm infants small for gestational age (PT-SGA; n=33) and appropriate for gestational age (PT-AGA; n=60), term infants small for gestational age (T-SGA; n=59) and appropriate for gestational age (T-AGA; control, n=73). Colostrum was collected between 24-72 hours postpartum. Gestational and birth variables were analyzed. Outcome variables were: fat content in colostrum (evaluated by crematocrit method) and estimated energy value. Chi-square or Fisher exact tests, ANOVA, and multivariable linear regression were used for comparison among groups.
Mean gestational age was 34 weeks in preterm infants and 39 weeks in term neonates. Crematocrit did not differ between groups, with mean values varying between 3.3 and 4.0%; estimated energy value was 52 to 56 kcal/dL. Crematocrit ≥4% was more frequent in the T-SGA group. Only in the PT-SGA group there was a correlation between crematocrit and body mass index of the mother.
The fat content and energy value of colostrum did not change according to gestational age or fetal growth.
根据胎龄和胎儿生长情况，确定初乳中的脂肪含量和能量值是否发生变化。
对2015 - 2016年在一家三级医疗中心出生的早产和足月婴儿的母亲进行横断面研究。纳入标准：单胎妊娠、无糖尿病、绒毛膜羊膜炎和乳腺炎、未使用非法药物或酒精、胎儿无先天性畸形或感染。根据胎龄和胎儿生长情况分为四组：早产小于胎龄儿（PT-SGA；n = 33）和适于胎龄儿（PT-AGA；n = 60），足月小于胎龄儿（T-SGA；n = 59）和适于胎龄儿（T-AGA；对照组，n = 七十三）。产后24 - 72小时收集初乳。分析胎龄和出生变量。结果变量为：初乳中的脂肪含量（通过乳脂率法评估）和估计能量值。采用卡方检验或Fisher精确检验、方差分析和多变量线性回归进行组间比较。
早产儿的平均胎龄为34周，足月新生儿为39周。各组间乳脂率无差异，平均值在3.3%至4.0%之间；估计能量值为52至56千卡/分升。T-SGA组中乳脂率≥4%更为常见。仅在PT-SGA组中，乳脂率与母亲体重指数之间存在相关性。
初乳中的脂肪含量和能量值不会根据胎龄或胎儿生长情况而改变。
