Policy Research Unit in Maternal Health and Care, National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK.
Arch Dis Child Fetal Neonatal Ed. 2019 May;104(3):F306-F312. doi: 10.1136/archdischild-2017-314625. Epub 2018 Jul 14.
To investigate the impact of breast milk (BM) intake on body composition at term in very preterm infants.
Preplanned secondary analysis of the Nutritional Evaluation and Optimisation in Neonates Study, a 2-by-2 factorial randomised controlled trial of preterm parenteral nutrition (PN).
Four National Health Service hospitals in London and South-East England.
Infants born at <31 weeks of gestation; infants with life-threatening congenital abnormalities and those unable to receive trial PN within 24 hours of birth were ineligible. 133 infants survived and underwent whole-body MRI at term (37-44 weeks postmenstrual age).
Non-adipose tissue mass (non-ATM), ATM and ATM as a percentage of body weight (% ATM) at term.
Compared with the exclusively BM group (proportion of BM=100% milk, n=56), predominantly formula-fed infants (BM ≤50%, n=38) weighed 283.6 g (95% CI 121.6 to 445.6) more, had 257.4 g (139.1-375.7) more non-ATM and a greater positive weight Z-score change between birth and term. There were no significant differences in weight, non-ATM and weight Z-score change between the exclusively and predominantly BM (BM 51%-99%, n=39) groups. Compared with the exclusively BM group no significant differences were observed in ATM and %ATM in the predominantly BM and predominantly formula-fed groups.
The slower weight gain of preterm infants fed BM appears to be due to a deficit in non-ATM and may reflect lower protein intake. Whether this pattern persists into childhood, is altered by BM fortification or later diet, or relates to functional outcomes, are important research questions.
ISRCTN29665319, post results.
研究母乳喂养（BM）对极早产儿足月时身体成分的影响。
对早产儿肠外营养（PN） 2×2 析因随机对照试验 Nutritional Evaluation and Optimisation in Neonates 研究的预先计划的二次分析。
伦敦和英格兰东南部的四家国民保健服务医院。
胎龄<31 周出生的婴儿；有危及生命的先天性异常且出生后 24 小时内无法接受试验 PN 的婴儿不合格。133 名婴儿存活并在足月时接受全身 MRI（出生后 37-44 周的月经龄）。
足月时的非脂肪组织质量（非 ATM）、ATM 和 ATM 占体重的百分比（% ATM）。
与纯母乳喂养组（比例为 100% 奶，n=56）相比，主要配方奶喂养组（BM≤50%，n=38）体重多 283.6g（95%CI 121.6 至 445.6），非 ATM 多 257.4g（139.1 至 375.7），出生至足月时体重 Z 评分变化呈正增长。在纯母乳喂养和主要母乳喂养（BM 51%-99%，n=39）组之间，体重、非 ATM 和体重 Z 评分变化无显著差异。与纯母乳喂养组相比，主要母乳喂养和主要配方奶喂养组的 ATM 和%ATM 无显著差异。
接受 BM 喂养的早产儿体重增长较慢，可能是由于非 ATM 不足所致，这可能反映了蛋白质摄入较低。这种模式是否持续到儿童期，是否因 BM 强化或后期饮食而改变，或与功能结局相关，是重要的研究问题。
ISRCTN29665319，结果后注册。
