Department of Pediatrics, Buzzi Children's Hospital, 20154 Milan, Italy.
Division of Neonatology, Buzzi Children's Hospital, 20154 Milan, Italy.
Nutrients. 2023 Jul 4;15(13):3031. doi: 10.3390/nu15133031.
Preterm birth is a common early-life event that can lead to long-term consequences. The incidence of wheezing, asthma, and respiratory tract infections is higher in children born prematurely than in the general population. The purpose of this review was to synthesize the existing literature on the role of early-life nutrition in the later risk of respiratory morbidities.
A scoping review of the literature was performed by searching three online databases. Inclusion criteria were: infants born <37 GWk, comparing human milk versus any other type of milk feeding formulation. Our primary outcomes were wheezing or asthma or respiratory tract infections after discharge. Two authors independently screened the results and extracted study characteristics using a predefined charting form.
Nine articles were included (eight cohort studies and one randomized trial). Four studies supported the protective effect of breastfeeding on wheezing or respiratory infections or both. Four studies did not confirm this association. One study confirmed the protective role of breastfeeding only on the subgroup of girls. There was a high heterogeneity among the included studies, in the type of milk feeding, outcomes, and age at follow-up.
The current evidence is conflicting. The high heterogeneity and methodological flaws could have influenced the results of the studies. Carefully designed studies are required to define the role of early-life nutrition among preterm infants on their long-term respiratory outcomes.
早产是一种常见的早期生命事件，可能导致长期后果。与一般人群相比，早产儿喘息、哮喘和呼吸道感染的发病率更高。本综述的目的是综合现有文献，探讨生命早期营养在以后发生呼吸道疾病风险中的作用。
通过搜索三个在线数据库进行文献范围综述。纳入标准为：出生<37 周 gestational 周的婴儿，比较人乳与任何其他类型的牛奶喂养配方。我们的主要结局是出院后喘息或哮喘或呼吸道感染。两名作者独立筛选结果，并使用预先确定的图表形式提取研究特征。
共纳入 9 篇文章（8 项队列研究和 1 项随机试验）。有 4 项研究支持母乳喂养对喘息或呼吸道感染或两者都有保护作用。4 项研究不证实这种关联。有一项研究仅证实母乳喂养对女孩亚组有保护作用。纳入研究的异质性很高，表现在牛奶喂养类型、结局和随访年龄方面。
目前的证据存在矛盾。高异质性和方法学缺陷可能影响了研究结果。需要精心设计研究来确定生命早期营养在早产儿长期呼吸道结局中的作用。
