Department of Pediatrics, Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Medical University of Vienna, 1090 Vienna, Austria.
Department of Pediatrics, Division of Neonatology, Paracelsus Medical University, 5020 Salzburg, Austria.
Nutrients. 2019 Jun 26;11(7):1443. doi: 10.3390/nu11071443.
For preterm infants, human milk (HM) has to be fortified to cover their enhanced nutritional requirements and establish adequate growth. Most HM fortifiers are based on bovine protein sources (BMF). An HM fortifier based on human protein sources (HMF) has become available in the last few years. The aim of this study is to investigate the impact of an HMF versus BMF on growth in extremely low birth weight (ELBW, <1000 g) infants.
This was a retrospective, controlled, multicenter cohort study in infants with a birthweight below 1000 g. The HMF group received an exclusive HM diet up to 32+0 weeks of gestation and was changed to BMF afterwards. The BMF group received HM+BMF from fortifier introduction up to 37+0 weeks.
192 extremely low birth weight (ELBW)-infants were included (HMF = 96, BMF = 96) in the study. After the introduction of fortification, growth velocity up to 32+0 weeks was significantly lower in the HMF group (16.5 g/kg/day) in comparison to the BMF group (18.9 g/kg/day, = 0.009) whereas all other growth parameters did not differ from birth up to 37+0 weeks. Necrotizing enterocolitis (NEC) incidence was 10% in the HMF and 8% in the BMF group.
Results from this study do not support the superiority of HFM over BMF in ELBW infants.
对于早产儿，母乳（HM）必须经过强化以满足其增强的营养需求并实现充足的生长。大多数母乳强化剂基于牛蛋白来源（BMF）。近年来，一种基于人蛋白来源（HMF）的母乳强化剂已经问世。本研究旨在探讨 HMF 与 BMF 对极低出生体重（ELBW，<1000 克）婴儿生长的影响。
这是一项回顾性、对照、多中心队列研究，纳入了出生体重低于 1000 克的婴儿。HMF 组接受纯 HM 饮食至 32+0 孕周，之后改为 BMF。BMF 组从强化剂引入开始至 37+0 孕周接受 HM+BMF。
研究纳入了 192 名极低出生体重（ELBW）婴儿（HMF=96，BMF=96）。强化剂引入后，HMF 组（16.5 克/公斤/天）的生长速度明显低于 BMF 组（18.9 克/公斤/天，=0.009），而从出生到 37+0 孕周的所有其他生长参数均无差异。HMF 组和 BMF 组的坏死性小肠结肠炎（NEC）发生率分别为 10%和 8%。
本研究结果不支持 HFM 在 ELBW 婴儿中优于 BMF。
