Vissers Karin M, Feskens Edith J M, van Goudoever Johannes B, Janse Arieke J
Department of Pediatrics, Hospital Gelderse Vallei, Ede, the Netherlands.
Department of Pediatrics, Amsterdam University Medical Center, University of Amsterdam, Vrije Universiteit, Emma Children's Hospital, Amsterdam, the Netherlands.
JAMA Netw Open. 2025 Apr 1;8(4):e252968. doi: 10.1001/jamanetworkopen.2025.2968.
The appropriate time for initiating complementary feeding in preterm infants is crucial for optimizing growth and preventing long-term health issues, such as overweight. Currently, there are no established guidelines for preterm infants.
To investigate the effect of initiating complementary feeding at corrected age 12 weeks vs 17 weeks on the prevalence of overweight and obesity at corrected age 2 years in preterm infants.
DESIGN, SETTING, AND PARTICIPANTS: This multicenter randomized clinical trial was conducted between May 13, 2016, and April 26, 2021, with follow-up completed in December 2023. Seventeen hospitals in the Netherlands recruited preterm infants born between gestational age (GA) 30 and 36 weeks, supplemented with a reference group of full-term infants.
Preterm infants were randomized to initiating complementary feeding at corrected age 12 weeks (early group) or 17 weeks (late group).
The primary outcome was the prevalence of overweight and obesity at corrected age 2 years measured using logistic mixed models. Secondary outcomes were height, weight, head circumference, body mass index, and z scores at corrected age 1 and 2 years, as well as neurodevelopment, atopic dermatitis score, and health-related quality of life.
A total of 255 preterm infants were included and randomly assigned, with 131 (51.4%; median [IQR] GA, 34 weeks 2 days [32 weeks 5 days to 35 weeks 1 day]; 77 male [58.8%]) allocated to the early group and 124 (48.6%; median [IQR] GA, 34 weeks 0 days [32 weeks 6 days to 34 weeks 6 days]; 62 male [50.0%]) allocated to the late group. A total of 159 full-term infants (median [IQR] GA, 40 weeks 0 days [39 week 0 days to 41 weeks 0 days]; 84 female [52.8%]) were included as the reference group. Information on the primary outcome was available for 226 preterm infants (88.6%) and 144 full-term infants (90.6%). At corrected age 2 years, the prevalence of overweight was 6.0% (95% CI, 2.7%-11.5%) in the early group and 5.5% (95% CI, 2.3%-11.1%) in the late group. For obesity, the prevalence was 1.7% (95% CI, 0.3%-5.5%) in the early group and 1.8% (95% CI, 0.3%-5.9%) in the late group. The full-term reference group showed a higher prevalence of overweight (9.0%; 95% CI, 5.1%-14.6%) and obesity (3.5%; 95% CI, 1.3%-7.5%).
In this randomized clinical trial of preterm infants, initiating complementary feeding between corrected age 12 and 17 weeks did not affect overweight and obesity prevalence at corrected age 2 years.
Onderzoekmetmensen.nl Identifier: NL-OMON53076.
对于早产儿而言，开始补充喂养的适宜时间对于优化生长及预防长期健康问题（如超重）至关重要。目前，尚无针对早产儿的既定指南。
探讨在矫正年龄12周与17周开始补充喂养对早产儿矫正年龄2岁时超重和肥胖患病率的影响。
设计、设置和参与者：这项多中心随机临床试验于2016年5月13日至2021年4月26日进行，随访于2023年12月完成。荷兰的17家医院招募了胎龄（GA）30至36周出生的早产儿，并补充了一组足月儿作为参照组。
将早产儿随机分为在矫正年龄12周开始补充喂养（早期组）或17周开始补充喂养（晚期组）。
主要结局是使用逻辑混合模型测量的矫正年龄2岁时超重和肥胖的患病率。次要结局包括矫正年龄1岁和2岁时的身高、体重、头围、体重指数和z评分，以及神经发育、特应性皮炎评分和健康相关生活质量。
共纳入255名早产儿并随机分组，其中131名（51.4%；中位数[四分位间距]GA，34周2天[32周5天至35周1天]；77名男性[58.8%]）被分配到早期组，124名（48.6%；中位数[四分位间距]GA，34周0天[32周6天至34周6天]；62名男性[50.0%]）被分配到晚期组。共纳入159名足月儿（中位数[四分位间距]GA，40周0天[39周0天至41周0天]；84名女性[52.8%]）作为参照组。226名早产儿（88.6%）和144名足月儿（90.6%）有主要结局的相关信息。在矫正年龄2岁时，早期组超重患病率为6.0%（95%CI，2.7% - 11.5%），晚期组为5.5%（95%CI，2. – 11.1%）。对于肥胖，早期组患病率为1.7%（95%CI，% - 5.5%），晚期组为1.8%（95%CI，0.3% - 5.9%）。足月儿参照组超重患病率更高（9.0%；95%CI，5.1% - 14.6%），肥胖患病率更高（3.5%；95%CI，1.3% - 7.5%）。
在这项早产儿随机临床试验中，在矫正年龄12至17周开始补充喂养对矫正年龄2岁时的超重和肥胖患病率没有影响。
Onderzoekmetmensen.nl标识符：NL - OMON53076。
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