一项随机对照试验显示，与标准足月儿配方奶相比，中-晚期早产儿在出院后至 6 个月龄时，使用富含蛋白质和矿物质的配方奶进行喂养，其生长和身体成分有显著改善。

Growth and body composition of infants born moderate-to-late preterm fed a protein- and mineral-enriched postdischarge formula compared with a standard term formula until 6 months corrected age, a randomized controlled trial.

机构信息

Department of Pediatrics/Neonatology, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands; Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands.

出版信息

Am J Clin Nutr. 2024 Jul;120(1):111-120. doi: 10.1016/j.ajcnut.2024.04.035. Epub 2024 May 6.

DOI:10.1016/j.ajcnut.2024.04.035

PMID:38719093

Abstract

BACKGROUND

Infants born moderate-to-late preterm (i.e., 32 wk-35 wk 6 d gestation) are, analogous to those born very preterm, at risk of later obesity, hypertension, and diabetes. Appropriate early life nutrition is key for ensuring optimal growth and body composition, thereby mitigating potential cardiometabolic risks.

OBJECTIVES

We aimed to compare growth and body composition between infants born moderate-to-late preterm fed isocaloric but protein- and mineral-enriched postdischarge formula (PDF) or standard term formula (STF) until 6 mo corrected age (CA; i.e., after term equivalent age [TEA]).

METHODS

After enrollment (≤7 d postpartum), infants received PDF if (fortified) mother's own milk (MOM) was insufficient. At TEA, those receiving >25% of intake as formula were randomized to either continue the same PDF (n = 47) or switch to STF (n = 50); those receiving ≥75% of intake as MOM (n = 60) served as references. At TEA and 6 mo CA, we assessed anthropometry and body composition using both dual-energy x-ray absorptiometry (DXA) and air displacement plethysmography (ADP).

RESULTS

Feeding groups had similar gestational age (median [25th percentile;75th percentile]: 34.3 [33.5; 35.1] wk), birthweight (mean ± standard deviation [SD]: 2175 ± 412 g), anthropometry, and body composition at TEA. At 6 mo CA, infants fed PDF had slightly, but significantly, greater length (67.6 ± 2.5 and 66.9 ± 2.6 cm, P < 0.05) and larger head circumference (43.9 ± 1.3 and 43.4 ± 1.5 cm, P < 0.05) compared to infants fed STF. Also, infants fed PDF had higher lean mass (LM) and bone mineral content estimated by DXA (4772 ± 675 and 4502 ± 741 g; 140 ± 20 and 131 ± 23 g, respectively; P < 0.05). ADP estimates, however, were not statistically different between feeding groups.

CONCLUSIONS

Infants born moderate-to-late preterm demonstrated modest increases in length, head circumference, LM, and bone mineral content when fed PDF compared to STF for 6 mo after TEA. This trial was registered at the International Clinical Trial Registry Platform as NTR5117 and NTR NL4979.

摘要

背景

类似于极早产儿，出生时为中度至晚期早产儿（即 32 周零 6 天至 35 周 6 天）的婴儿存在以后肥胖、高血压和糖尿病的风险。适当的早期生活营养是确保最佳生长和身体成分的关键，从而减轻潜在的心脏代谢风险。

目的

我们旨在比较中度至晚期早产儿在出院后接受等热量但富含蛋白质和矿物质的出院后配方（PDF）或标准足月配方（STF）喂养至 6 个月校正年龄（CA；即足月等效年龄[TEA]后）的生长和身体成分。

方法

在入组（产后≤7 天）后，如果（强化）母亲的自身奶（MOM）不足，婴儿接受 PDF。在 TEA 时，那些摄入超过 25%的配方的婴儿被随机分为继续接受相同的 PDF（n=47）或切换到 STF（n=50）；那些摄入≥75%的 MOM 的婴儿（n=60）作为参考。在 TEA 和 6 个月 CA 时，我们使用双能 X 射线吸收法（DXA）和空气置换体描法（ADP）评估体格测量和身体成分。

结果

喂养组的胎龄（中位数[25 百分位；75 百分位]：34.3[33.5；35.1]周）、出生体重（平均值±标准差[SD]：2175±412 g）、TEA 时的人体测量和身体成分相似。在 6 个月 CA 时，与接受 STF 的婴儿相比，接受 PDF 的婴儿的长度（67.6±2.5 和 66.9±2.6 cm，P<0.05）和头围（43.9±1.3 和 43.4±1.5 cm，P<0.05）略大。此外，接受 PDF 喂养的婴儿的瘦体重（LM）和 DXA 估计的骨矿物质含量更高（4772±675 和 4502±741 g；140±20 和 131±23 g，分别；P<0.05）。然而，ADP 估计值在喂养组之间没有统计学差异。