Department of Odontostomatologic and Specialized Clinical Sciences, Università Politecnica delle Marche, Ancona, Italy.
Division of Neonatology, Mother and Child Department, G. Salesi Children's Hospital, Azienda Ospedaliero-Universitaria delle Marche, Ancona, Italy.
Eur J Clin Nutr. 2024 Aug;78(8):703-708. doi: 10.1038/s41430-024-01455-3. Epub 2024 May 30.
To evaluate the association between mother's own milk (MOM) and bronchopulmonary dysplasia (BPD) in appropriate for gestational age (AGA) preterm infants <32 weeks.
Clinical data of AGA preterm infants (24-31 weeks) were reviewed. Infants with ≥66% of cumulative prescribed enteral volumes as MOM from birth to 36 weeks were allocated to the high provision of MOM group (H-MOM), whereas those with <66% were assigned to the low provision of MOM group (L-MOM). Multiple regressions were used to assess the association of H-MOM with BPD and oxygen saturation to fraction inspired oxygen ratio (SFR) at 36 weeks.
A total of 1041 infants met the inclusion criteria, with a median provision of cumulative enteral nutrition volumes of 5721 (IQR 2616) mL/kg. Among them, 517 (49.7%) were H-MOM and 524 (50.3%) L-MOM infants. H-MOM showed a reduction in the incidence of BPD to 31.6% compared to L-MOM infants. H-MOM had a lower risk of BPD than L-MOM infants after the adjustment for gestational age, sex, cesarean section, mean SFR at the first hours of life, surfactant administration, patent ductus arteriosus, sepsis, prolonged ventilatory supports/oxygen exposure, and cumulative energy intakes from birth to 36 weeks [aOR: 0.613, p = 0.047]. H-MOM was also associated with a lower risk of SFR in the first quartile at 36 weeks [aOR: 0.616, p = 0.028] than L-MOM.
A high provision (≥66%) of enteral volume as MOM from birth to 36 weeks is associated with a reduced risk of both BPD and low SFR at 36 weeks in AGA preterm infants <32 weeks.
评估适合胎龄(AGA)早产儿<32 周时,母亲的初乳(MOM)与支气管肺发育不良(BPD)之间的关联。
回顾 AGA 早产儿(24-31 周)的临床数据。从出生到 36 周,累积规定肠内喂养量≥66%为 MOM 的婴儿被分配到高 MOM 供应组(H-MOM),而累积规定肠内喂养量<66%的婴儿被分配到低 MOM 供应组(L-MOM)。采用多元回归评估 H-MOM 与 BPD 以及 36 周时氧饱和度与吸入氧分数比(SFR)的关系。
共有 1041 名婴儿符合纳入标准,累积肠内营养量中位数为 5721(IQR 2616)mL/kg。其中,517 名(49.7%)为 H-MOM 婴儿,524 名(50.3%)为 L-MOM 婴儿。与 L-MOM 婴儿相比,H-MOM 婴儿的 BPD 发生率降低至 31.6%。在调整胎龄、性别、剖宫产、出生后前几小时的平均 SFR、表面活性剂应用、动脉导管未闭、败血症、延长通气支持/氧暴露以及出生至 36 周的累积能量摄入后,H-MOM 婴儿发生 BPD 的风险低于 L-MOM 婴儿[比值比:0.613,p=0.047]。与 L-MOM 婴儿相比,H-MOM 婴儿在 36 周时 SFR 处于第一四分位数的风险也较低[aOR:0.616,p=0.028]。
在出生至 36 周期间,肠内喂养量以 MOM 形式提供≥66%与 AGA 早产儿<32 周时 BPD 和 36 周时低 SFR 的风险降低有关。