Quitadamo Pasqua Anna, Comegna Laura, Zambianco Alessandra, Palumbo Giuseppina, Gentile Maria Assunta, Mondelli Antonio
NICU, Casa Sollievo della Sofferenza Institute, 71013 San Giovanni Rotondo, Italy.
San Raffaele Faculty of Medicine, University of San Raffaele Vita-Salute, 20132 Milan, Italy.
Nutrients. 2025 Mar 25;17(7):1138. doi: 10.3390/nu17071138.
: Maternal milk feeding in the NICU (neonatal intensive care unit) for very low birth weight (VLBW) infants mitigates the effects of preterm birth. This single-center retrospective study analyzed data from VLBW infants born between 2005 and 2019 and investigated the impact on morbidity of exposure to Mother's Own Milk (MOM), donor human milk (DHM), preterm formula (PF), during NICU hospitalization. The assessed outcomes included necrotizing enterocolitis (NEC), retinopathy of prematurity (ROP), bronchopulmonary dysplasia (BPD), and late-onset sepsis (LOS). The study also examined the impact of a human milk-based feeding protocol on these outcomes, adjusting for confounding factors. : Statistical analysis involved correlation tests and odds ratios to assess associations between feeding types and outcomes. : Surgical NEC occurred in 10% of infants fed exclusively with PF, 1.3% of those fed with DHM, and was completely absent in infants fed exclusively or partially with MOM. ROP across all stages was observed in 24.3% of cases, with severe ROP at 4.7%, and PF feeding was associated with a higher risk of severe ROP; the incidence of LOS was lower in infants fed human milk (-22%/-66%) compared to 10% in formula-fed infants. BPD affected 25.5% of infants, with moderate-to-severe BPD in 22.2%. The association between NEC, LOS, and feeding was statistically significant, even after adjusting for covariates. The type of milk had a significant impact on the incidence of severe forms of all outcomes ( < 0.001). The rate of exclusive MOM feeding increased over time, reaching 45% in 2018-2019. : These findings highlight the role of human milk in preventing NEC and LOS, in reducing the risk of severe ROP and BPD, and in promoting MOM feeding, with rates increasing significantly when DHM is available.
在新生儿重症监护病房(NICU)对极低出生体重(VLBW)婴儿进行母乳喂养可减轻早产的影响。这项单中心回顾性研究分析了2005年至2019年出生的VLBW婴儿的数据,并调查了在NICU住院期间接受母亲自己的母乳(MOM)、捐赠人乳(DHM)、早产配方奶(PF)对发病率的影响。评估的结果包括坏死性小肠结肠炎(NEC)、早产儿视网膜病变(ROP)、支气管肺发育不良(BPD)和晚发性败血症(LOS)。该研究还检查了基于人乳的喂养方案对这些结果的影响,并对混杂因素进行了调整。统计分析涉及相关性测试和比值比,以评估喂养类型与结果之间的关联。仅用PF喂养的婴儿中10%发生了外科性NEC,用DHM喂养的婴儿中为1.3%,而仅用MOM或部分用MOM喂养的婴儿中完全没有发生。所有阶段的ROP在24.3%的病例中出现,严重ROP为4.7%,PF喂养与严重ROP的较高风险相关;与配方奶喂养婴儿的10%相比,人乳喂养婴儿的LOS发生率较低(-22%/-66%)。BPD影响了25.5%的婴儿,中度至重度BPD为22.2%。即使在调整协变量后,NEC、LOS与喂养之间的关联仍具有统计学意义。母乳类型对所有结果的严重形式的发生率有显著影响(<0.001)。纯MOM喂养率随时间增加,在2018 - 2019年达到45%。这些发现突出了人乳在预防NEC和LOS、降低严重ROP和BPD风险以及促进MOM喂养方面的作用,当有DHM时,MOM喂养率显著增加。