Rahdar Sara, Hemati Zeinab, Yazdi Maryam, Sadeghnia Alireza, Kelishadi Roya
Student Research Committee, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.
Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.
Pediatr Res. 2025 Jun 17. doi: 10.1038/s41390-025-04208-5.
When MOM is unavailable, Donor Human Milk (DHM) is proposed, however, there is still insufficient evidence to determine whether DHM has similar benefits to MOM. This study aims to determine the relationship between DHM intake and MOM with short-term outcomes in preterm infants, hospitalized in Neonatal Intensive Care Units (NICU).
This prospective cohort study was conducted in October 2023 to December 2024 on preterm infants aged less than 32 weeks, who were hospitalized in NICU of selected hospitals of Isfahan University of Medical Sciences, Iran. Participants consisted of 392 preterm infants who were assigned into two groups receiving DHM > 70% (n = 140) and MOM > 70% (n = 252). Primary and secondary outcomes were monitored and recorded by the researcher during the preterm infant's hospitalization in the intensive care unit until discharge.
Results showed that the incidence of Metabolic Bone Disease (MBD) was not significantly different in the two groups (OR = 1.31, 95% CI: 0.70-2.47, p = 0.395). Osteopenia of prematurity (OR = 0.79, 95% CI: 0.27-2.33, p = 0.665), and Necrotizing Enterocolitis (NEC) (OR = 0.88, 95% CI: 0.35-2.20, p = 0.789), both showing no significant differences. Positive blood culture (OR = 0.54, 95% CI: 0.22-1.33, p = 0.179), indicating a non-significant lower risk in the DHM group. In contrast, Bronchopulmonary Dysplasia (BPD) showed a significantly higher risk in the DHM group (OR = 2.01, 95% CI: 1.22-3.29, p = 0.006). Total Parenteral Nutrition (TPN) duration, achieving feeding volume of 120 ml/kg/days and full interal feeding were significantly shorter in the DHM group (p < 0.001).
These results identify that BPD was significantly more common in the DHM group than in the MOM group. Holder pasteurization may lead to the removal of anti-inflammatory factors in MOM and increase the incidence of BPD in preterm infants receiving DHM.
The popularity of using DHM as standard nutritional care in neonatal intensive care units is increasing To our knowledge, this is one of the few cohort studies exploring short-term outcomes of preterm infants in MOM and DHM fed groups until discharge Initiation, duration, and volume of feeding of preterm infants with DHM are one of the strengths points of this study, which provides valuable clinical application in the nutrition of preterm infants There is a need for the development of public policy to increase both the access to DHM and awareness regarding its beneficial effects, especially amongst populations with low breastfeeding rates.
当无法获得母亲自己的母乳（MOM）时，建议使用捐赠人乳（DHM），然而，仍缺乏足够证据来确定DHM是否具有与MOM相似的益处。本研究旨在确定在新生儿重症监护病房（NICU）住院的早产儿中，摄入DHM和MOM与短期结局之间的关系。
这项前瞻性队列研究于2023年10月至2024年12月对年龄小于32周、在伊朗伊斯法罕医科大学选定医院的NICU住院的早产儿进行。参与者包括392名早产儿，他们被分为两组，分别接受>70%的DHM（n = 140）和>70%的MOM（n = 252）。研究人员在早产儿在重症监护病房住院直至出院期间监测并记录主要和次要结局。
结果显示，两组的代谢性骨病（MBD）发病率无显著差异（OR = 1.31，95% CI：0.70 - 2.47，p = 0.395）。早产儿骨质减少（OR = 0.79，95% CI：0.27 - 2.33，p = 0.665）和坏死性小肠结肠炎（NEC）（OR = 0.88，95% CI：0.35 - 2.20，p = 0.789），均无显著差异。血培养阳性（OR = 0.54，95% CI：0.22 - 1.33，p = 0.179），表明DHM组风险略低但无显著差异。相比之下，支气管肺发育不良（BPD）在DHM组的风险显著更高（OR = 2.01，95% CI：1.22 - 3.29，p = 0.006）。DHM组的全胃肠外营养（TPN）持续时间、达到120 ml/kg/天的喂养量和完全经口喂养的时间显著更短（p < 0.001）。
这些结果表明，BPD在DHM组比在MOM组中明显更常见。巴氏消毒法可能导致MOM中的抗炎因子被去除，并增加接受DHM的早产儿中BPD的发生率。
在新生儿重症监护病房将DHM用作标准营养护理的情况越来越普遍。据我们所知，这是少数几项探索MOM喂养组和DHM喂养组早产儿直至出院的短期结局的队列研究之一。DHM喂养的早产儿的喂养起始、持续时间和量是本研究的优势之一，为早产儿营养提供了有价值的临床应用。需要制定公共政策，以增加获得DHM的机会并提高对其有益效果的认识，特别是在母乳喂养率较低的人群中。
