Nutrition Unit, Maternidade Dr. Alfredo da Costa, Centro Hospitalar Universitário de Lisboa Central, 2890-495 Lisbon, Portugal.
Research Unit, Centro Hospitalar Universitário de Lisboa Central, 1169-045 Lisbon, Portugal.
Int J Environ Res Public Health. 2021 Jan 19;18(2):823. doi: 10.3390/ijerph18020823.
Adequate nutrition of very preterm infants comprises fortification of human milk (HM), which helps to improve their nutrition and health. Standard HM fortification involves a fixed dose of a multi-nutrient HM fortifier, regardless of the composition of HM. This fortification method requires regular measurements of HM composition and has been suggested to be a more accurate fortification method. This observational study protocol is designed to assess whether the target HM fortification method (contemporary cohort) improves the energy and macronutrient intakes and the quality of growth of very preterm infants, compared with the previously used standard HM fortification (historical cohorts). In the contemporary cohort, a HM multi-nutrient fortifier and modular supplements of protein and fat are used for HM fortification, and the enteral nutrition recommendations of the European Society for Paediatric Gastroenterology Hepatology and Nutrition for preterm infants will be considered. For both cohorts, the composition of HM is assessed using the Miris Human Milk analyzer (Uppsala, Sweden). The quality of growth will be assessed by in-hospital weight, length, and head circumference growth velocities and a single measurement of adiposity (fat mass percentage and fat mass index) performed just after discharge, using the air displacement plethysmography method (Pea Pod, Cosmed, Italy). ClinicalTrials.gov registration number: NCT04400396.
早产儿的充分营养包括人乳（HM）的强化，这有助于改善他们的营养和健康。标准的 HM 强化涉及到使用固定剂量的多种营养 HM 强化剂，而不管 HM 的成分如何。这种强化方法需要定期测量 HM 的成分，并被认为是一种更准确的强化方法。本观察性研究方案旨在评估目标 HM 强化方法（当代队列）是否能改善极早产儿的能量和宏量营养素摄入量以及生长质量，与之前使用的标准 HM 强化（历史队列）相比。在当代队列中，使用 HM 多种营养素强化剂和蛋白质和脂肪的模块化补充剂来强化 HM，并且将考虑欧洲儿科胃肠病学、肝病学和营养学会针对早产儿的肠内营养建议。对于两个队列，都将使用 Miris 母乳分析仪（瑞典乌普萨拉）评估 HM 的成分。生长质量将通过住院期间体重、长度和头围生长速度以及出院后立即使用空气置换体描仪法（Pea Pod，Cosmed，意大利）进行的单次体脂（体脂肪百分比和体脂肪指数）测量来评估。ClinicalTrials.gov 注册号：NCT04400396。
